Support Staff Job Application Form

Support Staff Application Form

This document is available in additional formats, e.g. large print on request).
JOB INFORMATION
Position for which you are applying*
Pay Scale*
Please see the job advert to find this information.
Job Ref No*
Please see the job advert to find this information.
Where did you see the post advertised (i.e. website, google etc)*

PERSONAL INFORMATION
Full Name*

PrefixFirst NameMiddle NameLast Name
Any Former Name(s)*

YesNo
If Yes, please state your Former Name*
Home Address*

Home / Flat No

Street Address

CityState / Province

Postal / Zip Code
Home Phone Number
Work Phone Number
Mobile No*
Can we telephone you at work?*

YesNo
Email Address*
Please provide your National Insurance Number*

CURRENT OR MOST RECENT EMPLOYMENT
Name of the current/most recent employer*
Address of the employer*

No

Street Address

CityState / Province

Postal / Zip Code
Post Held*
Job title
Responsibilities*
Present annual salary*
Notice period required?
Date of Appointment*

DayMonthYear
Date
Did you leave this job?*

YesCurrent Employee
Date of Leaving*

DayMonthYear
Date
Reason for leaving*

PREVIOUS EXPERIENCE

Start with most recent - please explain any gaps in employment in the below section
Please select the appropriate option?*

I have previous employerI don't have any previous employer
Employer Name*
Annual salary*
e.g. School/retail/healthcare etc, active/dissolved
Post Held*
Job title
Responsibilities*
Date of Appointment*

DayMonthYear
Date
Date of Leaving*

DayMonthYear
Date
Reason for leaving*
Please select the appropriate option?*

I have more previous employer to addI don't have any further previous employer
Employer Name*
Annual salary*
e.g. School/retail/healthcare etc, active/dissolved
Post Held*
Job title
Responsibilities*
Date of Appointment*

DayMonthYear
Date
Date of Leaving*

DayMonthYear
Date
Reason for leaving*
Please select the appropriate option?*

I have more previous employer to addI don't have any further previous employer
Employer Name*
Annual salary*
e.g. School/retail/healthcare etc, active/dissolved
Post Held*
Job title
Responsibilities*
Date of Appointment*

DayMonthYear
Date
Date of Leaving*

DayMonthYear
Date
Reason for leaving*
Please select the appropriate option?*

I have more previous employer to addI don't have any further previous employer
Please state below your further previous employers*
To be considered, please include all the information (i.e. Employer Name, post held & responsibilities, dates From & To and reason of leaving)
Please account for any break in employment that creates a gap on the application form (e.g. maternity leave, VSO, travelling, research, career break etc). If you have no gaps, please state "None"*

EDUCATION AND ACADEMIC QUALIFICATIONS
State your education*

OTHER RELEVANT QUALIFICATIONS OR RECORDS OF ACHIEVEMENT (E.G. COURSES, MEMBERSHIPS ETC)
Training
DETAILS OF OTHER ACTIVITIES, SKILLS AND INTERESTS PAID OR UNPAID THAT YOU FEEL ARE RELEVANT TO THIS POST

EQUAL OPPORTUNITIES
We expect all our employees to have an understanding of and commitment to the school/London borough of Lewisham Equal Opportunities Policies. Please explain what you understand this to mean and how you would relate this policy to the post for which you are applying. *

GENERAL EXPERIENCE AND FURTHER INFORMATION
Please use this section to show us how your experience, skills and training gained both inside and outside paid work or through study, meet the selection criteria for this post as given in the person specification. The information that you give here will play a crucial part in the decision to shortlist you or not, so please ensure that you demonstrate your ability to meet the selection criteria described in the job specification for this post. *

PROFESSIONAL REFERENCES
External Applicants: When considering which referees to include, please make sure that at least 3 years of your most recent experience is covered. Please ensure that one of your referees is your current line manager/headteacher or your most recent line manager/headteacher if you are not in paid employment at the moment. if you are a school, college, or university leaver, one of your referees should be your headteacher or tutor.

Please note, we reserve the right to approach any of your previous employers for a reference.

N.B It is our policy to send reference requests via email where possible.

Internal Applicants: Please give the name and contact details of your current line manager/headteacher.

Reference 1 - Click to expand
Reference 1
Dates covered*
i.e. From 28-02-2015 to Current
Name*

PrefixFirst NameLast Name
Position Held*
Organisation Name*
Organisation Full Address*

No

Street Address

CityState / Province

Postal / Zip Code
Telephone / Mobile Number*
Ext No (if any)
Email*
example@example.com
What is your relationship to this referee?*
i.e. Line Manager / Headteacher

REFERENCE 2 - Click to expand
Reference 2
Dates covered*
i.e. From 28-02-2015 to Current
Name*

PrefixFirst NameLast Name
Position Held*
Organisation Name*
Organisation Full Address*

No

Street Address

CityState / Province

Postal / Zip Code
Telephone / Mobile Number*
Ext No (if any)
Email*
example@example.com
What is your relationship to this referee?*
i.e. Line Manager / Headteacher

ADDITIONAL INFORMATION
Are you currently under any Visa restrictions?*

YesNo
If yes, please detail your visa information here, i.e. type of visa, end date etc. *
Have you previously been employed by London of Lewisham?*

YesNo
Have you ever received a redundancy payment or enhanced retirement benefit from any organization?*

YesNo
If yes, please state from which organisation(s) and date(s) of payment *

DECLARATION
- I hereby declare that to the best of my knowledge, I am not a spouse, partner, child or relative of an existing member or employee of the School/London Borough of Lewisham, nor do I have a close personal or business or potential business relationship with any such person.
Please state in the space below any relationship of nature referred to. Please write N/A or NONE if not applicable.
- I hereby declare that all the information was given by me on the application form and this form is correct to the best of my knowledge, that all the questions relating to me have been accurately and fully answered and that I possess all the qualifications which I claim to hold. I understand that I will be required to provide original documents for scrutiny upon appointment. I also understand that falsification of qualification or information may lead to withdrawal of an offer or dismissal without notice.
- I agree that the information provided should form part of the basis of my engagement and I authorise the School/London Borough of Lewisham to check the information that I have supplied. I accept that by signing this form I am giving the School/London Borough of Lewisham permission to approach any of my former employers for a reference for the purposes of checking my work history.
- Our stringent pre-employment checks reflect the School/London Borough of Lewisham’s commitment to protecting our children and young people; these will include references, health, right to work in the UK, record check via the Disclosure and Barring Service (DBS) and, where applicable, a declaration that neither you nor anyone that lives in the same household as you is a disqualified person under the Childcare (Disqualification) Regulations 2009, for further details go to Disqualification Guidance
- Under the Data Protection Act 1998, I understand that the personal information supplied by me on this application form and in any accompanying documents will be used by the School/London Borough of Lewisham and any other appointed agent, for the purpose of appointment to the post applied for and to allow monitoring of the fairness of the recruitment and selection process. Furthermore, the information may be used to consider a complaint regarding the selection process and/or defend the School/London Borough of Lewisham against any legal action undertaken associated with the fairness of the selection process by any interested parties. I have also noted that certain information supplied by me will be used for verification purposes and that the School/London Borough of Lewisham may need to contact third parties to confirm facts contained within the application.
Canvassing of employees or other members of the Council or any Committee of the Council directly or indirectly for any appointment under the Council shall disqualify the candidate concerned for that appointment.
- I have read and understood the above statements and consent to the personal data submitted with this application form being used for the purposes described. I understand that the School/London Borough of Lewisham is under a duty to protect the public funds it administers, and to this end may use the information I have provided on this form within the School/London Borough of Lewisham for the prevention and detection of fraud. It may also share this information with other bodies administering public funds solely for this purpose.
Signature*

Clear
Date*

DayMonthYear
Date
Where you have been successfully appointed this information will be retained for the period you are employed and a subsequent 6 years in standard cases, 25 subsequent years where you have been employed to work with children and vulnerable persons and 40 years if you will come into contact with Asbestos as part of your duties. However, if you are unsuccessful your information will be retained for 6 months after the appointment to post

DISABILITY
We are working to improve the employment opportunities we offer to people with disabilities. Where a person with a disability applies for this post consideration will be given to restructuring the duties, including reasonable adjustment to the workplace, to meet their needs.

If you are shortlisted for an interview we are able to make provision for people with special needs. Such adjustments may include arranging a signer or changing the location of the interview if access to an upper floor office is not possible.
Is there any special help that you may require for the interview or throughout the application process? State "None" if there is nothing to report. *

	Description (e.g. type of document etc)	Checked By (Checks completed by)	Date (state the date)
ID Received
Proof of Address
DBS Certificate
Reference 1
Reference 2
Overseas Checks
UK Visa (If applicable)
Prohibition Check (Teacher only)
JD Attached
Interviews Notes
Offer Letter
Pension Pack (Support staff Only)
QTS Proof (Teacher only)
Medical Check from HR
NI Proof
Safeguarding code of conduct
School Policies Statement
Work Culture Statement
ICT Agreement
Risk Assessment (if applicable)

Support Staff Application Form

JOB INFORMATION

PERSONAL INFORMATION

CURRENT OR MOST RECENT EMPLOYMENT

PREVIOUS EXPERIENCE

EDUCATION AND ACADEMIC QUALIFICATIONS

OTHER RELEVANT QUALIFICATIONS OR RECORDS OF ACHIEVEMENT (E.G. COURSES, MEMBERSHIPS ETC)

EQUAL OPPORTUNITIES

GENERAL EXPERIENCE AND FURTHER INFORMATION

PROFESSIONAL REFERENCES

Reference 1

Reference 2

ADDITIONAL INFORMATION

DECLARATION

DISABILITY

SELF-DISCLOSURE FORM

EQUALITIES MONITORING FORM