Full-Time Application Form
For September 2017 start
Postgraduate Certificate in Education
(Incorporating Diploma in Education and Training)
Places will be given based upon applications received by the end of April 2017. It is therefore in your interest to
return your completed application to us as soon as possible as we cannot guarantee teaching placements. Late
applications will be considered for any remaining places.
If you are invited to interview:


Your original educational qualification certificates (GCSEs or equivalent and degree) or transcripts must be
provided.
You will be expected to deliver a Micro-Teach on your chosen teaching speciality. Further details will be given in
the invite.
Please state subject you wish to teach:
Preferred Placement
Truro College
☐
Penwith College
☐
Personal Details
Title: (Dr, Mr, Mrs, Ms etc.):
Surname:
Gender:
Preferred Name:
Date of Birth:
Forenames:
National Insurance No:
Previous Surname:
Home Address:
Postcode:
Home Telephone:
Work Telephone:
Mobile:
Email:
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No preference
☐
Qualifications Completed – Please complete on separate page if necessary
Full title of Award
English GCSE
(or equivalent)
Level
Grade:
Grade/
Classification
Maths GCSE
(or equivalent)
Awarding Institution
Date
Grade:
Qualifications not yet completed
Full title of Award
Predicted Grade
Awarding Institution
Date when your
award will be
fully completed
Employment History (please continue on a separate sheet if necessary)
Post
Employer/Work Address
Full-time or Part-time
Dates:
From and To
Work Experience Please give details of work experience, training and employment relevant to your application
Post
Employer/Work Address
Full-time or Part-time
Dates:
From and To
Please describe on a separate sheet any unusual features or omissions from your pattern of
employment and education shown above.
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References
Please supply contact details of two referees (ideally an academic/professional and/or employer reference). They must
not be a family member/friend.
1.
2.
Or the referee can email the reference to me at this address: [email protected].
Supporting Statement
Please use this section to indicate why you want to teach your chosen subject area within the Further Education and Skills
Sector, your expectations of a teaching career and the personal skills and abilities you can bring to teaching. You should
aim to write approximately 500 words. Please attach additional sheets if required.
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Disclosure and Barring Service (formerly Criminal Records Bureau disclosure)
Applicants to this course are required to have completed a full enhanced DBS disclosure
Yes ☐
Do you have any outstanding criminal
No ☐
convictions, cautions, reprimands?
You are required to state whether or not you have any past or pending criminal convictions, cautions and reprimands,
including any that may be considered spent under the Rehabilitation of Offenders Act 1974. If you tick the ‘yes’ box, the
tutor may ask if you wish to disclose anything at interview.
Ethnic Origin
White – any other white background ☐
Black Other–Black or Black British ☐
African – Black or Black British ☐
Caribbean – Black or Black British ☐
Mixed White & Black African ☐
Mixed White & Black Caribbean ☐
Indian – Asian or Asian British ☐
Pakistani Asian or Asian British ☐
White British ☐
White Irish ☐
Bangladeshi – Asian or Asian British ☐
Chinese ☐
Other Asian, Asian or Asian British ☐
Mixed – Any other mixed background ☐
Mixed White & Asian ☐
Any Other ☐
Information refused ☐
Disability
Please state nature of disability:
No known disability
☐
Personal care support
☐
Dyslexia
☐
Mental health difficulties
☐
Blind, partially sighted
☐
Unseen e.g. diabetes, epilepsy
☐
Deaf/Hearing Impairment
☐
Multiple disabilities
☐
Use wheelchair/have mobility difficulties
☐
Disability not listed above
☐
I have a disability but do not receive SDA
☐
Do you receive Student Disability Allowance (SDA)?
No Known Disability
☐
I have a disability and I am in receipt of SDA ☐
I have a disability but have not applied for SDA ☐
Declaration
I declare that to the best of my knowledge the information given in this form is correct and complete. I understand that
these courses require an interview and that any offer of a place will be conditional on the grounds outlined in the enclosed
guidance notes.
Signed
Date
Please return the completed application form via email or post to:
Email: [email protected]
Jina Prior
Education Curriculum Secretary
Truro & Penwith College
College Road
Truro
Cornwall
TR1 3XX
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