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Job Application Form This is an interactive PDF form, all boxes can be filled out using Acrobat Reader. Please email completed documents to headmaster@stdavidscollege.co.uk If you do not have Adobe Acrobat Reader download here http://get.adobe.com/uk/reader/ Name: Position Applied for: St David s College Gloddaeth Hall Llandudno rth Wales LL30 1RD Tel: 01492 875 974 Email: headmaster@stdavidscollege.co.uk Web: stdavidscollege.co.uk

Section 1 Personal details Title: Dr/Mr/Mrs/Miss/Ms Forename(s): Surname: Date of birth: Former name: Preferred name: Address: National Insurance number: Are you currently eligible for employment in the UK? Yes Please provide details: Telephone number(s): Teacher's R P number (if applicable): Home: Work: Mobile: Are you registered with the GTC for England or Wales? Yes Email address: Do you have Qualified Teacher status? Yes Are you related to or do you maintain a close relationship with an existing employee, volunteer, Governor or Trustee of the School? If so, please provide details. 2

Section 2 Education Please start with the most recent Name of school/college/university Dates of attendance Examinations Subject Result Date Awarding body To: To: To: 3

Section 3 Other vocational qualifications, skills or training Please provide details of any vocational qualifications or skills that you possess or training that you have received which you consider to be relevant to the role for which you have applied. Section 4 Employment Current/most recent employer: Current/most recent employer's address: Current/most recent job title: Date started: Brief description of responsibilities: Date employment ended (if applicable): Current salary/salary on leaving: Do you/did you receive any employee benefits? If so, please provide details of these. Reason for seeking other employment: Please state when you would be available to take up employment if offered: 4

Section 5 Previous employment and/or activities since leaving secondary education Please continue on a separate sheet if necessary Dates Name and address of employer Position held and/or duties Reason for leaving To: To: To: 5

Section 6 Interests Please give details of any interests, hobbies or skills that you could bring to St David s College for the purposes of extra curricular activity 6

Section 7 Suitability Please give your reasons for applying for this post and say why you believe you are suitable for the position. Study the job description and describe any experience and skills you have gained in other jobs or similar environments which demonstrate your ability and aptitude to undertake the duties of the post. Please feel free to attach an additional sheet. 7

Section 8 Health St David s College is committed to being an equal opportunities employer and welcomes applications from disabled candidates. The purpose of the following questions is to ensure that the School complies with its obligations under the Disability Discrimination Act 1995 ("the Act"). For the purposes of the Act a disability is defined as a physical or mental impairment, which has a substantial and long-term adverse effect on a person's ability to carry out normal day to day activities. Do you consider yourself to be disabled? Yes If you wish please give further details here Are there any special arrangements you might require to attend an interview? Yes If yes, please give details here If offered the position applied for, (on the basis of the job description provided) are there any arrangements or adjustments that the School would need to make to enable you to carry out the role? Yes If yes, please give details here In accordance with the guidance published by the DCSF any offer of employment made by the School will be conditional upon the School verifying the successful applicant's medical fitness for the role. Therefore, if your application is successful, you will be required to complete a medical questionnaire the responses to which will be assessed by the School's medical adviser before any offer of employment is confirmed. There may be circumstances when it will be necessary for the School's medical adviser to seek access to your medical records and/or for you to be referred to a specialist clinician. 8

Section 9 Criminal records An offer of employment is conditional upon the School receiving an Enhanced Disclosure from the CRB which the School considers to be satisfactory. If you are successful in your application you will be required to complete a Criminal Records Bureau Disclosure Application Form. Any information disclosed will be handled in accordance with the Code of Practice published by the Criminal Records Bureau (a copy of which is available from the School on request). The School is exempt from the Rehabilitation of Offenders Act 1974 and therefore all convictions, cautions, reprimands and final warnings (including those which would normally be considered "spent" under the Act) must be declared. If you have a criminal record this will not automatically debar you from employment. Instead, each case will be assessed fairly by reference to the School's objective assessment procedure (a copy of which is available from the School on request). Have you been convicted by the courts of any criminal offence? Yes Is there any relevant court action pending against you? Yes Have you ever received a caution, reprimand or final warning from the police? Yes If 'YES' to any of the above, please provide details on a separate sheet and send this in a sealed envelope marked "confidential" with your Application Form. Section 10 References Please supply the names and contact details of two people who we may contact for references. One of these must be your current or most recent employer. If your current/most recent employment does/did not involve work with children, then your second referee should be from your employer with whom you most recently worked with children. Neither referee should be a relative or someone known to you solely as a friend. The School intends to take up references from all shortlisted candidates before interview. Referee 1 Referee 2 Name: Organisation: Name: Organisation: Address: Address: Occupation: Telephone number: May we contact prior to interview? Yes Occupation: Telephone number: May we contact prior to interview? Yes 9

Section 11 Recruitment It is the School's policy to employ the best qualified personnel and to provide equal opportunity for the advancement of employees including promotion and training and not to discriminate against any person because of their race, colour, national or ethnic origin, sex, sexual orientation, marital or civil partnership status, religion or religious belief, disability or age. All new posts within the School are subject to a probationary period. The School is committed to safeguarding and promoting the welfare of children and young people and expects all staff and volunteers to share this commitment. A copy of the St David's College Recruitment Policy is enclosed with this Application Form. Please take the time to read it. If your application is successful, the School will retain the information provided in this form (together with any attachments) on your personnel file. If your application is unsuccessful, all documentation relating to your application will normally be confidentially destroyed after six months. Section 12 Declaration I confirm that the information I have given on this Application Form is true and correct to the best of my knowledge. I confirm that I am not on either the ISA Children's Barred List or the ISA Vulnerable Adults Barred List, disqualified from work with children or subject to sanctions imposed by a regulatory body. I understand that providing false information is an offence which could result in my application being rejected or (if the false information comes to light after my appointment) summary dismissal and may amount to a criminal offence. I consent to the School processing the information given on this form, including any 'sensitive' information, as may be necessary during the recruitment and selection process. I consent to the School making direct contact with all previous employer's where I have worked with children or vulnerable adults to verify my reason for leaving that position. I consent to the School making direct contact with the people specified as my referees to verify the reference. Signature. Date.. 10