Contact Edstaff Ltd are based in Newton Le Willows and service the whole of the North West area. EdStaff Limited 10 High Street, Newton Le Willows WA12 9SN Telephone: 01925 295 810 Contact Us Name Former names Title MrMrsMsMiss Date of birth Age Address Post code Mobile Home phone Email How long have you lived at your current address If you have lived at your address for less than 5 years, please provide your 5 year address history below Address Post code Dates from To Address Post code Dates from To Right to work in the UK Are you a British citizen? YesNo If you are not a British citizen, can you produce evidence of your right to work in the UK (passport, visa, etc)? YesNo Sectors in which you are qualified to teach: NurseryKS1KS2SecondarySpecialFE Sectors in which you are prepared to teach: NurseryKS1KS2SecondarySpecialFE Subject specialisms that can be offered: 1 2 3 4 Special Needs qualifications that can be offered: 1 2 3 4 Availability Day Mondays Tuesdays Wednesdays Thursdays Fridays Morning MondaysTuesdaysWednesdaysThursdaysFridays Afternoon MondaysTuesdaysWednesdaysThursdaysFridays D2D YesNo Sameday YesNo Perm YesNo Means of transport What travelling time would you consider Areas in which you are prepared to work LiverpoolSeftonWidnesManchesterBoltonBuryKnowsleySt HelensPrestonSalfordOldhamWiganW.LancsWarringtonRuncornStockportRochdaleotherChesterWirralN.WalesTamesideTrafford Please list any school(s) you would/would not like to teach in Please list any school(s) you would/would not like to teach in Education (further / higher) College/University Date of qualification Qualification Subjects Additional qualifications eg Catholic Teacher’s cert., sign language, SEN etc. Have you had any recent safeguarding training? YesNo If yes, please give date What year did you qualify? Are you an ECT? YesNo How many years have you taught? Induction done: Term 123 Work history – start with most recent employer Position Dates from To Starting salary Leaving salary School or Agency Full name & address Telephone No Reported to Subject/Age groups taught: Reason for leaving Reference YesNo Position Dates from To Starting salary Leaving salary School or Agency Full name & address Telephone No Reported to Subject/Age groups taught: Reason for leaving Reference YesNo Are you registered with other agencies? YesNo If yes, please list: Agency Workers Regulations After completing 12 weeks in the same job you are entitled to the same basic employment and working conditions as if you had been recruited directly. To help us calculate when this applies to you, please list your previous assignments. School Position Dates worked We would like your CV: There must be no gaps on your CV, every year must be accounted for. Please give the name & address of a person of good standing who can verify any period of unemployment greater than 6 months in the last 2 years. Name Address References: Please provide references covering the last 2 years(school/education), one of whom should be your present Headteacher/employer. NQTs should give a) your course tutor from university and b) the Headteacher of your last teaching practice Name Position Address Telephone Email Relationship Length known Name Position Address Telephone Email Relationship Length known Name Position Address Telephone Email Relationship Length known Name Position Address Telephone Email Relationship Length known Consent for release of information In order for us to obtain references for you we require a signed declaration to enable the release of information. This is in accordance with the Data Protection Act. I give my consent to the release of any information which may be necessary to assist with Edstaff’s vetting procedures and opportunities to secure future work. By my signature below, I consent to the release of the information/documents. Signed Date DBS update search If you are a member of the DBS update service, we would like to check your details and need permission. Please complete the following to give us permission to check. I am registered with the DBS update service and give Edstaff Ltd permission to carry out an annual online check to see whether any new information has come to light since the issue of the DBS check. I agree that, if I do not have a DBS on the update service, or my update service membership lapses, that a DBS will be processed and £52 deducted from my pay. Signed Date Please find a link to the Department for Education Disqualification under the Childcare Act 2006 – statutory guidance for schools dated July 2018 (the statutory guidance) below. https://www.gov.uk/government/publications/disqualification-under-the-childcare-act-2006/disqualification-under-the-childcare-act-2006 It sets out the circumstances in which individuals are disqualified from undertaking certain childcare work (relevant childcare work) under the relevant statutory provisions. As part of our safeguarding checks we are required to check whether any candidates who are seeking work that involves relevant childcare work are ‘disqualified’ from carrying out that type of work. Individuals may be disqualified because they have either been convicted of a relevant offence or are subject to a relevant order. Please review the statutory guidance which provides further details and sign below if you can confirm the following: I confirm that: I have read the statutory guidance I am not disqualified on any of the grounds set out in the statutory guidance I will notify Edstaff Ltd immediately if any of the above changes Signed The Education (Health Standards) Regulations 2004 prohibit an individual from teaching if they do not have the health and physical capacity to do so. There is an exception to Section 60 of the Equality Act 2010 where health questions can be asked in order to establish whether the person will be able to undertake “a function which is intrinsic to the role”. The following questions on health and disability are asked in order to find out your needs in terms of reasonable adjustments to access our recruitment service and to find out your needs in order to perform the job or position sought. Do you have any health issues or a disability relevant to the role which may make it difficult for you to carry out functions which are essential for the role you seek? YesNo If yes, please specify If you have a disability, what are your needs in terms of reasonable adjustments in order to access this recruitment service and to attend interview, or to take aptitude tests etc.? YesNo Please specifyYesNo IF YOU ANSWER YES TO ANY OF THE ABOVE, WE MAY REQUIRE YOU TO PROVIDE A DOCTORS FIT TO WORK NOTE Have you been retired on medical grounds If a teacher has been retired on medical grounds by the Department of Education after the 1st April 1997, this teacher will not be able to teach, even part time as they have been deemed medically unfit. However, if the teacher was retired before 1st April 1997 they may be able to work if they can show they have the health and physical capacity to teach. They can show they are fit to work by obtaining a GP’s letter confirming that they are fit to teach. However, even if they are confirmed as fit to teach they will only be able to work for 2.5 days per week. We must be satisfied that you are medically fit to return to teaching and it is your responsibility to tell us that you are in receipt of ill-health benefits. If you start work again in any form of teaching, lecturing or tutoring you must inform Teachers Pensions. Your pension will stop immediately. If you fail to inform Teachers Pensions that you have returned to work, you will have to pay back any pension paid to you since returning to work. YesNo In case of emergency please contact: Name Relationship Home telephone Alternative telephone I understand that any false information or omissions may disqualify my application. I declare I will keep Edstaff updated with any changes in my personal, criminal and medical circumstances. I certify that the information is true and complete. Signed Date Send