EMPLOYMENT
APPLICATION
FORM
SUPPORT
STAFF
Please complete each section in this form fully, in capital letters using black ink.
A ‘Guidance Section’ can be found at the back.
2015-16 VERSION
APPLICATION FOR EMPLOYMENT
-SUPPORT STAFFPLEASE COMPLETE IN CAPITAL LETTERS USING BLACK INK AND TICK RELEVANT BOXES
Put your name, job title and job reference at the top of any additional sheets you use.
Sign and date the declaration at the end of this form.
A ‘Guidance Section’ can be found on pages 13-14.
POST APPLIED FOR:
ON WHAT BASIS ARE YOU APPLYING FOR THIS POST?
SCHOOL:
FULL TIME
REFERENCE NUMBER:
PART TIME
NO. OF HOURS:
GRADE/SALARY:
JOB SHARE
NO.OF HOURS:
APPLICANT PERSONAL DETAILS
TITLE:
SURNAME:
FIRST NAME:
HAVE YOU EVER USED ANY OTHER NAMES?
MIDDLE NAME(S):
YES
IF ‘YES’ PLEASE STATE:
ADDRESS (INCL. POSTCODE):
HOME PHONE NUMBER:
MOBILE PHONE NUMBER:
EMAIL ADDRESS:
DATE OF BIRTH:
NI NUMBER:
DATE ON WHICH YOU COULD TAKE UP THE APPOINTMENT:
Page 1 of 17
NO
APPLICANT PERSONAL DETAILS (CONT.)
DO YOU HOLD A VALID DRIVING LICENCE FOR USE IN THE UK?
PLEASE SPECIFY TYPE: PROVISIONAL
FULL
OTHER
YES
NO
(PLEASE STATE):
ARE YOU RELATED TO A SCHOOL GOVERNOR OR ANYONE
ALREADY EMPLOYED BY CLIFF PARK SCHOOLS TRUST?
IF ‘YES’ PLEASE GIVE THE NAME AND POSITION OF THE PERSON(S):
YES
NO
EMPLOYMENT
CURRENT OR MOST RECENT EMPLOYMENT
NAME AND ADDRESS OF EMPLOYER:
JOB TITLE:
CURRENT OR LAST SALARY/GRADE:
WEEKLY HOURS:
DATE STARTED IN POST:
DATE OF LEAVING:
REASON FOR LEAVING:
BRIEF DESCRIPTION OF DUTIES:
EMPLOYMENT HISTORY
PLEASE LIST ALL APPOINTMENTS STARTING WITH THE MOST RECENT
EMPLOYERS NAME &
ADDRESS
DATES
FROM
TO
Page 2 of 17
JOB TITLE
WEEKLY
HOURS
REASON FOR
LEAVING
BREAKS IN EMPLOYMENT
If you have had breaks in employment since leaving school, please give dates and details of
these times (e.g. unemployment, raising a family, study, illness, voluntary work, etc.)
DATES FROM/TO
DETAILS OF APPOINTMENT/REASON FOR BREAK
EDUCATION, QUALIFICATIONS & TRAINING
SCHOOL, COLLEGES ATTENDED SINCE AGE 14 (EXCLUDING DEGREE COURSES)
DATES
SCHOOL/COLLEGE
FROM
TO
QUALIFICATIONS ACHIEVED
(INCLUDE DATES & GRADES)
Page 3 of 17
SUBJECT(S)
EDUCATION, QUALIFICATIONS & TRAINING (CONT.)
UNIVERSITY/POLYTECHNIC
FROM
TO
SUBJECT(S)
SUBSIDIARY
SUBJECT(S)
DEGREE
(WITH/WITHOUT HONS)
CLASS
& DIV.
DATE OF
AWARD
OTHER TRAINING, PROFESSIONAL/PERSONAL DEVELOPMENT, SHORT COURSES ETC.
ORGANISING
BODY/COLLEGE, ETC.
QUALIFICATION(S)
DATE(S)
DESCRIPTION/DETAILS/REG.
NUMBER, ETC.
You will be required to bring documentation evidence of all of the above if called for an interview.
Page 4 of 17
SUPPORTING INFORMATION
It is important that you provide evidence in this section of how you meet the essential and
desirable criteria set out in the person specification. It is only information contained in this
application which will decide whether you are short listed for interview.
Tell us about things you have been responsible for or involved in, what you have achieved
and any feedback given. Include examples from paid or unpaid work or other activities you
have undertaken in your personal life that are relevant to the job you are applying for. Also
include here information about why you want the job and anything else you wish to say.
Please continue on a separate sheet if necessary. Put your name, job title and job reference at the
top of any additional sheets you use.
Page 5 of 17
SUPPORTING INFORMATION (CONT.)
Page 6 of 17
REFERENCES
Normally, references will be requested for all candidates invited for interview, unless you ask
us not to by ticking the ‘no’ boxes below. This will not affect our decision to invite you for
interview. Satisfactory references will be required before an offer of employment can be
made and your permission will be sought at that stage.
Please give the names and addresses of two people who would be willing to supply a
reference for you. Where possible both of these should be your two most recent employers,
or if you have not worked before, please use your school or college teacher/tutor. If this is
not possible a suitable alternative would be a previous employer, business associate or
leader/organiser of a voluntary organisation. Please do not include friends or relatives.
REFERENCE 1
TITLE:
NAME:
PHONE NUMBER:
ORGANISATION:
FAX NUMBER:
OCCUPATION:
EMAIL ADDRESS:
ADDRESS (INCL. POSTCODE):
CAN WE CONTACT BEFORE
INTERVIEW?
YES
NO
HOW DO THEY KNOW YOU?
Page 7 of 17
REFERENCE 2
TITLE:
NAME:
WORK PHONE NUMBER:
ORGANISATION:
FAX NUMBER:
OCCUPATION:
EMAIL ADDRESS:
ADDRESS (INCL. POSTCODE):
CAN WE CONTACT BEFORE
INTERVIEW?
YES
NO
HOW DO THEY KNOW YOU?
DISCLOSURE OF CRIMINAL CONVICTIONS & REHABILITATION OF OFFENDERS ACT 1974
The appointment of any member of staff who may have contact with, or access to children or
vulnerable adults will be subject to the receipt of a satisfactory disclosure from the Criminal
Records Bureau. Please make the following declaration and tick the appropriate box.
“I have read the statement about the Trust’s policy on convictions as detailed in the
‘Guidance Section’ on pages 13-14, and:
I HAVE NOTHING TO DECLARE
I HAVE INFORMATION TO DECLARE AND I HAVE ATTACHED A SEALED (MARKED
‘PRIVATE AND CONFIDENTIAL’) ENVELOPE CONTAINING DETAILS
If you are not short-listed the envelope will be securely destroyed.
Page 8 of 17
SAFEGUARDING AND DISABILITIES
East Anglia Schools Trust is committed to safeguarding and promoting the welfare of its pupils
and staff. Assessment of applicants’ suitability to work with children is an integral part of the
selection process. Any discrepancies or anomalies in information provided will be taken up at
interview. Current or previous employers will be contacted as part of the verification process.
If you have a disability and have demonstrated in your supporting information that you meet
the minimum (essential) criteria for the vacancy you will be invited for interview.
We will make reasonable adjustments to the recruitment and selection process (and to the job
for successful candidates) if you let us know what your requirements are.
DO YOU HAVE A DISABILITY AS DEFINED BY THE
EQUALITIES ACT 2010?
YES
NO
IF ‘YES’ PLEASE GIVE BRIEF DETAILS TO TELL US IF THERE IS SUPPORT WHICH WE CAN PROVIDE AT
INTERVIEW OR IN EMPLOYMENT IF YOU ARE OFFERED THE JOB:
East Anglia Schools Trust wishes to ensure that you do not have any ill health or disability which
might make the proposed work difficult or unsafe to yourself or others. The Trust is an equal
opportunities employer and will consider any reasonable adjustments to the proposed work or
workplace that may be appropriate.
We ask that you also complete a Pre-Employment Health Screening Questionnaire before
commencement of a post.
Page 9 of 17
EMERGENCY CONTACT DETAILS
CONTACT NAME
RELATIONSHIP
HOME PHONE NUMBER
MOBILE PHONE NUMBER
ASYLUM AND IMMIGRATION ACT 1996
DO YOU HAVE A WORK PERMIT OR WORKER REGISTRATION CERTIFICATE TO WORK IN THE UK?
YES
NO
NOT APPLICABLE
DETAILS:
You will be required to bring documentation evidence of the above if called for an interview.
DECLARATION
I DECLARE THAT ALL FOREGOING ANSWERS ARE TRUE TO THE BEST OF MY KNOWLEDGE. I ACCEPT
THAT IN THE EVENT OF MY BEING EMPLOYED, AND IT IS SUBSEQUENTLY SHOWN THAT MEDICAL
INFORMATION HAS NOT BEEN DISCLOSED BY ME, OR HAS BEEN MISLEADING OR FALSE, THAT I
BECOME LIABLE TO DISCIPLINARY PROCEEDINGS WHICH MAY CAUSE MY DISMISSAL.
I AGREE TO BEING REFERRED TO OCCUPATIONAL HEALTH, IF APPROPRIATE, AND FOR A COPY OF THIS
FORM AND A JOB DESCRIPTION TO BE SENT TO THEM.
I AM AWARE THAT A REPORT WILL BE SENT TO THE RECRUITING OFFICER FOLLOWING ASSESSMENT.
IF SUCCESSFUL, THE INFORMATION WILL BE KEPT ON MY ELECTRONIC AND/OR PAPER PERSONNEL
FILE UNTIL 6 YEARS AFTER LEAVING, AND MAY BE SEEN BY ANYONE WITH AUTHORIZED ACCESS TO
MY FILE.
APPLICANT SIGNATURE:
DATE:
Please note: If you are returning this form by email, you will be asked to sign your application if
you are called for an interview.
Page 10 of 17
DATA PROTECTION AND DECLARATION
I understand that the information contained in this form is personal data which will be
held on file and, if I am appointed, further information about me will be filed and/or
computerized for personnel administration purposes, including analysis for management
purposes and statutory returns and that such data is subject to the Data Protection Acts
1998.
I have completed this application form accurately and truthfully. I have not withheld any
information that could reasonably be considered relevant to my application. I understand
that the appointment, if offered, will be subject to the information on this application
being correct. I understand that providing false information with regard to this
application shall disqualify me from such appointment, or if discovered after
employment, may lead to my dismissal. The information will be filed and disposed of
securely after 6 months if your application is unsuccessful.
I declare that the information given on this form is correct to the best of my knowledge
and belief, and I understand that any false statement on this form is an offence and could
result in my application being rejected or summary dismissal and possible referral to the
teachers’ misconduct team or police if appropriate. I agree that the information I give you
in connection with this application for employment may be stored and processed for the
purpose of personnel management.
APPLICANT SIGNATURE:
DATE:
Please note: If you are returning this form by email, you will be asked to sign your application if
you are called for an interview.
Before you return your form, please read through it to ensure all sections have been fully
completed and you have addressed all criteria in the person specification of the job description.
We suggest that you make a photocopy of your application for before returning it.
Page 11 of 17
The decision to short list you for an interview will be based solely on the information you
provide on the application form. We will not make any assumptions about your experience,
knowledge, skills or abilities to do the job you are applying for.
The person specification in the job description describes the essential knowledge, experience
and professional qualifications you will need in order to do the job described. In your
application you must demonstrate that you have these skills, knowledge and qualifications,
and further, that you understand and are committed to abiding by all East Anglia Schools
Trust policies.
We hope that the following information answers any questions you have about this
application form, but if you still have questions please do not hesitate to contact us (contact
information can be found on the job advertisement, the Trust’s website, and both Cliff Park
Infant and Junior Schools’ websites).
PERSONAL DETAILS
Complete this section fully and clearly. All successful applicants will be required to produce
documentary evidence of identity before confirmation of appointment.
PRESENT OR MOST RECENT EMPLOYMENT
It is important to give full information, including the organization or school you work in, or most
recent employment if not currently working, full dates, addresses and other requested details.
REFERENCES
For all employees, you referees will be contacted prior to interview under the safeguarding children
and safer recruitment process. Your first referee should be your current or most recent employer.
East Anglia Schools Trust reserves the right to approach any previous employer for a reference. If your
last post did not include working with children, a reference will be sought from your most recent
previous employer where you were working with children.
PREVIOUS EMPLOYMENT
Include here any relevant work experience, including part-time or voluntary work in this section,
starting with your most recent experience. Ensure you put in full details of dates, names and
addresses and your job title, explaining any gaps in your employment history in the ‘Breaks In
Employment’ section.
EDUCATION, QUALIFICATIONS AND TRAINING
Ensure that you give all the information requested. Proof of qualification is required before any
appointment is confirmed.
PERSONAL STATEMENT
Page 12 of 17
This is your chance to explain how you meet the person specification for the post. Ensure that the
information you give is well organized, relevantGUIDANCE
and brief. It is acceptable to list each person
specification requirement as a separate heading to explain how you meet that requirement. If you do
not complete this section of the form you will not be considered for short listing.
Page 13 of 17
GUIDANCE SECTION (CONT.)
DISCLOSURE OF A CRIMINAL RECORD
GUIDANCE
SECTION
All
positions within
East(CONT.)
Anglia Schools Trust will be exempt from the Rehabilitation of Offenders Act
1974. You must declare all cautions and convictions including those that are ‘spent’, and you will be
subject to of
anconditions
Enhanced covered
Disclosure
and Barring Service check if you are successful. You must provide
Examples
include:
details
any conviction(s)
or offence(s)
in a sealed
envelope
markedcancer,
‘Private
and Confidential’
 ofPhysical
Impairments:
epilepsy, diabetes,
multiple
sclerosis,
cerebral
palsy, heartwith
your application
form. This will be safely destroyed if you are not short listed.
disease, etc.
 doMental
dyslexia,
bi-polar
disorder,
learning you
difficulties,
If you
have aImpairments:
spent caution schizophrenia,
or conviction this
will not
automatically
disqualify
from etc.

Progressive
Conditions:
cancer,
muscular
dystrophy,
multiple
sclerosis,
HIV/AIDS,
etc.
employment. We operate a Disclosure Procedure in line with DBS guidelines. If you are successfully
 Sensory
Impairments:
blindness,
hearing
etc. to this procedure. All Disclosures are
selected
for a position
within the
Trust you
will beloss,
subject
carried out in the strictest confidence and are made only in connection with your application for
RECRUITMENT
FORM All Trust based posts will require an Enhanced Disclosure.
employment andMONITORING
for no other purpose.
In the
of a successful
candidate
havingthe
a criminal
record,
the candidate
willassist
haveus
the
All
jobevent
applicants
are expected
to complete
recruitment
monitoring
form to
in complying
opportunity
to requirements
discuss the disclosure
with a senior
member
of staff.
a minimum,
will
with
statutory
and advertising
monitoring.
These
formsAswill
be treatedthe
as following
confidential
haveanonymous,
been taken into
account:
and
and will
be separated from your application form. The information will not be taken
intoaccount
whenthe
your
application
is processedwas disclosed during the application stage;
Whether
conviction
or information
 Whether the conviction or information revealed is relevant to the job;
 How long ago the offence(s) took place;
 The candidate’s age at the time of the offence(s);
 The number and pattern of offences;
 Any other relevant circumstances
No decision will be made until your explanation and the above issues have been considered.
If you believe the disclosure information is inaccurate you would need to contact the CRB.
All disclosure information is kept securely and will only be seen by those who need to use it to carry
out their duties. The disclosure forms are not kept on personal files.
SAFEGUARDING, DISABILITIES & HEALTH SCREENING QUESTIONNAIRE
It is important to give full information in these sections. You are not required to give any confidential
information. If you answer ‘yes’ to any of the questions in these sections, you will be given the chance
to elaborate if asked to attend an interview. East Anglia Schools Trust is committed to safeguarding
and promoting the welfare of its pupils and staff. Assessment of applicants’ suitability to work with
children is an integral part of the selection process. East Anglia Schools Trust is an equal opportunities
employer. If you have a disability and have demonstrated that you meet the minimum criteria for the
vacancy, you will be invited for interview.
Definition of a Disability:
The Disability Discrimination Act 1995 defines disability as follows:
A person has a disability if he/she has a physical or mental impairment which has a substantial and
long term effect on his/her ability to carry out normal day to day activities.
(continued)
Page 14 of 17
Page 15 of 17
(FOR OFFICE USE ONLY)
APPLICATION NOT FULLY COMPLETED/NEED MORE INFORMATION
APPLICANT SHORT LISTED
IF SHORT LISTED, INTERVIEW INFORMATION AND RIGHT TO WORK
IN UK FORMS SENT
Page 16 of 17
(FOR OFFICE USE ONLY)
Application form completed in full
Two references
Qualification/QTS evidence checked
DBS check
Offer letter
Appointment form completed
Evidence of date of birth, National Insurance number (add details on appointment
form)
Evidence of entitlement to work in the UK form (photocopy evidence)
Recruitment monitoring form
Pre-employment health assessment questionnaire
Completed payment of salary – bank details form
HM Revenue & Customs Starter Checklist
Most recent P45
Issue Privacy Notice
Pension pack (support staff only)
Pension – employee options when taking authorised unpaid leave (support staff
only)
Childcare (Disqualifications) Regulations 2009 – staff declaration (not cleaners)
Pre-employment checks for teaching staff must be completed
Page 17 of 17