For Office Use Only

Job Ref: Applicant No:

SUPPORT STAFF APPLICATION FORM

This School/Academy/Trust is committed to safeguarding and promoting the welfare of children,

young people and expects all staff and volunteers to share this commitment.

Vacancy Details

Job Title:

Job reference number:

School/Academy/Trust:

Where did you hear about this vacancy?

SECTION A – to be removed before shortlisting

It is the school’s policy to ensure that all appointments are made on merit. Any information you
provide in this section will be removed prior to shortlisting. The details you disclose will only be
used for monitoring and reporting purposes and will be held in accordance with the UK General
Data Protection Regulation and any other subsequent legislation. Details supplied are confidential
but will form part of the employee record of the successful candidate.

Personal Details
First name(s):
Last name:
Previous Name(s):
Address and Postcode:
Contact Number:
Email address:
National Insurance Number:

MONITORING EQUALITY AND DIVERISTY

Gender

What best describes your gender?

Man Non – binary Woman Prefer not to say Other : If other, please describe:

Is your gender the same as at birth?

Yes No Prefer not to say

Ethnic Origin
White British
Irish
Traveller of Irish Heritage
Gypsy/Roma
Any Other White Background
Mixed White and Black Caribbean
White and Black African
White and Indian
White and Pakistani
White and Bangladeshi
Other mixed
Asian or Asian British Indian
Pakistani
Bangladeshi
Kashmiri
Chinese
Other Asian
Black or Black British Caribbean
African
British
Other black background
Other Other Ethnic group
Unknown
Prefer Not to Say

Religion/Belief
Buddhist Muslim
Christian Sikh
Hindu Other
Jewish No Religion
Taoism Prefer Not to Say

Sexual Orientation
Ace (asexual, gray-
Gay Man
sexual, demi sexual)

Bisexual Gay Woman/Lesbian

Heterosexual/Straight
Other

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If other, please describe:

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 DISABILITY
Equality Act (2010)

This Act protects people with disabilities from unlawful discrimination. We actively encourage
applications from people with disabilities. The Equality Act defines a disabled person as someone
who has a physical or mental impairment which has a substantial and adverse long-term effect on
his or her ability to carry out normal day to day activities.

Do you consider yourself to be disabled according to this definition?

Yes No
Please specify any arrangements we can make to assist you if you are invited for
interview/assessment:

REHABILITATION OF OFFENDERS ACT

Any offer of employment will be subject to checks being carried out in order to ensure that you are
not subject to a prohibition order or an interim prohibition order. An online search may be
completed for shortlisted candidates in line with KCSIE Guidance.
As an applicant it is an offence to apply for a role that involves engaging in regulated activity
relevant to children, schools and colleges if you are barred from engaging in such activity.
All posts involving direct contact with children are exempt from the Rehabilitation of Offenders Act
1974. However, the amendments to the Rehabilitation of Offenders Act 1974 (Exceptions) Order
1975 (2013 and 2020) provides that when applying for certain jobs and activities, certain
convictions and cautions are considered ‘protected’. This means that they do not need to be
disclosed to employers, and if they are disclosed, employers cannot take them into account.
Guidance about whether a conviction or caution should be disclosed can be found on the Ministry
of Justice website.

https://www.gov.uk/government/publications/dbs-filtering-guidance/dbs-filtering-guide

Shortlisted candidates will be asked to provide details of all convictions, cautions, reprimands or
final warnings that are not “protected” prior to the date of the interview. You may be asked for
further information about your criminal history during the recruitment process. If your application is
successful, this self-disclosure information will be checked against information from the Disclosure
& Barring Service before your appointment is confirmed.

Please note that a conviction will not necessarily be a bar to obtaining employment.
By checking this box you consent to an Enhanced DBS Check being made: ☐

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 For Office Use Only
Job Ref: Applicant No:

SECTION B – to be used for shortlisting

The information provided in this section will be used as part of the short-listing process. Your
application should be fully completed and will be assessed against the criteria in the person
specification. Shortlisted candidates will be asked to complete a self-declaration of their criminal
record or information that would make them unsuitable to work with children.

Eligibility to work in the UK

Current legislation means that it is a criminal offence to employ a person who is subject to
immigration control, unless he or she has documentary proof showing an entitlement to work in
the UK. If selected for interview you will asked to provide proof of your work entitlements.

Do you have an entitlement to work in the UK? Yes No

Other Applicant Details

Are you currently, or have you previously been employed

Yes No
by this organisation?

If yes, please provide dates from and to and, reasons for leaving (if applicable):

Date from: Date to: Reason:

Do you have a personal or business relationship with

anyone from the Council / School / Academy / Trust or it’s
Yes No
partner organisations which could lead to a potential
conflict of interest?
Dismissed
Have you ever been dismissed from any employment for any reasons other than redundancy?
Yes No
If YES please give details, including dates, reasons and employer.
 REFERENCES

Please give details of two referees, one of which must be from your current/last line manager. If you
are not currently working with children but have done so in the past the second referee should be
the employer by whom you were most recently employed in with children. If you have not been
previously employed, please provide a personal reference. References will not be accepted from
relatives, or persons who only know you as a friend. If you are a school or college leaver, then your
Headteacher or Tutor’s name should be given. In all cases make sure you use someone who
knows your capabilities, can comment on your reliability and is aware of your potential. References
will be sought prior to interview and will ask your current/previous employer/tutor about any
disciplinary offences relating to children. Please provide valid email addresses so we can progress
your application. If an invalid email address is provided the progress of your application may be
delayed.

Current or Most Recent Employer

Employer Name:
Referee name:
Referee Job title (if applicable):
Organisation:
Address:
Postcode:
Referee Contact Number:
Email address:
Relationship to you:

Previous Employer
Employer Name:
Referee name:
Referee Job title (if applicable):
Organisation:
Address:
Postcode:
Contact Number:
Email address:
Relationship to you:

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 EMPLOYMENT HISTORY

Please provide details of your current or most recent employer, if applicable. If there are any
periods of time that you were not employed, these should also be included, for example you may
have been travelling, seeking work, bringing up a family or in higher education. You should include
voluntary work in this section too. Please make sure there are no gaps in the dates.

Are you currently employed? Yes No

Current Employer
Name of employer:
Job Title:
Salary:
Date employed from and to (dd/mm/yyyy):
Period of notice required (if applicable):
Reason for leaving:
Please provide brief details of duties and responsibilities:

Previous Employer
Name of employer:
Job Title:
Salary:
Date from (dd/mm/yyyy):
Date to (dd/mm/yyyy) (if applicable):
Reason for leaving:
Please provide brief details of duties and responsibilities:

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 Employment History/Gaps in Employment
Date Employed
Name of Tel
Job Title from and to Reason for leaving
Employer Number/Email
(dd/mm/yyyy)

If there are any periods of time that have not been accounted for, for instance, periods of travel, or
caring for others please give the details of them here with dates. The information provided must
provide a complete chronology from the age of 16; please ensure that there are no gaps in the
history of your employment and other experience.

EDUCATION AND TRAINING

Apart from giving details of formal education and qualifications, mention any short/non-qualification
courses that you may have attended to improve your knowledge and skills, if they are relevant to the
job you are applying for. Successful applicants will be required to provide proof of qualifications.

Education

College / University Qualification/Result/Grade Date Obtained

Relevant Training
Date Course Title Organising Body

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 SUPPORTING INFORMATION

Skills, Knowledge and Experience

This section of the application form is very important, as this is where you demonstrate your
suitability for the job. Read through the job description to get a clear view of what the job involves.
The person specification describes the necessary skills, experience and qualifications we are
looking for. The best way to show how you match the requirements of the job is by paying
particular attention to those areas on the person specification described as essential, providing
examples of how you meet these requirements. These may be from your current or previous job, or
from community or voluntary work, or from skills transferable from other life experience, particularly
if you have been out of paid employment for some time. For example, you may have considerable
domestic responsibilities, or may organise social or community activities in your spare time (1500-
word count).

 Ensure that the information you provide is well organised and relevant.
 It should show to that extent you have gained the skills and experience necessary for
the post.
 Give specific examples of the work you have been involved in, how you went about it
and the outcome.
 Remember to specify your responsibilities rather than those of your r department

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 DECLARATIONS

I can confirm that the information contained in this application is correct. I understand that my
application may be rejected or that I may be dismissed without notice for giving false, or
withholding, information.
I also give my consent to the processing of data contained, or referred to, in this application in
accordance with the requirements of the Data Protection Act 2018 and any subsequent legislation.
To find out how the School/Academy/Trust may process your personal data please contact the
Headteacher.

I can confirm that I am not barred or disqualified from working with children or subject to sanctions
imposed by a regulatory body.

By checking this box, you agree to the above statements being true and give your consent
as outlined above:

(Please note you will be required to sign this declaration if you are invited for interview).

Date:

Signed: ………………………(only if invited for interview)

Thank you for taking the time to complete your application. Once fully complete, this should be
returned to the address stated within the advertisement.

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