ࡱ> |yz{  nbjbjss |I z  8pbXj6 :,P,P,P,?-/L1aVcVcVcVcVcVcV$Z~]VV1?-?-11VP,P,X4441P,P,U41aV44GMOP,TUhA2|NU2X0bXN]2 ]4OO&]!Px11411111VV4111bX1111]111111111 @: CONFIDENTIAL  SCHOOL SUPPORT STAFF APPLICATION FORM FOR A POST IN A CATHOLIC SCHOOL (Before completing this form please read Notes to Applicants) NAME OF CANDIDATE:  FORMTEXT       TO BE USED FOR THE FOLLOWING SUPPORT STAFF POSITIONS ONLY:- Teaching Assistants at Levels 1 4 inclusive Temporary Welfare Assistant/Classroom Assistant Support Staff Member (Not Teaching Assistants) Nursery Employee Please use the latest version of this application form which can be downloaded from the Catholic Education Service website: HYPERLINK "http://www.catholiceducation.org.uk"www.catholiceducation.org.uk Before you begin please check that you have the following:- Correct Application Form for the post being applied for Notes to Applicants Recruitment Monitoring Form Rehabilitation of Offenders Act 1974 Disclosure Form PLEASE DO NOT RETURN ANY COMPLETED APPLICATION FORMS AND/OR SUPPLEMENTARY DOCUMENTS TO THE CATHOLIC EDUCATION SERVICE. PLEASE RETURN ALL COMPLETED APPLICATION FORMS AND/OR SUPPLEMENTARY DOCUMENTS TO THE SCHOOL/COLLEGE WHERE THE POSITION APPLIED FOR IS BASED, OR AS INSTRUCTED IN THE DETAILS OF THE POST. DETAILS OF ROLE APPLIED FOR Application for the position of:  FORMTEXT      Full Time:  FORMCHECKBOX  Part Time:  FORMCHECKBOX  Job Share:  FORMCHECKBOX At:  FORMTEXT       FORMTEXT VA School / Voluntary AcademyAt which the Governing Body / Academy Trust Company is the employer of staffIn the Local Authority of:  FORMTEXT      In the Archdiocese/Diocese of:  FORMTEXT       Please state where (or how) you first learned of this vacancy:  FORMTEXT      APPLICANT S PERSONAL DETAILS 1.1 1.1.1 Title:  FORMTEXT        PRINT \* MERGEFORMAT  1.1.2 Surname:  FORMTEXT       1.1.3 First Name(s):  FORMTEXT       1.1.4 Known as (if applicable):  FORMTEXT       1.1.5 Any former name(s):  FORMTEXT       1.1.6 Religious Denomination/Faith:  FORMTEXT       1.1.7 Address:  FORMTEXT      1.1.8 If you have lived at this address for less than 5 years, please list all other addresses at which you have lived during this period with dates: Address Dates  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       1.1.9 Telephone numbers: Home:  FORMTEXT       Mobile:  FORMTEXT       Work:  FORMTEXT       1.1.10 Email Address:  FORMTEXT       1.2 How do you prefer to be contacted?:  FORMTEXT       1.3 National Insurance No.:  FORMTEXT       1.4 DBS No.:  FORMTEXT       1.5 DBS Check Date:  FORMTEXT        DETAILS OF APPLICANT S PRESENT EMPLOYMENT 2.1 Are you presently employed? Yes:  FORMCHECKBOX  No:  FORMCHECKBOX  If no, please proceed to the next section. 2.2 Name and address of Employer:  FORMTEXT       2.2.1 Post title:  FORMTEXT       2.2.2 Local Authority (if applicable):  FORMTEXT       2.2.3 Permanent:  FORMCHECKBOX  Temporary:  FORMCHECKBOX  2.2.4 Full time:  FORMCHECKBOX  Part time:  FORMCHECKBOX  Job share:  FORMCHECKBOX  2.2.5 Date of Appointment:  FORMTEXT       2.2.6 Notice Required/date Notice due to expire:  FORMTEXT       2.2.7 Reason for leaving (if applicable):  FORMTEXT       2.2.8 Gross annual salary:  FORMTEXT       2.2.9 Description of key duties/responsibilities:  FORMTEXT        APPLICANT S EMPLOYMENT HISTORY AND WORK EXPERIENCE 3.1 Please complete in chronological order, starting with the most recent: Employers Name, Address and nature of business Full or Part Time Job Title and brief description of duties and responsibilities Dates employed Month/ Year Reason for Leaving From - To  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       -  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       -  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       -  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       -  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       -  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       -  FORMTEXT        FORMTEXT        If there are any periods of time that have not been accounted for in your application, for instance, periods spent raising a family or of extended travel, please give details of them here with dates. The information provided in this form must provide a complete chronology from the age of 16 please ensure that there are no gaps in the history of your education, employment and other experience. Failure to provide a full account may lead to your application being rejected. Dates (from to) Activity  FORMTEXT       -  FORMTEXT        FORMTEXT        FORMTEXT       -  FORMTEXT        FORMTEXT        FORMTEXT       -  FORMTEXT        FORMTEXT        FORMTEXT       -  FORMTEXT        FORMTEXT        FORMTEXT       -  FORMTEXT        FORMTEXT       Please confirm whether you have ever been ordained and/or been a member of a religious community. Yes:  FORMCHECKBOX  No:  FORMCHECKBOX  If yes, please provide details:-  FORMTEXT        POST-11 EDUCATION AND TRAINING Please complete in chronological order, starting with the most recent Full name and address of establishment Full time or part time Qualifications, date Award made and Awarding Body Dates Attended Month/ Year From - To  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       -  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       -  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       -  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       -  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       -  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       -  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       -  FORMTEXT       Date of most recent safeguarding training, if relevant:  FORMTEXT       INTERESTS AND HOBBIES Please list your interests and hobbies outside of work:  FORMTEXT        FORMTEXT        FORMTEXT        SUPPORTING STATEMENT Please provide a written statement of no more than 1,300 words detailing why you believe your experience, skills, personal qualities, training and/or education are relevant to your suitability for the post advertised and how you meet the person specification applicable to the post. You should pay particular attention to the national standards for the position for which you are applying.  FORMTEXT       REFERENCES 7.1 A referee who is a current or former employer should have full access to the applicant s personnel records, to the extent that this is achievable in compliance with the General Data Protection Regulation. Schools/Colleges of a Religious Character (in England only) are permitted, where recruiting for Support Staff posts, to give preference to applicants who are Catholic where attaching this requirement to the post is a proportionate means of achieving a legitimate aim (commonly known as a genuine occupational requirement). If you are a practising Catholic, you should nominate as one of your referees, the Parish Priest of the parish where you regularly worship. If you are a Catholic but do not consider yourself to be practising, you may (as an alternative to nominating your Parish Priest as a referee) provide a copy of your baptism certificate, or the name and address of the Parish where you were baptised and the date of your baptism. It is the responsibility of the Applicant to ensure that all named referees, including Parish Priests, where applicable, have explicitly consented to providing a reference. You are advised to read the relevant section of the Notes to Applicants before completing this section. If you are non-practising Catholic, you should provide your certificate of baptism, or the name and address of the parish where you were baptised and the date of your baptism. Alternatively, non-practising Catholics may nominate their Parish Priest for the purpose of obtaining a reference. It is the responsibility of the Applicant to ensure that all named referees, including Parish Priests, where applicable, have consented to providing a reference. Please be aware that a failure to obtain your referees consent may result in your committing a data breach. You are advised to read the relevant section of the Notes to Applicants before completing this section. Present School/Employer: Name:  FORMTEXT       Address:  FORMTEXT       Role:  FORMTEXT       Telephone:  FORMTEXT       Email:  FORMTEXT       Other Professional: Name:  FORMTEXT       Address:  FORMTEXT       Role (if applicable):  FORMTEXT       Telephone:  FORMTEXT       Email:  FORMTEXT       Relationship:  FORMTEXT       Parish Priest/Priest of the Parish where you regularly worship (or Additional Professional (if applicable)): Name:  FORMTEXT       Address:  FORMTEXT       Telephone:  FORMTEXT       Email:  FORMTEXT       Please tick this box if you have enclosed a copy of your baptism certificate with this application form.  FORMCHECKBOX  If you have not provided a Parish Priest s reference or copy of your baptism certificate, please enter the name and address of the Parish where you were baptised and the date of your baptism here:  FORMTEXT       Notes: (i) We reserve the right to take up references with any previous employer. Please advise if you do not want us to do so at this stage and provide reasons. (ii) If any of your referees knew you by another name, please specify that name(s) here:  FORMTEXT      7.2 Are you (or your spouse/civil partner/partner) related by marriage, blood or as a co-habitee to any member of the Governing Body / Academy Trust Company or any current employees of the Governing Body / Academy Trust Company? Yes:  FORMCHECKBOX  No:  FORMCHECKBOX  If yes, please complete the following: Name of Governing Body / Academy Trust Company member/employee Relationship to you  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        DISCLOSURE OF CRIMINAL AND CHIILD PROTECTION MATTERS AND DISCLOSURE AND BARRING SERVICE CHECKS 8.1 The Governing Body / Academy Trust Company is obliged by law to operate a checking procedure for employees who have access to children and young people. Please confirm whether you have ever been the subject of any child protection concern either in your work or personal life, or been the subject of, or involved in, any disciplinary action in relation thereto, including any which is time expired. 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GGGGGGGGGGGGGGG HHHHH HHHIIIJJJJJϽϫڠwoc[hmCJaJjhmCJUaJhB CJaJh<CJaJ#jQhwhwCJUaJjhwhwCJUaJhwhwCJaJ#jnh#~h[ UmH sH #jh#~h[ UmH sH h#~hrdmH sH  h#~hrdjh#~hrdUmH sH jh#~h[ UmH sH H HIIIJJs`$d$Ifa$gd<K$$d$Ifa$gd<$d$Ifa$gdwjkdؼ$IfK$L$l!'# t0'44 laytV+!JJJJJJJJJLLLLLLLLLLLMNENFN]NeNzsleZeSFeh#~h@>^JmH sH  h#~h@>h#~h2mmH sH  h#~hMb h#~h h<hrdjh#~hrdUmH sH #jh#~h[ UmH sH h#~hrdmH sH jh#~h[ UmH sH  h#~hrdh:n h#~hB h<hmCJaJ"jhmCJUaJmHnHujhmCJUaJjǽhmCJUaJJJLL|g$pd$If^pa$gd<$p`d$If^p``a$gd:njkd?$IfK$L$l'# t0'44 laytV+!LL`NNNN Onn[[$d$Ifa$gdN:K$$d$Ifa$gdN:$0d$If^`0a$gdN:fkd"$$Ifl5&$ t08)44 laiytRz3eNfNtNuNwNNNNNNNNN OOOOOP P PPPP&P(P*P4P6P:Pkkd$$Ifl45&$ t08)44 laif4ytRz3PPPTQVQXQQQQFSGSUSVSXSbScSqSrStSSSSST0 0 00001ȭȢȭȗȈ}kiZS h#~hdjh#~hdUmH sH U#jEh#~h[ UmH sH h#~hdmH sH jh#~h[ UmH sH jh[ UjYh[ Ujh[ UhtVh2mmH sH h2mmH sH hdhDUT h`56CJOJQJ^JaJ&hph`56CJOJQJ^JaJh> h#~hMb      8.2 By checking the box below I hereby confirm that I am not disqualified from working with children and/or have information held about me under section 142 Education Act 2002 (formerly known as inclusion on the DfE List 99):  FORMCHECKBOX  8.3 In the event of a successful application an offer of employment may be made to you which is conditional upon receipt of satisfactory Disclosure and Barring Service Checks ( DBS Checks ) (formerly CRB Check and ISA Check) in relation to criminal and child protection matters. Please note that a conviction will not necessarily be a bar to obtaining employment. By checking the box below you hereby consent to a DBS Check being made to the Disclosure and Barring Service ( DBS ):  FORMCHECKBOX  REHABILITATION OF OFFENDERS ACT 1974 If you have any convictions, cautions, reprimands or final warnings that are not  protected as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) order 1975 (as amended in 2013), then the details of these must be disclosed on a separate document. The Rehabilitation of Offenders Act 1974  Disclosure Form must be enclosed with your application in a sealed envelope marked  Confidential  Rehabilitation of Offenders Act 1974  Disclosure Form . If you do not have disclosable convictions, please complete the relevant section of the Disclosure Form.REQUEST TO PROCESS YOUR PERSONAL DATA In compliance with the General Data Protection Regulation (GDPR), we wish to ensure you are aware of the purpose for which we are requesting your consent to collect and process the data we have asked you to provide on this application form. Important Information Regarding Your Consent 1. We are  FORMTEXT St Gregory's Catholic Science College, our address is Donnington Road, Kenton, Middx. HA3 0NB.We are a VA academy that is part of the All Saints' Trust. The Academy Trust is the data controller and the school is part of the Academy Trust Company.. 2. Being a Catholic education provider we work closely with  FORMTEXT the Diocese of Westminster      with whom we are required to share the information you provide on this application form. 3. The person responsible for data protection within our organisation is  FORMTEXT Mr Matt Lantos      and you can contact them with any questions relating to our handling of your data. You can contact them by  FORMTEXT emailing them at dpo.lantos@bsp.london     . 4. We require the information we have requested on this form in order to process your application for employment. 5. To the extent that you have shared any special categories of personal data this will not be shared with any third parties except as detailed in paragraph 2 above, unless a legal obligation should arise. 6. If your application is successful, the information you have provided on this form will become part of your personnel file which shall be retained throughout the duration of your employment within our organisation and afterwards in accordance with our data retention policy. 7. If you are unsuccessful, your application form and any documents you have submitted in support of your application will be destroyed after a period of 6 months. 8. We will keep a record of your consent as evidence that we have obtained your consent to collect and process the data you have provided on this application form. 9. You have the right to withdraw your consent at any time and can do so by informing our organisation s Data Officer (see 3 above) that you wish to withdraw your consent. 10. To read about your individual rights and/or to complain about how we have collected and processed the information you have provided on this form, you can make a complaint to our organisation by  FORMTEXT our academy Complaints Procedure which is available on our Academy website. If you are unhappy with how your complaint has been handled you can contact the Information Commissioners Office via their website at: ico.org.uk Request For Your Consent Please ensure that you have read paragraphs 1-10 above and raised any relevant questions before providing your consent below. I confirm that I have read and understood paragraphs 1-10 above and that I have been offered the opportunity to raise any relevant questions: YES  FORMCHECKBOX  NO  FORMCHECKBOX  [Tick applicable box]. Please tick this box if you have any objection to our collecting and processing your personal information as described in paragraphs 1-10 above  FORMCHECKBOX . I agree to my personal data being shared as stated in paragraphs 2 and 5 above: Yes  FORMCHECKBOX  No  FORMCHECKBOX  [Tick as applicable]. IMMIGRATION, ASYLUM AND NATIONALITY ACT 2006 The Governing Body / Academy Trust Company will require you to provide documentary evidence of your entitlement to undertake the position applied for and/or of your ongoing entitlement to live and work in the United Kingdom in accordance with the Immigration, Asylum and Nationality Act 2006. More information can be found in paragraph 17 of the Notes to Applicants. By checking the box you are hereby confirming that you are legally entitled to work in the United Kingdom and that you will promptly provide documentary evidence of such entitlement when requested:  FORMCHECKBOX   IMMIGRATION ACT 2016 The ability to communicate with the public in accurate spoken  FORMTEXT [ENGLISH/WELSH]  is an essential requirement for the post. This requirement is applicable to public sector workers with public-facing roles as per the statutory code of practice relating to Part 7 of the Immigration Act 2016. DECLARATION If you know that any of the information that you have given in this application form is false or if you have knowingly omitted or concealed any relevant fact about your eligibility for employment which comes to our attention then your application may be withdrawn from the recruitment process. Providing false information is an offence and may result in this application being rejected. If such a discovery is made after you have been appointed then you may be liable to be dismissed summarily. You may also be reported to the Teaching Regulation Agency (TRA) (England only) and/or Education Workforce Council (Wales only) and/or the Police, if appropriate. By signing below I hereby certify that all the information given by me both on this form and in any supplementary pages and/or the supporting evidence provided, is correct to the best of my knowledge and belief, that all the questions relating to me have been accurately and fully answered and that I possess all the qualifications that I claim to hold. I acknowledge that it is my responsibility as the applicant, if invited for interview, to disclose information to the panel which may affect my suitability and/or eligibility to work with children and/or vulnerable adults Signature:  FORMTEXT       Date:  FORMTEXT       The post will be subject to the terms and conditions of the appropriate Catholic Education Service model contract, a copy of which will be provided to you before interview if you are shortlisted). Additional Pages Name:  FORMTEXT       Position applied for:  FORMTEXT        FORMTEXT         Article 9(1) GDPR sets out the special categories of personal data as follows:  personal data revealing racial or ethnic origin, political opinions, religious or philosophical beliefs, or trade union membership, and the processing of genetic data, biometric data for the purpose of uniquely identifying a natural person, data concerning health or data concerning a natural person s sex life or sexual orientation&      Page |  PAGE \* MERGEFORMAT 1 Model Application Form  Support Staff  version 12  Sept 2013  updated December 2018 THE CATHOLIC EDUCATION SERVICE S0000124ykRAR$d$Ifa$gdN:$0d$If^`0a$gdN:d$IfgdN:hkd$IfK$L$l=#8# t044 laytId$IfgdN:K$d$IfgdN:11111122445555555555:6<6@6B6F8H8:::::屝|s|l[ hB 56CJOJQJ^JaJ h!4th|Ph!4t]mH sH hz]h!4t]mH sH h!4t hR56CJOJQJ^JaJ&hphR56CJOJQJ^JaJ h|P56CJOJQJ^JaJ&hN:hd56CJOJQJ^JaJjh[ UhKLhdj$h[ Ujh[ Uh|P44555<6H8J8\TCC$d$Ifa$gd!4t & FgdRfkd$$Ifl#$ t044 laytN:d$IfgdN:$d$If^a$gdN:$0d$If^`0a$gdN:J8::::<<>=@=b?{jYYYYP $Ifgd)|$d$Ifa$gd!=}$d$Ifa$gd}2 & Fgd jkd$$IflG#G# t0644 lalyt ~$d$Ifa$gd!4t ::::<>=@=V=X=l=n=p=r=Z?\?^???????*@4@6@AAAùätl\tRtäj *h Ujy *hx@hx@U *hx@hx@j *hx@hx@U h h h j *hx@hx@U *hx@hx@j *hx@hx@UhiIh!=}>*hiIh!=}5>* hiIh!=} h56CJOJQJ^JaJ h 56CJOJQJ^JaJ&hph 56CJOJQJ^JaJb?@@CCCCEEGGIIdJfJKK.O0ObOdOhPjPR$ & F d$Ifa$gd!=}$d$Ifa$gd!=}AAAAAAABBBBBC CCRD~DDDEEXGGGG*HHIIfJhJKPKKKMVMXMlMnMpMNNN0ObOdOOO㿯ǫǞǫǫǫǫǫǫǫǫǫ㿎DŽ|ǫhiIh!=}>*hiIh!=}5>*j *hx@hx@UjhiIh!=}H*Uh!=}ji *hx@hx@U *hx@hx@ hiIh!=}hx@j *h U h h j *hx@hx@Uj *hx@hx@U0OPPQQQQQQQQQQR2SDSFSbSdShSTT8T:T>TJTLThTjTnTTTTTTU Uxgch2m h w56CJOJQJ^JaJ&hph w56CJOJQJ^JaJh&hN:h!=}56CJOJQJ^JaJj1hiIh!=}UjhiIh!=}UjEhiIh!=}UjhiIh!=}UjYhiIh!=}UjhiIh!=}Uh hiIh!=}$R RlSnSTTTTHjkd$$Ifs"(# t0644 sayt ~$d$Ifa$gd}2$d$Ifa$gd!=}$ & F d$Ifa$gd!=}$d$If^a$gd!=}TTYYYYY\pkcV $If^gd] & FgdbBgdhkd$$Ifl#$ t0644 laytN:d$IfgdN:$d$Ifa$gdN: & Fgd w UNUPUWWXXhYjYYYYYYYYY:Zh@h~hhhh$d$Ifa$gdN:d$IfgdN:gdRz3 hhiiiii i iiiiiiiid$IfgdN:jkd.$$Ifl4/&2) t02)44 laiytRz3hhhhhi@iDiFiHiJiiiiiilllllllllllllĶ}q}q}a}]U]J]U]J]U]h<hsCJaJjhsUhsh h!=}6CJaJmH sH h!=}CJaJmH sH h h!=}CJaJmH sH h h!=}CJaJ!jh h!=}0JCJUaJ h}2hxZ h#~hNIh#~hNI5CJmH sH hRz3hNImH sH jh#~hNIUmH sH jh#~h[ UmH sH #jh#~h[ UmH sH iii i"i$i&i(i*i,i.i0i2i4i6i8i:ii@iBid$IfgdN:BiDiFillllllllllllzzz dgdTW&gd!=}  gd}2kkd$$Ifl/&2) t02)44 laiytRz3lllllllllllmmmmmmmmmnnnnn n  gd}2 $&dPa$ dgdTWlllllllllllllllllmmmmm,m.mlmnm|m~mmmmmmmmnnnnn n˽˸ӭӞӎ劆 h}2hxZhB h}2hK#h2mhJ\h 'h >h<h6 CJaJh<h6 CJaJ h6 5h0h05mHnHujh6 Uh6 h6 @<B*phhqo+h!4tjhsUhsh<hsCJaJ(z+p,p-p.p1h/R 4567:p'R%. 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