Wa0000.

APPLICATION FORM
Position applied for : HEAD OF SCIENCE
Personal details
Family name: TABASUM First name: YASMEEN
Title: MRS Telephone number: 07788 572584
Address: 8 PINNER RoAD

Email: [email protected]/
Postcode: HA6 1QS
[email protected]
Do you have entitlement to work in the UK? YES/ NO
Secondary/ further education
Name of school: NGARA SECONDARY SCHOOL
Dates attended from: JAN 1976 To: DEC 1979
Qualifications, Subjects & grades: ENGLISH: B

LITERATURE: A, MATHEMATICS: A, CHEMISTRY:
A, PHYSICS: A, BIOLOGY: B, GEOGRAPHY: A,
FOOD & NUTRITION: A,
ADDITIONAL MATHEMATICS: A
University / Higher education
Dates attended: SEPTEMBER 1984 – JULY 1986

Place of study (2) QUEEN MARY COLLEGE
Qualifications 2 YEARS OF B.SC DEGREE
achieved
Dates attended: SEPTEMBER 2003 – JULY 2006
Place of study (1). LONDON METROPOLITAN
Qualifications B.A MATHEMATICS EDUCATION
Achieved: DIPLOMA
Professional qualifications
Page 1 of 7
Please detail any other qualifications/ memberships or achievements that you consider
relevant for the position:
NCTEM - MEMBER
Current Employment (if necessary please provide details of all previous employers on a separate
sheet) IMMAUEL COLLEGE , ELESTREE ROAD, BUSHEY, HERTS WD23 4EB 020 89500604
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Please provide brief details of your main duties and responsibilities
no:
YR10 BOYS – FORM TUTOR AM/PM REGISTRATION, MATHEMATICS TEACHER IGCSE FOR YR
7 - 11
Payscale (if
Current salary: £55,000 per annum
applicable): L12
Reasons for leaving: Fixed term contract
Previous employment
Previous employer: DRAYTON MANOR HIGH

SCHOOL
Telephone no:
(1):
Address:
Employment dates from/ to: APRIL 2022 TO

JUNE 2022
Yours Job title (incl’ additional PHYSICS TEACHER FOR KS4
responsibilities): GENERAL SCIENCE FOR KS3
Name & Position of the person you report to: KATE WEDGEWOOD – HEAD OF SCIENCE
Please provide brief details of your main duties and responsibilities:
Page 2 of 7
PLANNING AND DELIVERY OF GENERAL SCIENCE FOR YR 7 TO 9; MARKING & RECORDING
OF END OF TOPIC ASSESSMENTS, FEEDBACK TO STUDENTS;
Payscale (if
Leaving salary: £270 per day
applicable):
Reasons for leaving:
Previous employer
Telephone no:
(2):
Address:
Employment dates from/ to:

Yours Job title (incl’ additional
responsibilities):
Name & Position of the person you report to:
Page 3 of 7
Payscale (if
Leaving salary:
applicable):
Previous employer
Telephone no:
(3):
Address:

responsibilities):
Payscale (if
Leaving salary:
applicable):
If necessary please provide details of all other employment, not stated above, on a
sperate sheet.
Please tell us about any hobbies or interests that you may have.
Page 4 of 7
Please tell us why you think you are the right person for this role.
Continue on a separate sheet if necessary
Page 5 of 7
References: Please give the name of three referees. One should be your most recent employer.
Please note, in accordance with Keeping Children Safe in Education, we will ask them whether they
had any safeguarding concerns.
Reference 1 name FAYE WESTBROOK Telephone Number: 020 8950 0604
Organisation: IMMANUEL COLLEGE Position held: HEAD OF HR
Email: [email protected]
Relationship to you : HR
Address ELESTREE ROAD, BUSHEY, HERTS,

WD23 4EB
Yes
Can we contact this referee before interview?
Reference 2 name MR FOUZY BARAJAM Telephone Number 0161 393 4260

Position held: RECRUITMENT DIRECTOR
Organisation: ONE 2 EDUCATE
Relationship to you: RECRUITMENT AGENT
Address
Page 6 of 7
YES
Telephone Number 020 8573 1039 / 07889

Reference 3 name DR MAMTA KUMARI
921437
Position held: DIRECTOR OF MATHEMATICS &
Organisation HEWENS COLLEGE
SCIENCE
Relationship to you : LINE MANAGER
Address: HEWENS ROAD, HAYES, MIDDLESEX

UB40 8JP
YES
Declarations
If applying for a teaching post, please state your DfE/ QTS number:
0540408
Child Safeguarding: We are required to ensure that staff are not employed who pose a threat to children. All
members of staff are required to have an enhanced DBS (Disclosure and Barring Scheme) check. We cannot
employ anyone who is on the Children's
Barred List (it is an offence to apply for the role if you are barred from engaging in regulated activity relevant to
children). Individuals who are disqualified under the Childcare (Disqualification) Regulations 2009 are not
permitted to work in early or later years provision or be directly concerned in the management of that
provision.
I confirm that:
I agree to inform the Head or Director of HR immediately of any change to my own situation. The information
provided above and in the rest of this application form is accurate and true to the best of my knowledge. In
addition, if I am short-listed, I consent to an online search of my publicly available data, and will comply with
other role-appropriate vetting, in accordance with KCSIE.
Signature: ytabasum Date 14 July 2023
Current employer: Telephone

Imm no:
Address

responsibilities):
Page 7 of 7

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APPLICATION FORM

Position applied for : HEAD OF SCIENCE

Family name: TABASUM First name: YASMEEN

Title: MRS Telephone number: 07788 572584

Address: 8 PINNER RoAD

Secondary/ further education

Name of school: NGARA SECONDARY SCHOOL

Dates attended from: JAN 1976 To: DEC 1979

Qualifications, Subjects & grades: ENGLISH: B

University / Higher education

Dates attended: SEPTEMBER 1984 – JULY 1986

Qualifications 2 YEARS OF B.SC DEGREE

Qualifications B.A MATHEMATICS EDUCATION

Reasons for leaving: Fixed term contract

Previous employer: DRAYTON MANOR HIGH

Employment dates from/ to: APRIL 2022 TO

Please provide brief details of your main duties and responsibilities:

Reasons for leaving:

Employment dates from/ to:

Please provide brief details of your main duties and responsibilities:

Employment dates from/ to:

Please provide brief details of your main duties and responsibilities:

Reference 1 name FAYE WESTBROOK Telephone Number: 020 8950 0604

Organisation: IMMANUEL COLLEGE Position held: HEAD OF HR

Address ELESTREE ROAD, BUSHEY, HERTS,

Reference 2 name MR FOUZY BARAJAM Telephone Number 0161 393 4260

Telephone Number 020 8573 1039 / 07889

Address: HEWENS ROAD, HAYES, MIDDLESEX

Signature: ytabasum Date 14 July 2023

Current employer: Telephone

Employment dates from/ to:

Yours Job title (incl’ additional

Name & Position of the person you report to:

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