Application form

For all teaching posts in Kent

Dartford Grammar School for Girls

Confidential

Post title: Curriculum Area Leader: Music

This form is also available in alternative formats (computer disk, audio tape and Braille).

Please complete using black ink or type.

This is your opportunity to tell us as much as possible about yourself and will help us make a fair decision in the
selection process. Please refer carefully to the information you have been provided for this post.
Please ensure you complete ALL sections of the application form. Your application will be treated in the
strictest confidence.

PA RT 1 : P E R S O N A L D E TA I L S

Name: Previous Surname(s):

Address: Alternative address:

Postcode: Postcode:

Telephone – Home: Mobile:

Work: Email address:

DfEs number: /

National Insurance Number

(You can obtain this information from the Department of Social Security)

We no longer require candidates to provide this information.

1
General
Health Declaration
Do you consider Yes No
yourself to be in
good health? If NO,
please provide
details

Yes No

Superannuation Scheme
Do you contribute to the Teacher’s
Superannuation Scheme?
If you contribute to another scheme please
provide details:
Yes No

Have you elected to pay Superannuation

contributions for part time teaching?

2
Disclosure of relationship
Are you related to any elected member of the Council, a Senior Officer in Kent County Council or a member of the
School Governing Body?

Yes No (If YES, please provide details)

How did you become aware of this vacancy?

Media: Date:

Please indicate two people who can provide professional references – one of whom should be your
present/most recent employer. If in a school, this should be the Headteacher.
References will be taken up before an offer of employment is made and may be taken up prior to interview.

1. Name: 2. Name:

Address: Address:

Tel. No.: Tel.No.:

Email: Email:

Occupation: Occupation:

3
PA RT 2 : C O M P E T E N C Y

Education and Training

Original documentation of qualifications will be required prior to an appointment.
a) Training as a Teacher
Name of Teacher Training Institute
Dates From: To:
Qualification obtained
Subjects – Main and Subsidiary
Age Range / Key Stage
Other special interests

b) University, College, etc (other than initial teacher training)

Name of Institution(s) Date from Date to Full or Part Time
1. Month Year Month Year

2.

Degree / Diploma / Title Subjects Hons or Pass Grade Date of Award

1. Month Year Month Year

2.

c) Secondary Education
Name of School(s) and area 1.

2.

Qualifications gained
(Give subjects, grades, dates)

‘O’ Levels, GCSE (or equivalent)

‘A’ Levels (or equivalent)

4
In-Service Training and Development
Please give details of relevant courses and training undertaken in the last five years.

Dates and duration Title of Course / Training incl. Name of Provider e.g. Qualification
Home Study & Distance Learning LEA, College etc. obtained (if any)

Employment History
Please give details of all jobs held after the age of 18, including part time and unpaid work, starting with your current
or most recent employer. Please explain any gaps.
When giving details of school employment please include the age range, approximate school roll number and school
type i.e. academy, independent, foundation.
(Continue on a separate sheet if necessary giving page number and title heading)

Employer name and details:

Title of post:

Dates: Salary upon leaving

Full or Part Time:
(and TLR payments):
Reason for leaving:

Employer name and details:

Title of post:

Salary upon leaving

Dates: Full or Part Time: (and TLR payments):
Reason for leaving:

Employer name and details:

Title of post:

Salary upon leaving

Dates: Full or Part Time: (and TLR payments):
Reason for leaving:

5
Other Skills and Interests
Please include languages (spoken / written), computers, etc. Please provide details of any community or voluntary
work.

Applicant Statement
In this section you are asked to outline how your knowledge, skills and experiences meet the competencies required
for this post. Remember to consider experience in previous employment and relevant experience outside of paid
work e.g. that gained at home, through the community or through leisure/college activities.

6
Protection of children
Disclosure of criminal background is required of those with substantial access to children.
You are required to give details as this post, for which you are applying, is exempt from the provisions of Section 4(2)
of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act 1974
(Exceptions) (Amendment) order 1986. A subsequent offer of appointment will be dependent upon the
completion of a satisfactory DBS check.

7
Have you ever been convicted or cautioned of a criminal offence? Yes No
(If YES, please provide details of the Offence, the Sentence and the Date)

Are there any restrictions to your residence in the UK which

might affect your right to take up employment in the UK? Yes No
(If YES, please provide details)

8
If you are successful in your application, would you require a
work permit prior to taking up employment? Yes No

Data Protection Statement

‘I hereby give my consent for KCC to process and retain on file information (including health and ethnic data) contained
on this form and in accompanying documents. This is required for recruitment purposes, the payment of staff and the
prevention and detection of fraud. All information will be dealt with in accordance with data protection legislation.’

Declaration
I declare that the information I have given in this application is accurate and true. I understand that providing
misleading or false information will disqualify me from appointment OR, if appointed, may result in my dismissal.

Signature Date

Please return your completed application form to:

Mrs Sharon Pritchard

Headteacher
Dartford Grammar School for Girls
Shepherds lane
Dartford
Kent DA1 2NT
PA RT 3 : E Q UA L O P P O R T U N I T I E S M O N I T O R I N G
This section of the form is CONFIDENTIAL and will be detached from your application prior to interview.

Kent County Council recognises and actively promotes the benefits of a diverse workforce and is committed
to treating all employees with dignity and respect regardless of race, gender, disability, age, sexual
orientation, religion or belief. We therefore welcome applications from all sections of the community.

Ethnic Group (These are approved by the commission for Racial Equality)
White
British Irish Any other White background*

Mixed
White & Black Caribbean White & Black African White & Asian Any other Mixed background*

Black or Black British

Caribbean African Any other Black background*

Asian or Asian British

Indian Pakistani Bangladeshi Any other Asian background*

Chinese or Other Ethnic Group

Chinese Other Ethnic Group*

*Please specify

Gender
Male Female

Date of Birth

If you wish you may disclose information about yourself in this section about your:

Religion

Sexual Orientation
Disability Statement
Kent County Council aims to be a fair employer and is committed to equal opportunity for disabled
people. Applications from disabled people are welcome. If you are offered an interview, we have a policy of
providing appropriate access and equipment to ensure that disabled people are considered on an
equal basis.
If you would like any further assistance or advice about this application we will try to help.

Please answer the following questions:

1. Do you consider yourself to be disabled? Yes No

If YES, do you consider yourself to be disabled under the terms of

the Disability Discrimination Act? Yes No
The Disability Discrimination Act 1995 defines disability as ‘a physical or mental impairment which has a substantial
and long-term adverse affect on an individual’s ability to carry out normal day-to-day activities.’

2. Is there anything you would particularly like to tell us about your disability?

3. Do you wish us to try to arrange for any of the following to be available, if you are called for interview?
Please tick.

Induction loop or other hearing enhancement

Sign language interpreter (please state type)

Keyboard for written tests

Someone with you at the interview (e.g. advocate or facilitator)

Assistance in and out of vehicle

Accessible car parking

Wheelchair access

Accessible toilet

Other assistance (please specify)

The information you have given will be treated as confidential and is necessary to enable us to provide
appropriate adjustments and facilities. Thank you for providing this information.