Personal Information * Title * First Name * Surname * Address * Postcode Ethnicity * Date of Birth * Telephone/Mobile * Email Teaching Abilities Please indicate which age groups you have experience in: NurseryKey Stage 1 (5–7)Key Stage 2 (7–11)Key Stage 3 (11–14)Key Stage 4 (14–16)A Level Main Specialism Specialism One (if applicable) Specialism Two (if applicable) Non-Specialism Subject Pay Scale Last Pay Scale Point Declaration * Have you ever been subject of any disciplinary procedures? [radio* disciplinary "Yes" "No"] * Is anyone in your household disqualified from working with children under regulations? [radio* disqualified "Yes" "No"] Availability Available Date to Start Days Available MondayTuesdayWednesdayThursdayFriday Interested in long-term assignments? YesNo Bank Details Branch Sort Code Account Number Pre-Employment Health Declaration * Surname * Title * Forename(s) * Date of Birth Please answer the following (tick all that apply): Physical or mental condition affecting ability to workCondition affecting safety of self/othersDisabilities (Equality Act 2010)Need workplace adjustmentsRetired or contract terminated due to ill healthOther relevant health conditionCurrently taking medication/treatmentsHearing difficultiesIllness that could affect young people in careAny other health problem If YES to any above, please explain: Signature Date * I confirm that all information provided is true and correct. [acceptance* confirm "I Agree"] Post navigation Previous ServiceImproving Resource
