Trevenson Road Newquay Cornwall TR7 3BH
www.newquayjunior.com www.tretherras.net
Executive Headteacher: Mrs Sue Martin M.Ed, National Leader of Education
APPLICATION FOR A TEACHING APPOINTMENT
CONFIDENTIAL
This form should be typed or clearly written in black ink and returned as requested in the advertisement/letter to applicants.
Post Title
Name of School
Newquay Education Trust
Surname
Title
First Name(s)
Previous Surname(s)
Home Address
Telephone Number
Day
Evening
E-mail Address
Teacher Reference
Number
National Insurance
Number
Title of present or last
teaching post held
Date of recognition by DfE
as a qualified teacher
Name, address and
telephone number of
school/college in
which present or last
employed
Name, address and
telephone number of
present or last
employing LA
OR
If employer
independent or GMS
establishment
Commencement Date
On which date would you be
able to start duty if appointed?
Registered in England and Wales.
Company registration no 8961355
An Exempt Charity
EDUCATION AND PROFESSIONAL TRAINING
Education at Degree Level and beyond
Name of University/College and
inclusive dates of attendance
Title of course followed and qualification
obtained – if Honours degree – state class
Date awarded
AGE RANGE/SUBJECTS THAT YOU ARE QUALIFIED TO TEACH
Age range
Principal subjects
Other subjects
RECENT PROFESSIONAL DEVELOPMENT (Courses etc, within the last three years)
Course / Venue / Organising Body
Period of Course and Year
PARTICULARS OF TEACHING EXPERIENCE – INCLUDING CURRENT OR LAST POST
(most recent post first)
Establishment name, type
of school, status of school,
gender taught, and name of
LA if applicable
Number Key
on roll
Stages
taught
Post held,
grade/scale etc
FT/PT
If PT
give
hours
PLEASE GIVE
PRECISE DATES
From
To
D M Y D M Y
SALARY
If current or last post
was on standard scale
If current or last post
was as a Headteacher
or Deputy Headteacher
Salary - £pa
Salary Point
Details of any additional
payments/allowances
Salary - £pa
Salary Point
School Group Size
ALL EMPLOYMENT OTHER THAN TEACHING
Name and address of
employer/ organisation
Post held, grade/scale and nature of
activities undertaken
FT/PT
If PT
give
hours
M
From
Y
M
To
Y
REFEREES
Please give two referees who can write from experience about your professional competence. Do not
use friends or relatives. If you are a qualified teacher, unless you are seeking your first appointment, you
should quote your present or most recent Headteacher from whom a reference may be sought.
Applicants for headships should (if employed by an LA) give the name of a Senior LA Officer as one
referee.
Referee One
Referee Two
Full name
Job title
Employer
Address (including postcode)
Daytime telephone number
E-mail address
DECLARATION OF CRIMINAL CONVICTIONS
This post is exempt from the Rehabilitation of Offenders Act 1974 and applicants are therefore required
to disclose all criminal convictions, including any which may be ‘spent’. Applicants should also include
details of any cautions, reprimands or final warnings.
Have you ever been convicted of any criminal offence, whether ‘spent’ or ‘unspent’, as
Yes
No
defined in the Rehabilitation of Offenders Act 1974 or do you have any charges
pending?
If yes, please provide details:
□
Have you ever been cautioned, reprimanded or received a final warning which
although not considered to be criminal convictions and become ‘spent’ immediately,
must be considered in relation to this exempt post?
If yes, please provide details:
□
□ Yes □ No
Any subsequent offer of employment will be subject to a Disclosure & Barring Service (DBS) check. This
check will include details of cautions, reprimands or final warnings as well as convictions. Appointment
will be subject to the information received from the DBS.
I accept that if any of the information is found to be false or misleading I will be disqualified from
appointment. I understand that any subsequent offer of employment will be subject to the outcome of a
Disclosure & Barring Service (DBS) check and that Newquay Education Trust will request my
authorisation for such a check to be made.
Signature:
Date:
DISCLOSURE OF INTEREST
Are there any restrictions to you living and working in the UK which might affect your
right to work at Newquay Education Trust (eg needing a work permit/visa)?
If yes, please provide details:
□ Yes □ No
Do you hold a full current UK driving licence?
□ Yes □ No
□ Yes □ No
□ Yes □ No
Do you have access to transport?
The Working Time Regulations (1998) require us to check the hours worked by our
employees. Please confirm whether this role would be your only employment.
If not, please provide details of your other role(s) and the days and hours worked:
Canvassing of Governors and employees of the School (asking them to help you to get this role), directly
or indirectly, for any appointment at the School will disqualify your application. Also, any candidate who
fails to declare any relationship with a Governor or employee of the School may be disqualified and, if
appointed, may be liable to dismissal without notice.
Are you related to or have you formed any relationship (personal, financial or
Yes
No
professional) with any current Governor or employee of Newquay Education Trust?
If yes, please provide details:
□
□
Do you, your partner or family have any interests (personal, financial or professional)
that may conflict with you doing this role?
If yes, please provide details:
□ Yes □ No
Have you ever been the subject of a formal disciplinary procedure or have you ever
been dismissed from any previous employment?
If yes, please provide details:
□ Yes □ No
DATA PROTECTION
We keep on file information from this application form, equal opportunities form and any documents you
attach. This is required for recruitment and equal opportunities monitoring purposes, the payment of staff
and the prevention and detection of fraud. All information will be dealt with in accordance with data
protection legislation and will not be sold to any third party. Application forms for unsuccessful
candidates will be destroyed after 6 months; anonymised data will be kept for monitoring purposes.
DECLARATION
I understand that any employment, if offered, will be subject to the information on this form being correct
and I confirm that no valid information has been wilfully withheld. I understand that if I am appointed, I
am liable to dismissal without notice if the information on this form is later proved to be inaccurate.
Signature:
Date:
Please sign and date if you are returning the form by post. If returning by email, you will be asked to sign
a copy before any offer of employment is made.
STATEMENT IN SUPPORT OF YOUR APPLICATION
Please use this sheet to make any further points you wish to be considered in support of your application
and attach it to the back of the completed form.
JOB APPLICATION
DECLARATION OF CRIMINAL CONVICTIONS
CONFIDENTIAL
Please read Guidance Notes for Applicants - Declaration of Criminal Convictions’ on the
reverse before completing this form.
This post is exempt from the Rehabilitation of Offenders Act 1974 and you are therefore
required to disclose all criminal convictions, including any which may be ‘spent’. You should
also include details of any cautions, reprimands or final warnings.
Have you ever been convicted of any criminal offence, whether ‘spent’ or ‘unspent’ as
defined in the Rehabilitation of Offenders Act 1974 or do you have any charges pending?
Yes
No
If yes, please give details:
.....................................................................................................................................................................................
.....................................................................................................................................................................................
.....................................................................................................................................................................................
.....................................................................................................................................................................................
Have you ever been cautioned, reprimanded or received a final warning which although not
considered to be criminal convictions and become ‘spent’ immediately, must be considered
in relation to this exempt post?
Yes
No
If yes, please give details:
.....................................................................................................................................................................................
.....................................................................................................................................................................................
.....................................................................................................................................................................................
Any subsequent offer of employment will be subject to a criminal record check
(Disclosure request) from the Disclosure and Barring Service (DBS). This check will
include details of cautions, reprimands or final warnings as well as convictions.
I accept that if any of the information is found to be false or misleading I will be disqualified
from appointment. I understand that any subsequent offer of employment will be subject to
the outcome of a criminal record check from the DBS and that Newquay Education Trust will
request my authorisation for such a check to be made.
Signature …………………………………………………………………………. Date: …………………………………………………..
Print name: ………………………………………………………………………………………………………………………………………….
GUIDANCE NOTES FOR APPLICANTS
DECLARATION OF CRIMINAL CONVICTIONS
The Rehabilitation of Offenders Act 1974 provides that certain criminal convictions become ‘spent’ after
the passage of time, that is the law will treat them for most purposes as if they had never happened
and it is not necessary to disclose them. However, the Rehabilitation of Offenders Act 1974 (Exceptions)
Order 1975 and 1986 contain certain classes of employment where a person can be asked to disclose
all criminal convictions, including any which may be ‘spent’.
The post for which you are applying falls within these Orders and you are therefore required to detail all
previous convictions on the form entitled ‘Declaration of Criminal Convictions’ whether or not they are
spent. Details of what constitutes a conviction are given below.
Please note that you should also include details of any cautions, reprimands or final warnings which,
although not considered to be criminal convictions and become ‘spent’ immediately, have to be
considered in relation to exempt posts such as this one.
A conviction includes:








a sentence of imprisonment, youth custody or borstal training;
an absolute discharge, probation order, conditional discharge, bind-over order;
a fit person order, supervision or care order arising from criminal conviction;
simple dismissal from the Armed Forces, Cashiering, discharge with ignominy, dismissal with
disgrace or detention by the Armed Forces;
detention by direction of the Home Secretary;
detention centre, remand home, approved school or attendance course orders;
a suspended sentence
a fine or any other sentence not mentioned above.
In accordance with the Police Act 1997, any offer of employment will be subject to a criminal record
check (‘Disclosure’) from the Disclosure and Barring Service (DBS). This will include details of cautions,
reprimands or final warnings as well as convictions.
Explanatory Notes
1. Any information that you provide on the ‘Declaration of Criminal Convictions’ form will be treated in
strictest confidence and will be considered only in relation to the post that you have applied for on
this occasion.
2. Newquay Education Trust aims to promote equality of opportunity for all with the right mix of talent,
skills and potential and welcomes applications from diverse candidates. Criminal records will be
taken into account for recruitment purposes only where the conviction is relevant. Disclosure of a
conviction, caution etc does not necessarily mean that you will not be appointed to this post; your
suitability will be looked at as a whole in light of all the information available, merit and ability. Main
considerations will be whether the offence is one which renders you unsuitable to undertake the
duties of the post for which you have applied and the circumstances and background to the offence.
3. Relevant criminal convictions and other associated information that you provide on the ‘Declaration
of Criminal Convictions’ form will be discussed at interview in order to assess job related risks.
4. You will be given the opportunity to discuss any Disclosure information provided by the DBS before
a final recruitment decision is made. Should you think that a mistake has been made by the DBS
you will be given the right to appeal to them.
5. In order to request information from the DBS, Cornwall Council has registered with them. (Cornwall
Council requests information from the DBS on behalf of Newquay Education Trust.) As part of this
registration it is necessary for Cornwall Council to comply with the DBS ‘Code of Practice’. A copy
of this Code of Practice is available on request. The Council has policies on Criminal Record
Checking, Security of Disclosure and Disclosure Information and Recruitment of Ex-offenders, copies
of which are available on request. To request a copy you should contact HR Services.
6. Any information regarding offences will be kept confidential and on a ‘need-to-know’ basis.
Disclosures will not be retained for longer than 6 months after the date on which recruitment or
other relevant decisions have been taken or after the date on which any dispute about the accuracy
of the Disclosure information has been resolved. This period will only be exceeded in exceptional
circumstances which justify retention for a longer period.