POST DETAILS Post applied for


If the post you are applying for is Part-time or Job Share please indicate the period/times of day you would prefer

PERSONAL DETAILS Surname Address Forenames Preferred title (delete) Mr/Mrs/Miss/Ms/ Other _______ Telephone Number E-mail Vehicle Owner Postcode Date of Birth National Insurance Number Full current driving licence Yes or No

Yes or No

Do you require a work permit? (If you are appointed, you will be asked to provide documentary evidence of your eligibility to work in the UK under the Asylum & Immigration Act 1996) Yes or No Do you have a disability? Yes or No As an employer, we are keen to support the careers of disabled people. Please let us know of any adaptations or special conditions that you would require at interview.

EMPLOYMENT HISTORY – Current/ Most Recent

Name and address of present or most recent employer (including postcode)

Date started Day Month Year

Date of leaving (if applicable) Day Month Year

Position Held

Present basic salary (exclude any bonus)

Amount of notice required Number of sick days in last 12 months

EMPLOYMENT HISTORY - Current/ Most Recent (cont’d) Write a brief description of your present duties/responsibilities stating to whom you report i.e. their position and, if appropriate, who reports to you. (You may attach a simple diagram of your position in the organisation to illustrate this).

EMPLOYMENT HISTORY - PREVIOUS EMPLOYMENT Please list all previous employers showing the most recent first, accounting for any breaks in employment. Continue on a separate sheet if necessary Date from Date to Name and address of Job title and salary Reason for leaving employer Day Month Year Day Month Year

QUALIFICATIONS Please state all qualifications gained, grades and dates obtained. You will be required to provide evidence if a qualification is essential to this job and we reserve the right to contact the relevant institution for verification.


Please give details (e.g. short courses, relevant specialist training), including courses currently being undertaken, continuing on a separate sheet if necessary.

Course Title

Date Attended


Name of Professional or Technical Association

Entry date to Membership


Membership number

SUPPORTING STATEMENT Please demonstrate below your suitability by relating your application to any skills, qualifications, training and experience (both through paid employment or otherwise) you have which are relevant to the job for which you are applying. Shortlisting for interview will be made on the basis of how well you meet the requirements of the person specification. NB: Please continue on separate sheets if necessary and attach securely.

Please give dates on which you would be UNAVAILABLE for interview.

REFERENCES Please complete both boxes below and supply the names and addresses of two referees, who should not be related to you, from whom references may be obtained. One should be your present, or most recent, employer (or teacher/tutor in the case of a college/school leaver) and the other, preferably, a previous employer. NB – references for shortlisted candidates may be taken up prior to an interview unless you wish otherwise (see below) Please indicate if you are known to your referees by another name. We reserve the right to contact any of your previous employers. Name Name Address Telephone No. Fax No/E-mail Occupation Capacity in which known to you May references be taken up prior to interview Yes/ No Address Telephone No. Fax No/E-mail. Occupation Capacity in which known to you May references to taken up prior to interview Yes/No


I understand that canvassing of school governors or senior school staff directly or indirectly, for any appointment shall disqualify my application. I hereby declare that the information provided on this form is correct to the best of my knowledge. The job for which you are applying is exempt from the Rehabilitation of Offenders Act 1974 and you are required to declare all unspent and spent cautions and criminal offences, including any pending convictions. Since this post provides substantial unsupervised access to children you will be asked to disclose details in the event that your application is successful. I understand that if the information I have supplied is false or misleading in any way it will automatically disqualify me from appointment or in the event of employment result in disciplinary action or dismissal by Enfield Council. In accordance with the 1998 Data Protection Act, I agree that the information I have provided on this form may be held and used for personnel reasons and the enable the organisation to keep in touch with me.

Signature of Applicant___________________________________

Date ____________________________________

If you have not been contacted within 6 weeks of the closing date, please assume that your application on this occasion has been unsuccessful.