Red Balloon Application Form

CONFLICTS OF INTEREST

(Personal relationships include immediate family, sexual relationships, very close personal relationships and close business, commercial or financial relationships)
Do you have any personal relationships with current members of staff?*

YesNo
If yes, please give details.

EDUCATION & QUALIFICATIONS
Do you have a valid teaching qualification?*

YesNo
What is your highest level of qualification?

Professional body membership
Please give details of any professional membership which you hold, including level and start date.

AVAILABILITY FOR WORK
What is your current notice period? *
If successful, when would you be available to start? *
STATEMENT

Please outline your motivation for applying for this role and describe specifically how your experience, skills, knowledge and personal attributes match those in the job description. Please also include any specific responsibilities or achievements from previous roles that you feel would support you in this role. Maximum 1000 words
Statement of application*

0/1000

CURRENT or MOST RECENT EMPLOYER
Business / School Name *
Address*
Job title*
Start date*

DayMonthYear
Date
End date

DayMonthYear
Date
I am currently employed here
Reason for leaving
Please supply a brief outline of your main duties and responsibilities*

0/250
Please detail any significant achievements during your employment*

0/250

PREVIOUS EMPLOYMENT

Please give details of all previous positions held (most recent first) since completing your full-time education. Please state dates employed as month / year and brief reason for leaving. To add a new row click the "Add more employment history" button. To remove a row click the x button.
Pervious emplopyment*
Please outline any additional periods of work, voluntary work, travel, career breaks and unemployment.*
Have you ever been dismissed from employment?*

YesNo
If yes please give the reason(s)
Please note any employment, paid or unpaid, you would continue if you were successful in obtaining this position and the number of hours you would work

REFERENCES

Please provide details of two people (not relatives or friends) who we can contact to provide information in support of your application. One of these must be your current/latest employer.
First reference
Name*

First NameLast Name
Position*
Relationship to you*
Organisation*
Address*

Street Address

Street Address Line 2

CityCounty

Postcode
Daytime telephone number*
Email*
example@example.com
Can we contact this referee prior to an interview?*

YesNo
Can we contact this referee following a conditional offer and acceptance of employment?*

YesNo
Second reference
Name*

First NameLast Name
Position*
Relationship to you*
Organisation*
Address*

Street Address

Street Address Line 2

CityCounty

Postcode
Daytime telephone number*
Email*
example@example.com
Can we contact this referee prior to an interview?*

YesNo
Can we contact this referee following a conditional offer and acceptance of employment?*

YesNo

APPLICANT DECLARATION
Note: Red Balloon reserves the right, at any time, to check on any experience, achievements, qualifications and skills claimed by you either on this application form, in any accompanying or subsequent correspondence, or at interview. By signing this form you will be providing us with your agreement for us to proceed with this course of action and confirming that you will not unreasonably refuse to sign a suitably worded information release form that will allow such an investigation to take place.

The information provided on this application form will remain confidential and will be used solely for the purpose of selection/recruitment.
Are you subject to a teacher prohibition order or an interim prohibition order, issued by the secretary of state, as a result of misconduct?*

YesNo
Are you subject to a General Teaching Council sanction or restriction?*

YesNo
Are you happy to be contacted about other roles that may be of interest to you ?*

YesNo
DECLARATION

I declare that to the best of my knowledge and belief, all particulars I have given are complete and true. I understand that any false declaration or misleading statement or any significant omission may disqualify me from employment and render me liable to dismissal. I understand that any job is subject to satisfactory references and a probationary period and (if Red Balloon believes it appropriate) a satisfactory medical report. I understand that this post involves direct work with vulnerable young people and is subject to a Disclosure and Barring Service check. Should I be offered the post, I understand that a DBS check will be sought before the appointment is confirmed.
Signature

Clear

Private and confidential

DISABILITY MONITORING FORM

This page will be detached from your application prior to it being considered.

Red Balloon welcomes applications from individuals regardless of disabilities, and is committed to ensuring fair treatment throughout the selection process. We will make adjustments to enable applicants to compete to the best of their ability, wherever it is reasonable to do so, and if appointed, to assist them during their employment. We encourage applicants to declare any disabilities so that any special arrangements can be accommodated.

Disability, under the Equality Act 2010, includes physical or mental impairment that has a *substantial and **long-term negative effect on your ability to do normal daily activities.

*Substantial is defined as more than minor or trivial, eg it takes much longer than it usually would to complete a daily task such as getting dressed.

**Long-term means 12 months or more, such as a breathing condition that develops as a result of a lung infection.
Do you regard yourself in any way disabled?

YesNo
REQUEST FOR REASONABLE ADJUSTMENTS
If you have need for any adjustments please provide details below. If you would prefer to discuss over the phone please contact the HR team on 0118 958 3004.

	Yes	No
A passport showing that you are a British citizen or a citizen of the United Kingdom and Colonies and have the right of abode in the United Kingdom
A current document issued by the Home Office to a family member of an EEA or Swiss citizen, and which indicates that the holder is permitted to stay in the United Kingdom indefinitely.
Utility bill or other document to verify your name and address ( dated within 3 months)
Birth Certificate or a full adoption certificate issued in the United Kingdom
Photocard Driving License

PERSONAL DETAILS

ADVERTISING SOURCE

ELIGIBILITY FOR EMPLOYMENT

CONFLICTS OF INTEREST

EDUCATION & QUALIFICATIONS

AVAILABILITY FOR WORK

STATEMENT

CURRENT or MOST RECENT EMPLOYER

PREVIOUS EMPLOYMENT

REFERENCES

APPLICANT DECLARATION

REQUEST FOR REASONABLE ADJUSTMENTS

What is your ethnic origin?

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