Online application Applying for a Position: Student LeaderTeacherMedical studies teacher * School: Sidcot School, BristolDLD College, LondonAbbey College Cambridge * What is your availability in the summer? (Please see the dates of our programmes on our website) * Please write below any specific dates that you CANNOT work What subject/s can you teach? * What level can you teach these subjects at? * SECTION 1 This section will not be seen by the selection panel Personal details Title First name Last name Address (Flat & House No, Street Name, Town/City, Country) Postcode Daytime telephone Email address Mobile Where did you find the advert for this job? School email notification No Yes Gumtree No Yes Academic Summer website No Yes Other – please state source Birth date and other info Date of birth Nationality at birth Present nationality (if different) Do you require a visa to work in the UK? No Yes If yes, please state the type SECTION 2 This will be passed to the selection panel Employment history Current or most recent employer Employer Address Postcode Position held Period employed from to Reason for leaving Current grade Annual salary Brief description of duties Previous employer Employer Address Postcode Position held Period employed from to Reason for leaving Brief description of duties Other employment Information Education history Higher education establishment(s) attended. Name of University/School and Qualifications Achieved Further education establishment(s) attended Name of University/School and Qualifications Achieved Secondary school(s) attended Name of School(s) and Qualifications Achieved Other relevant training courses and professional qualifications (It is particularly helpful if you include details of First Aid and coaching qualifications, driving licence etc.) Information about any gaps in career history Please provide details regarding any gaps in your career history, for example career breaks, unemployment or travelling. Supporting statement Please tell us why you are interested in working with us this summer and how you think your qualifications, skills and experience are relevant to the position you are applying for. What are your hobbies and interests? SECTION 3 References Should you be successful in your application for employment with Academic Summer, we ask you to supply the contact details of at least two people who can provide references. References should cover at least three years of employment and one of them must be your current or most recent employer, unless you have never been in paid employment.Please indicate two people who can provide references in the space provided below. Where the two references do not cover a three-year period, we ask that you provide contact details of subsequent referees on a separate sheet.It will be our intention to seek references prior to interview to ensure that we have the opportunity to discuss any concerns with you. Reference 1 ( most recent employer ) Name and job title of referee Employer Address Postcode Contact telephone Email Please state in what capacity they know you (for example, previous line manager) Reference 2 Name and job title of referee Employer Address Postcode Contact telephone Email Please state in what capacity they know you (for example, previous line manager) Tick here if you don't agree to your references being sought prior to your interview Suitability for employment declarations . Criminal record The guidance document outlines in detail what needs to be declared in this section and the impact of the 1974 Rehabilitation of Offenders Act. It is important to read the guidance before you complete this section.You must answer all the questions below. If you give any information which is false, or if you withhold any relevant information, this may lead to your application being rejected or, if you have already been appointed, to your dismissal. You must tell us immediately if you are charged with an offence after you complete your form and before you take up any job offered as a result of your application. Are you or have you ever been debarred from working with children or vulnerable adults? No Yes Have you ever been convicted or found guilty by a court of any offence in any country (excluding parking but including all motoring offences, even where a spot fine has been administered by the police), or have you ever been put on probation or absolutely No Yes Have you ever been convicted by a Court Martial or sentenced to detention or dismissal while serving in the armed forces of the UK or any other country? No Yes Have you been charged with any offence which is still pending? No Yes Have you ever received a police caution? No Yes If you have answered ‘yes’ to any of the above questions, please give full details below. If you were cautioned and/or convicted please outline the details including the date and place. Other matters Do you know of any other matters not covered above relating to you and/or your background, which might cause your reliability or suitability to be called into question regarding any of the following:– employment with Academic Summer– working with children and/or vulnerable adults No Yes If you have answered ‘yes’ to the above question, please give full details below or speak confidentially to your interviewer. Declaration I declare that the information I have given in this whole form is, to the best of my knowledge and belief, true and accurate. I understand that any false information or omission in the information I have given above may mean that my application is rejected, or an offer is withdrawn, or I may be disqualified from employment with Academic Summer.I understand that if I am employed by Academic Summer and any incorrect or omitted information relating to this application comes to light, my employment may be terminated.I understand that if I am employed by Academic Summer I have a continuous obligation to disclose any new information that emerges in relation to the questions regarding suitability for employment. This includes any changes to the information given above. Failure to do so may mean my employment may be terminated. Confirmation I have read and understood the above Yes Name Date Data protection Any data about you will be held in secure conditions, with access restricted to those who need it in connection with the application and selection process. Data may also be used for the purposes of monitoring the effectiveness of recruitment. In these circumstances all data will be kept anonymous. If you are unsuccessful, your personal data relating to your application will be kept for one year and will then be destroyed confidentially. Verification code: Enter the code shown in the image: Thank you for taking the time to complete this form.