Application Form | Educators Connected

Personal Details

Full name *

Previous Full Name ( If Applicable)

Date Of Birth *

Gender *

Address Form *

Address

Address 2

City

Postcode

Previous Address

Home Phone / Work Phone *

Mobile *

Email *

Nationality *

National Insurance *

Do you have the right to remain and work in the UK? *

Yes

Do you hold a full, valid driving licence in the UK ? *

Yes

Employement History

Please explain if you have any gaps in employment. If you can please fill in your most recent employment for the last 0-3 years

Do you have any previous employment *

Yes

Employer Name *

Full Address *

Address 1

Address 2

City

Postcode

Start Date

End Date

Employment Type

Full / Part Time

Job Title

Reason for Leaving

Add Another

Yes

Employer Name *

Full Address *

Address 1

Address 2

City

Postcode

Start Date

End Date

Employment Type

Full / Part Time

Job Title

Reason for Leaving

Add Another

Yes

Employer Name *

Full Address *

Address 1

Address 2

City

Postcode

Start Date

End Date

Employment Type

Full / Part Time

Job Title

Reason for Leaving

Add Another

Yes

Employer Name *

Full Address *

Address 1

Address 2

City

Postcode

Start Date

End Date

Employment Type

Full / Part Time

Job Title

Reason for Leaving

References

Name of Referee :

Job Title

Capacity in which known to you:

Address

Address 1

Address 2

City

Postcode

Phone

Date To

Date From

Name of Referee(2):

Job Title

Capacity in which known to you:

Address

Address 1

Address 2

City

Postcode

Phone

Date To

Date From

N.B: We reserve the right to seek a reference from any previous employer, school, college, or university in addition to the preferred reference. If you have not been employed in the last two years please supply details of a referee (non-relative) who can comment on your suitability for the job.

Educational Qualifications

Do you have any previous education *

Yes

Name of School / College / University

Name of Course

Start Date

End Date

Qualifications and Levels Achieved

Add Another

Yes

Name of School / College / University

Name of Course

Start Date

End Date

Qualifications and Levels Achieved

Add Another

Yes

Name of School / College / University

Name of Course

Start Date

End Date

Qualifications and Levels Achieved

Declaration

This job is not protected by the Rehabilitation of the Offenders Act 1974 or Section 41 of the Mental Health Act.

You must sign these declarations.

The Rehabilitation of Offenders Act 1974 (Exceptions)Order 1975 (Exceptions)

Amendment Order 1986

This job is not protexted by the above provisions. If we decide to offer you the job, we will ask the police for details of any convictions, bind over orders or cautions you may have, This is so we can decide wheather we should gice you substaintial access to children. So you must tell us about anu convictions, bind over orders or cautions, including those which for other purposes are ‘spent’ under the Act, before we can officially offer you the job.

We will not approach the police without your permission

Have you ever been convicted of a criminal offence, bound over or cautioned? *

Yes

If ‘YES’, please provide details:

The teachers’ qualifications and Health Standards Regulations 1999, states “a person shall not be appointed to relevant employment if, having regard to any duty of the employer under part ii of the disability discrimination act 1995, does not have the health and mental and physical capacity for that employment

Please declare any relevant health issues (e.g. drugs, alcohol, etc…), medical conditions or disabilities

that clients and schools will need to be aware of, should you be working either on-site or at a public

a venue such as a library including special aids or requirements for access to the premise.

**medical and disability**

I certify the information I have provided is accurate to the best of my knowledge.

Can you please confirm any known medical conditions or disabilities *

Yes

If ‘YES’, please provide details:

Date *

Your Signature *

Form Submitted Successfully!

We will contact you as soon as possible.

Personal Details

Employement History

References

Educational Qualifications

Declaration

Section 41 Mental Health Act

Form Submitted Successfully!