AQUINAS Church of England Education Trust "Life - Transforming - Learning" St Mark s C of E Primary

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1 AQUINAS Church of England Education Trust "Life - Transforming - Learning" St Mark s C of E Primary APPLICATION FOR POST OF: SENCO and Inclusion Leader Please return to: Or to: Miss C Farrow St Mark s C of E Primary Aylesbury Road Bromley BR2 0QR claire.farrow@st-marks.bromley.sch.uk PERSONAL DETAILS Surname of applicant: Christian name(s)/forename(s): Title: (Mr/Mrs/Ms/Miss/Dr/Revd) Address: Address: Home telephone number: Work telephone number: Mobile telephone number: Date of qualification as a teacher: DfES reference number: Do you require permission/sponsorship to work in the UK? (NB The successful candidate will be required to provide proof of their right to live and work in the UK.) PRESENT POST: Employer Name and type of school or Age range Boys/girls/ mixed No. on roll Nature of responsibility and salary grade (state if part-time) Date From Present Salary and Pay Scale TLR:

2 PREVIOUS TEACHING EXPERIENCE: A) List in chronological order: Employer Name and type of school or Age range Boys/girls/ mixed No. on roll Nature of responsibility and salary grade (state if part-time) Dates From To B) Age-groups and/or subjects you would be willing to teach: OTHER EMPLOYMENT: Employer Name and type of Nature of responsibility and salary grade (state if part-time) Date From and To EDUCATION: Please list all training and qualifications which are relevant to this post including GCSE, GCE, 0/A level or equivalent, and teacher training qualifications (please specify whether Cert.Ed., Dip., PGCE, ACT or other) and participation in courses whether or not they result in a formal qualification. Use additional sheet if necessary. Course title and main subject At school Certificate/ Qualification/Grade (if any) Dates From To Where obtained

3 In higher education PERSONAL STATEMENT: This application form is an important part of our selection procedure. Please state your reasons for applying for this post and why you would be the best candidate for this position, emphasising any points which you consider relevant to your application. Continue on a separate sheet if necessary.

4 REFEREES: Please give the names of two persons who are able to comment on your suitability for this post. One should be your present Headteacher or employer. Name Position Address Name Position Address address: Telephone no. address: Telephone no. OTHER INFORMATION: Please state where you learned of this vacancy. Are you, to your knowledge, related to any member of the Governing Body or any holder of senior office in the school? If yes, please state the person(s) and relationship(s): REHABILITATION OF OFFENDERS ACT 1974 For teaching and lecturing posts you are required before appointment to disclose any conviction, caution or binding over, including spent convictions, under the terms of the Rehabilitation of Offenders Act 1974 (Exemptions) Order Disclosure will be required only if, following interview, it is considered that you are the most suitable applicant for the post. STATEMENT To the best of my knowledge and belief the information contained in this form is accurate. Signature Date Before signing this form please check that every section has been completed. This form and your covering letter should be returned as instructed in the details of the post. You are reminded that this is an application form for a post in a Church of England Sponsored Academy and that the employer is the Aquinas Church of England Education Trust. If you are appointed, the Contract you will be asked to sign includes the first paragraph of the following clause and may include parts of the second paragraph:- As a teacher in a Church of England School you are required to have regard to the Christian character of the School and its Foundation and to undertake not to do anything in any way contrary to the interests of the Foundation. You are required, if called upon to do so by the Headteacher, to give religious education in accordance with the doctrines of the Church of England and the Trust Deed of the Academy. You are required to take part in and lead acts of religious worship, if required by the Headteacher.

5 Equal Opportunities Monitoring To help us check that we are employing people fairly, please tick the appropriate sections below. Female Male Date of Birth Do you consider your ethnic origin to be: White Mixed Black British White and Black Caribbean Black British Irish White and Black African Caribbean Any other white background White and Asian Any other mixed background African Any other black background Asian Any other ethnic group Asian British Chinese / Vietnamese Prefer not to say Indian Pakistani Bangladeshi Any other Asian Background Cypriot Greek Cypriot Turkish Cypriot Other Any other ethnic group Do you consider yourself to have a disability: If yes, please state nature of disability: The Disability Discrimination Act defines disability as A physical or mental impairment which has a substantial and long-term effect on the person's ability to carry out normal dayto-day activities

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