Thank you for your interest in working for the Basildon Academies. 
 
In order to maximise your application please ensure that you have completed all sections fully either electronically or clearly by hand.  You are welcome to provide us with a copy of your CV as an additional supporting document, but unfortunately we are unable to accept your CV without a completed application form. 

Guidance notes on completing this application can be found at the back of this form. 
	
Section 1 – Your details	
Name: 		Title (please circle)	Mr, Mrs, Miss, Ms, Dr, 
Other: ...........................	
Address:	

	Your Teacher number (non teaching applicants please leave blank)		
Postcode:
		Do you hold full QTS status? (non teaching applicants please leave blank)		
Home Telephone Number		Date QTS was obtained? (non teaching applicants please leave blank)		
Mobile Telephone Number		Are you an NQT? (non teaching applicants please leave blank)		
Email address:		Your Date Of Birth:		
Your Nationality:		Age at last birthday:		
Do you have the right to live and work in the UK?	If time limited please enter the date:

	Are you a driver?		
Your National Insurance Number:		Do you have the use of a vehicle?		
Have you lived or worked outside the UK for 6 months or more in the last 5 years.				

Section 2 – The role you are applying for	
Which role are you applying for:		
How did you hear about this role?		
Are you related to anyone who currently works for the Academy? If so, please provide their name and how they are known to you:	

	
What subjects have you previously taught?	Subject	Key Stage	

			

Section 3 – Your most recent employment	
What were your employment dates? (DD/MM/YYYY)	From: 	To:	
Who did/do you work for? (the school/company name)		
What type of School/Business is this?		
If a school, how many students were on role?		
What is/was your job title at this employment?		
What is/was your salary upon leaving?		
Why are you looking to leave / Why did you leave this role? 		
What were your main duties?	

	
What is your notice period / when are you available from?		

Section 4 – Please tell us about your previous experience 
(continuing on a separate sheet if necessary & please ensure any gaps in employment are fully explained)	
What were your employment dates? (DD/MM/YYYY)	From: 	To:	
Who did you work for? (the school/company name)		
What type of School/Business was this?		
If a school, how many students were on role?		
What was your job title at this employment?		
What was your salary upon leaving?		
Why did you leave this role? 		
What were your main duties?	

	

What were your employment dates? (DD/MM/YYYY)	From: 	To:	
Who did you work for? (the school/company name)		
What type of School/Business was this?		
If a school, how many students were on role?		
What was your job title at this employment?		
What was your salary upon leaving?		
Why did you leave this role? 		
What were your main duties?	

	

What were your employment dates? (DD/MM/YYYY)	From: 	To:	
Who did you work for? (the school/company name)		
What type of School/Business was this?		
If a school, how many students were on role?		
What was your job title at this employment?		
What was your salary upon leaving?		
Why did you leave this role? 		
What were your main duties?	

	

Section 5 – Your Education & Qualifications
Please start with your most recent first	
What were the dates of this period of Education?	From: 	To:	
Where was this undertaken? (i.e. the name of the  school/University)		
What type of qualification did you gain? (i.e. GCSE, Degree, PGCE etc)		
What subject and grade was this? (Please list all - i.e. Maths A, English B etc)		

What were the dates of this period of Education? (MM/YY)	From: 	To:	
Where was this undertaken? (i.e. the name of the  school/University)		
What type of qualification did you gain? (i.e. GCSE, Degree, PGCE etc)		
What subject and grade was this? (Please list all - i.e. Maths A, English B etc)		

What were the dates of this period of Education? (MM/YY)	From: 	To:	
Where was this undertaken? (i.e. the name of the  school/University)		
What type of qualification did you gain? (i.e. GCSE, Degree, PGCE etc)		
What subject and grade was this? (Please list all - i.e. Maths A, English B etc)		

What were the dates of this period of Education? (MM/YY)	From: 	To:	
Where was this undertaken? (i.e. the name of the  school/University)		
What type of qualification did you gain? (i.e. GCSE, Degree, PGCE etc)		
What subject and grade was this? (Please list all - i.e. Maths A, English B etc)		

Section 6 – Professional Development
Please tell us about any other relevant professional Development you may have had	
Title of course	From	To	

			

			

Section 7 – Information to support your application for this role
Please tell us anything else that you feel is relevant to your application	

	

Section 8 – Your interests
Please give details of your spare time interests including membership of clubs and organisations	

	

Section 9 – Your References	
Reference 1 (your most recent employer)	Name		
	Their Job Title		
	Address		
	Email		
	Telephone Number		
	Relationship		
If you are shortlisted may we contact this person	Yes / No (Please circle)	
Reference 2 (A previous employer)	Name		
	Their Job Title		
	Address		
	Email		
	Telephone Number		
	Relationship		
If you are shortlisted may we contact this person	Yes / No (Please circle)	

Section 10 – Attendance	
Do you consider yourself to be in good health?	Yes / No	If no, please provide details	
How many occasions of sickness and absence have you had in the past 2 years?	Number of days	Reasons	

			

Section 11 – Safeguarding	
Disclosure of Criminal Background of those with Access to Vulnerable Groups
Failure to disclose information concerning previous convictions may lead to dismissal or disciplinary action by the Academy.
You have applied for a post which is an exempt position under the provisions of the Rehabilitation of Offenders Act 1974.  Therefore the statement “that after a certain period of time, convictions need not be disclosed and those convictions be treated as if they never took place” does not apply.
You must disclose any pending prosecutions, any convictions, cautions or bind-overs which you have had at any time, at the time of your application.  In the event of employment being offered and taken up, any failure to disclose such convictions is likely to result in disciplinary action by the Federation/Academy that may lead to dismissal.  Any information may be given on a separate sheet from your application form and will be kept completely confidential.  
In addition the Basildon Academies will require the successful candidate to agree to a DBS (Criminal Records check) for convictions that may or may not be relevant to the appointment.  A separate authorisation form will need to be completed after the interview.

Have you ever been convicted of a criminal offence?	 Yes / No	If yes, when was this?	
If yes, Please provide details		

Section 12 – Applicants with Disabilities	
Are you Disabled?	Yes  / No	What is the nature of your disability?	

Do you require any reasonable adjustments during the interview process? (if so, please provide details)		Would you require any reasonable adjustments within the role applied for? (if so, please provide details)		

Section 13 – Applicants Statement	
Declaration 
I declare that the particulars given are correct and that I have not withheld any facts which might unfavourably affect my application.  I am aware that to withhold or falsify information could result in dismissal or disciplinary action.
 	Signed:	
	Date:	

                                                                    Please return your completed Application Form to:

recruitment@basildonacademies.org.uk

Any documents you have provided to us as part of our recruitment processes are stored in accordance with the Data Protection Act 1998. If you have been successful in securing a role with us these will be transferred to your personnel file. If not, then they will be shredded as confidential information.  

Recruitment monitoring information form

The Basildon Academies are committed to ensuring that applicants are selected for appointment on the basis of their ability relevant to the job.  Completion of this section is not compulsory but will help us to ensure that our policy and procedures are effective in avoiding discrimination and promoting equal opportunities in recruitment.  The information you provide will be used for monitoring and statistical data purposes only and will not be seen by the short listing panel.  This section will be detached from your application form prior to short listing.

First name(s):		Role Applied for:		
Last name(s):		N.I. Number:		

The categories below are in line with the 2001 census.	
1.	Ethnic origin		d.	Asian British		
I would describe my ethnic origin as:		Bangladeshi		
a.	White			Indian		
	British			Pakistani		
	Irish			Any other Asian background		
	Any other white background			Please specify……………………….	
	Please specify…………………………				
			e.	Chinese		
b.	Black or Black British			Chinese		
	African					
	Caribbean		f.	Other ethnic group		
	Any other Black background			Other ethnic group		
	Please specify…………………………		Please specify……………………….	
						
c.	Mixed		2.	Gender		
	White and Asian			Female		
	White and Black African			Male		
	White and Black Caribbean					
	Any other Mixed background		3.	Marital Status		
	Please specify…………………………		Married		
	
			Not Married		

Guidance notes on completing your application form

Please read these notes carefully as the decision to invite you to an interview will depend on the information you provide on your Application Form.

Section 1	Your Details 
It is important that you fill all sections of the Application Form in accurately and in full.  Please do not leave any section blank. This part tells us some basic information about you and how we can reach you should you be short-listed

Section 2	The role you are applying for
It is important that we know which role you are applying for so please ensure you complete this section in full. 
To maximise your application we recommend that you submit a separate application form for each of roles you are applying for as requirements for roles may vary.  
We are interested in how you found out about this vacancy as this helps us with future recruitment advertising. 

Section 3	Your most recent employment
Please tell us about where you are working now. If you are currently unemployed or have more than one current employer please note this. 

Section 4	Your previous experience
Starting with your current or last job, list the main duties of the jobs you have had. We recommend this for the past 10 years.  This information may be used to assess whether you meet the person specification for the job.  Please ensure that you explain any gaps in your employment. 

Section 5 	Your Education and Qualifications
Please tell us about your education and qualifications in this section, starting with your most recent first. For example if your qualification is a degree you should tell us when this was achieved, the subject, the type of degree and the grade you obtained.   

Section 6	Professional Development
Please tell us about any other professional development you have undertaken and the outcome of this, for example a First Aid course you did. 

Section 7	Information to support your application
Please use this section to tell us why you are the right candidate for the role.  Where possible give us examples to show us that you possess the skills and experience required.  

Section 8	Your interests
We would like to know a bit more about you such as your interests and hobbies. Please reflect on those interests which may also be used in the Academies to support our students.

Section 9	References
References from your current or most recent employers will be required before any offer of employment is confirmed. You may wish to give the names of teachers, lecturers, and other professionals (but this must not be a relative).

Section 10	Attendance
We expect all members of staff to provide a regular and efficient service to our students. If you have had high levels of unexpected absence please make us aware of this. 

Section 11	Safeguarding
The Basildon Academies has a duty to protect children, vulnerable adults, people with disabilities and learning difficulties.  This section must be answered. 

Section 12	Applicants with Disabilities
The Basildon Academies are committed to supporting colleagues with disabilities.  If you have a disability, please give details of adjustments you require for the selection process or to do the job itself.

Section 13	Your Statement
Any false statements on this form is an offence and could result in the application being taken no further, or offer of employment withdrawn, or disciplinary action leading to dismissal will be taken (if employment has commenced).  

Recruitment monitoring information 
The Basildon Academies are committed to ensuring that applicants are selected for appointment on the basis of their ability relevant to the job.  Completion of the Recruitment monitoring information form is not compulsory but will help us to ensure that our policy and procedures are effective in avoiding discrimination and promoting equal opportunities in recruitment.  The information you provide will be used for monitoring and statistical data purposes only and will not be seen by the short listing panel.