Part-Time Application Form For September 2016 start Truro College Postgraduate Certificate in Education (Incorporating Diploma in Education and Training) Places will be given based upon applications received by the end of March 2016. It is therefore in your interest to return your completed application to us as soon as possible. Late applications will be considered for any remaining places. Entry requirements: You must have GCSE or equivalent at grade C or above in Maths and English. You must have a Level 3 qualification. A full degree. If you are invited to interview: Your original education qualification certificates (GCSEs, A levels, BTECs, Level 3) or transcripts must be provided. 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: Teaching Information for start of programme (we will accept provisionally confirmed teaching) It is your responsibility to obtain relevant subject area teaching hours and ensure you have mentor in place for the start of the year. The Mentor role is very important and requires dedication from your Mentor. Please see below some guidelines of what is required from your Mentor, please ensure they read the below before they commit: Defining the Mentor Role The Mentor role is: Complete the mandatory Mentor baseline training Meet regularly with the trainee Ensure that targets set are stretching and relate to developing the trainee s subject specialist Page 1
pedagogy and general teaching practice Conduct 4 teaching observations of your trainee and complete and sign the teaching observation form as per the schedule below. Provide regular developmental feedback on trainees evaluated lesson plans for submission at the end of each module (your trainee will provide their evaluated lesson plans) as per the schedule overleaf. It is not necessary to have observed these lessons, just provide feedback based upon your discussions with your trainee and your subject specialist knowledge. You should annotate targets and developmental points and add your signature to a minimum of 4 lesson plans for each of the 4 modules. Sign the Log of Professional Practice to confirm the trainee has made at least satisfactory progress and met the IfL Code of Professional Practice if the Mentor does not feel able to sign this, then the Cause for Concern procedure should be put into place. To be completed by Applicant: 1. Is your placement within the College? (If yes, go to question 2. If not go to question 3) 2. Please state: Name of Mentor: Name of Programme Team Leader for Curriculum Area: Confirmation that the Programme Team Leader has been made aware of your placement: Curriculum Area: Subject/s or lessons you will be teaching: Confirmed teaching hours how many per week (minimum of 2 hours per week is required)? 3. For applicants with external placements: Name and address of placement: Contact details for Mentor (Name, email or postal address): Curriculum Area (if applicable) Subject/s or lessons you will teaching: Confirmed teaching hours how many per week (minimum of 2 hours per week is required)? Relevant Qualifications Please complete on separate page if necessary Full title of Award Level Grade Awarding Institution Date English GCSE (or equivalent) Grade: Maths GCSE (or equivalent) Grade: Employment History - (please continue on a separate sheet if necessary) Page 2
Post Employer/Work Address Full-time or Part-time Dates: From and To Work Experience Please give details of any work experience, training and employment relevant to your application Job Title 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. 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: jinal@truro-penwith.ac.uk. Page 3
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. Page 4
Disclosure and Barring Service (formerly Criminal Records Bureau disclosure) Applicants to this course are required to have completed a full enhanced DBS disclosure Do you have any outstanding criminal Yes 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 British White Irish 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 Bangladeshi Asian or Asian British Other Asian, Asian or Asian British Mixed White & Asian Chinese Mixed Any other mixed background 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 Do you receive Student Disability Allowance (SDA)? No Known Disability I have a disability but do not receive SDA 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 along with your two references to: Jina Prior Education Curriculum Secretary Truro & Penwith College College Road Truro Cornwall TR1 3XX Page 5