Shelley Application Form

8/14/2019 Shelley Application Form

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Please insert details

Personal details

Job title:

Vacancy No:

School:

Application for employment in schoolsPlease do not use staples or glue anything to the application form.

Title (tick as appropriate): Dr Mr Mrs Miss Ms Other (please specify):

Surname(s):

First name(s):

Previous surname(s):

Address:

Postcode:

Email address:

Telephone:

Mobile:

DFES No (if applicable):

Where did you find outabout this vacancy?

Do you wish to jobshare this vacancy? Yes: No:

National Insurance No:

If you are related to any councillor or employee of Kirklees Council or a memberof a Kirklees school governing body, please give details. If none, please tick this box

Name:

Job title:

Relationship to You

(aunt, brother, partner etc):

If the job requires you to have a driving licence please tick which type of licence you hold:

Full HGV PSV None

Work: Home:


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Reference remember to ask your referee/s for permission before you give their name.

Name:

Address:

Post Code:

Tel:

Email:

Occupation:

Relationship:

May we contact this person if you are invited for interview Yes No

Name:

Address:

Post Code:

Tel:

Email:

Occupation:

Relationship:

May we contact this person if you are invited for interview Yes No

A reference will only be requested when you are invited for an interview. One referee must be yourpresent or most recent employer. Your referee will be asked for information regarding your sicknessabsence record during the past 24 months as well as details of any disciplinary action during the past12 months. If you are applying for a Headship your local education authority will also be asked for areference.

The information provided on this application is true and I have not canvassed (either directly orindirectly) any councillor or officer of Kirklees Council and will not do so. I am aware that to withholdfacts or falsify information could result in disciplinary action leading to dismissal.

Signed:

Date:

Data Protection Act 1998 applies. We will treat all information relating to your application inconfidence. If you are unsuccessful, your form will be destroyed 6 months after the closing datealthough the Council reserves the right to add your details to our database of suitable candidates forother similar posts. We also sometimes contact job seekers for recruitment research.

If you do not wish to be contacted or added to our database, please tick this box


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Work History

Present Employment, paid or unpaid (or last job for applicants currently unemployed)

Job title:

Date employmentstarted:

Date employment

ended:Reason for leaving(if applicable):

Notice required(if applicable):

Name of employer:

Name of employersauthority/agency:

Address:

Post Code:

Current Salary:

Grade:Briefly describeyour duties:


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PreviousEmployment

Thissectiondealswithyourpreviousemployment.Startwiththemo

strecentandpleaseinclude

anyrelevantpart-time,cas

ualorvoluntary

work.Weneeddetailsofpreviousemployment(paidorunpaid),andalsoperiodsofnon-employm

ente.g.childcareetc.Ifyo

uuseadditional

sheetspleaseremembertoputyournam

eandthepostappliedforo

neachextrapageandnumb

erit.

JobT

itle

NameofSc

hools/College/UniversityA

ttended

PeriodsOfStudy

PleaseIndicateFull/PartTime

Degreeor

certificatesobtained

Datesofawards

MainDuties

NameandAddressofEmployer

From

To

Wage/Salary

Re

asonforLeaving

EducationandQualifications

Thissectiondealswithyourschooleducation/further.Pleaseinclude

thedateswhenyoustarted

andfinishedeachlevelofeducation.

(Sightof

originalcertificateswouldBErequiredif

youaresuccessful)

Ifyouneedm

orespace,pleaseattachad

ditionalsheetsandtickthis

box


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Relevant Information

Please read this section carefully as this is the most important part of your application

Using this page and if needed additional paper demonstrate your ability to meet the requirements ofthe job by giving clear, concise examples of each criterion in the Employee Specification in thefollowing order or by completing the questionnaire if attached:

Relevant Experience, Education and Training Attainments, General and Special Knowledge, Skills and Abilities, Additional Factors

If you need more space, please attach separate sheets and tick here


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Criminal Convictions

REHABILITATION OF OFFENDERS ACT (EXEMPTIONS) ORDER 1975

NOTE:The Rehabilitation of Offenders Act 1974 provides that certain criminal convictions become spentafter the passage of time, that is the law will treat them for most purposes as if they had neverhappened and it is not necessary to disclose them on Application Forms. However, theRehabilitation of Offenders Act 1974 (Exemptions) Order 1975 contains certain classes of

employment where a person can be asked to disclose spent convictions. The post for which you arenow applying falls within that order and you are therefore required to detail below previousconvictions, cautions or bind-overs, whether or not they are spent.

For posts that are subject to a disclosure, please note that a criminal record will not necessarily baryou from employment. This will depend on the nature of the position and the circumstances andbackground of the offence.

Failure to disclose information concerning previous convictions, cautions or bind-overs may lead todismissal or disciplinary action by the authority. Any information given will be treated in the strictestconfidence and will be considered only in relation to an application for posts which the order applies.

Date Details of Convictions, Cautions or Bind-overs Penalty

Are there any matters pending? Yes No

If Yes pleasegive details

I declare that the particulars given are correct and I have not withheld any facts which mightunfavourably affect my application. I am aware that to withhold or falsify information could result indismissal or disciplinary action.

Please do not just sign this statement without declaring in the space provided above either Noconvictions, cautions or bind-overs or give details of all offences of which you have ever beenconvicted.

Last name:

First name:

Signed: Date:

N.B. If you fail to complete this section of the application form you may not be shortlisted or invited toattend for an interview.

We will treat all information provided on this form in the strictest confidence.


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Statement of Health

There are many posts which involve a high level of physical and strenuous effort or require a highlevel of fitness/mobility.

Applicants who feel they may be restricted by their health, either through their fitness or mobility,may need to enquire further as to the demands of the post.

After reading the Job Description, if you feel you may have some restrictions which may cause youdifficulties in carrying out the duties of the post, please indicate by ticking the box at Statement Abelow, and include details. If you feel that you will have no restrictions in carrying out the duties ofthe post, please tick the box at Statement B.

A I list below the fitness/mobility restrictions related to my health which I believe are relevant inrespect of my application for this post.

B After reading the Job Description, I know of no reason regarding my state of health whichcould be in any way detrimental to carrying out the duties of this post.

Last name:

First name:

Signed: Date:

Sickness Absence

Please list below all periods of sickness absence over the last 24 months, detailing both the natureand duration of each period of absence.

Date Nature of Sickness Duration

I agree to a medicalexamination ifnecessary

Signed: Date:

Additional Information

1. If you are in receipt of a pension payable under the Teachers Pensions Regulations following earlyretirement, please indicate the grounds on which you were retired:*in the interests of efficiency / redundancy / ill health (delete as appropriate)

Date of retirement

2. If you have received a redundancy payment in respect of a previous employment with a local

authority, please give details.

Name of Authority

Date of redundancy


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Important Notice to Applicants

RE: REFERENCES AND CRIMINAL RECORDS BUREAU CHECK

Kirklees Council takes its duty of care to the people who receive services from us very seriously.

To ensure all reasonable care is taken, references will always be taken from your current employerand we reserve the right to take up references from any previous employers, or places where you

have carried out voluntary work.

It is important, therefore, that you give exact names and current addresses of previousemployers/voluntary work areas. Please also advise us of any change to your name relevant toprevious employment, ie known by your maiden name. Failure to provide this information may resultin any offer of appointment being delayed.

You may also be offered the post subject to Criminal Records Bureau and other checks.

Please sign this form and if you have any objections regarding this process, please give details andreasons below.

Signed:

Date:


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Please insert details

Job title:

Vacancy No:

School:

Application for employment

Equal Opportunities Monitoring

Name:

We are committed to employing a workforce that reflects the community we serve. Please help us tomonitor our progress by completing the details below. Your information will be treated confidentially.

Are you Male Female Date of birth

I would describe my ethnic origin as (please tick):

White British Irish

Other White background (please specify)

Asian or Asian British Indian Pakistani Bangladeshi

Any other Asian background (please specify)

Black or Black British Caribbean African

Any other Black background (please specify)

Mixed White and Black Caribbean White and Black AfricanWhite and Asian

Any other mixed background (please specify)

Chinese orOther Ethnic Chinese Any other ethnic group (please specify)


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Disability

We have to ask you if you are disabled as defined under the Disability Discrimination Act(1995). As adisabled person, under this definition, you have a physical or mental impairment which has asubstantial and long term adverse effect on your ability to carry out normal day-to-day activities.

Do you consideryourself to be disabledunder this definition?: Yes No

If you have answeredNo to the questionabove, do youpersonally consideryourself to be adisabled person? Yes No

Sexual Orientation

If you wish to, you may disclose information about your sexual orientation below:

Heterosexual Gay Lesbian Bisexual

I do not wish to disclose information about my sexual orientation

Religion

If you wish to, you may disclose information about your religion below:

Christian Buddhist Hindu Jewish Muslim Sikh

Any other (Please specify)

I do not wish to disclose information about my religion No religion

The information you provide will be used to produce statistics for equal opportunity and recruitmentmonitoring only. Please see Guidance for Applicants regarding completing Equal OpportunitiesMonitoring Form below.

Guidance for Applicants regarding completing Equal Opportunities Monitoring Form

As a result of completing this information you will help us to monitor our progress around equalityand diversity representation within our workforce. Please provide as much information as you can to

help us with our monitoring.Kirklees council recognises its responsibility to remove barriers in our recruitment, retention anddevelopment processes. We take a holistic approach to equality and diversity to ensure that peoplefrom all sections of our community have fair and transparent opportunities within all areas of thecouncils control.

If you have an impairment which means you identify difficulties or barriers within the job or itsimplementation, please indicate these in your application form and we will consider reasonableadjustments.

Where groups are under-represented within the councils areas of responsibility, positive action

strategies will be considered.The council recognises that all employees have an individual responsibility in the promotion ofequality and diversity.


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Additional Information for Applicants(please read before completing the form)

Tear off and retain

Kirklees CouncilKirklees is situated in West Yorkshire and covers an area stretching from the high moorlands of the

Pennines eastwards to the edge of Leeds and Wakefield. It is a district of great contrast busycommercial areas and open countryside. The two largest towns in the district are Huddersfield inthe South West and Dewsbury in the North East.

The Council serves a diverse population consisting of approximately 383,000 people whom around10.9% are from minority ethnic communities and 14% have some form of disability. Kirklees hasresponsibility for all aspects of Local Government and employs 12,000 full time equivalent staff.

Applying for a job with KirkleesCompleting the application form is the first step in the recruitment process which may lead to aninterview, and a possible offer of a job.It is therefore important that you complete all sections of the application form as clearly and fully as

possible. Please type or write your form in black ink. We may have to photocopy the form and someother colours have poor reproductive qualities.

Job Description and Employee SpecificationYou have received a job description which list the duties that you will be expected to carry out and anemployee specification which lists the qualities that the Recruitment and Selection Panel will beseeking from you. Please read these carefully and ensure that your application demonstrates yourability to fulfil these criteria.

The Application FormIf you have applied for more than one job, complete a different form for each post, because the

employee specification may be different.If you feel you need more space, attach extra sheets as necessary.If you use extra pages put your name on these sheets together with the reference number shown onthe advertisement.Please do not send a Curriculum Vitae (C.V.), instead of an application form as it cannot be acceptedfor consideration by the Panel.

Job ShareKirklees Council operates a job share policy under which two people can share one full time job.If you wish to job share, please indicate when applying.Please remember that each individual job sharers application will be considered on its own merits.

Work HistoryPlease provide details of present and past employers. Include details of any part time or voluntarywork/experience relevant to the post.

Relevant ExperienceCheck the employee specification and give examples of your experience for each criterion. Thiscould have been from work, home or voluntary activities.

Education and TrainingIf a qualification is asked for in the employee specification, make sure that you give all the

information required and levels of any examinations such as GCSE, CSE, RSA, NVQ, A/O Levels,(also any qualifications you may have gained abroad). You are advised to ensure that you either haveoriginal certificates available, or can submit original notification from the relevant examining bodies.If applying for a teaching post you must hold a qualification recognised for qualified teacher statusunder the terms of the Education (Teachers) Regulations 1993 or any subsequent regulations.


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General and Special KnowledgeAgain check the employee specification and give examples of how you have used the knowledgeasked for. Personal experience as a member of a minority ethnic group, voluntary or communitywork may well be considered an asset for some posts.

Skills and AbilitiesYou should demonstrate that you have the specified skills and abilities in this particular section andgive examples.

Additional FactorsThis category may include further information about yourself which you consider is relevant but maynot have been covered elsewhere. If the post requires travel, out of hours working etc. pleaseconfirm your willingness to undertake these duties in this section.

What Happens Next?If you are shortlisted you will be contacted shortly after the closing date. If you dont hear from us in4-6 weeks, then please assume that on this occasion you were unsuccessful. However, do not letthis stop you from applying for other vacancies.

Interview Expenses

You may be able to claim expenses incurred. A form should be given to you at your interview.

Complaints ProcedureSchools are encouraged to follow the Councils Code of Practice on Recruitment and Selection toensure that the best person gets the job. Candidates can ask for feedback if their application hasbeen unsuccessful and if you feel that your application has not been dealt with fairly or if theexplanation for non-selection does not satisfy you then the complaint should be made in writing tothe chair of the schools governing body. The complaint should be made within 10 working days. Ifyou are not satisfied with the explanation provided by the chair of governors you should contactHuman Resources on 01484 225276.

Probation (Support Staff)All new entrants to Kirklees Council are subject to a probationary period of up to 6 months duringwhich time your performance and conduct will be monitored and appraised.

Induction (Teachers)The Education (Induction Arrangements for School Teachers)(England) Regulations 1999 requirenewly qualified teachers to complete successfully an induction period before taking up permanentemployment. For a full-time teacher the length of the induction is one year (3 terms) and for a part-time teacher the period of time it would take to complete a full year of service. Informationexplaining about the induction year will be provided upon appointment to a post.

PensionWhen you commence employment with the Council in most cases you will be able to join a pensionscheme. Support Staff will be eligible to join the Local Government Pension Scheme and Teacherswill be eligible to join the Teachers Pension Scheme.Further information will be provided when you start work.

Smoking at WorkThe Council has a duty to provide a safe working environment and recognises that both smoking andpassive smoking can damage peoples health and has introduced a policy which restricts smoking atwork.

and Finally!!Remember it may help you if you photocopy and keep a copy of the application form.Please get your application form in on time and GOOD LUCK!

Documents

Shelley Application Form