2012 (projected) 8. Personal data Current salary: Additional salary (please indicate management points or London allowance etc): Total salary: 8. Referees Please provide the contact details of two referees (covering the last three years), one of whom should be your current employer (see process flow chart for an indication of when your referees will be contacted) Name Name Job title Job title Organisaion Organisaion Relationship to Relationship to you you Address Address Tel Tel Mobile Mobile Email Email OK to contact? Yes No OK to contact? Yes No 9.Confidential Information Reach Academy Ltd requires all employees to undertake an enhanced CRB. You are required, before appointment, to disclose any conviction, caution or binding over including convictions’ under the Rehabilitation of Offenders ‘spent Act 1974 (Exemptions) Order 1975. Non-disclosure may lead to termination of employment. However, disclosure of a criminal background will not necessarily debar you from employment this will depend upon the nature of the offence(s) and when they occurred. – In relation to the above, if you have any convictions or cautions (including spent convictions) you are obliged to detail these below: - - - - Do you have any convictions (including cautions and bind-overs)? Yes No I can confirm that I am not on List 99, disqualified from working with children or subject to sanctions imposed by a regulatory body such as the General Teaching Council. Date: Signature: 10. Where did you hear about the vacancy? Where did you hear about the vacancy? 11. Declaration Information from this application may be processed for purposes registered by the Employer under the Data Protection Act 1984 and 1998. Individuals have, on written request and on payment of a fee of £10 the right of access to personal data held about them. I hereby give my consent to Reach Academy Feltham processing and retaining the data supplied in this application form for an appropriate period of time for the purpose of recruitment, selection and employment. I declare that the details given by me on this application form are correct to the best of my knowledge and belief. I understand that if I give any information is false, or I withhold any relevant information, this may lead to my application being rejected, or if I am already appointed, to termination of employment.
2012 (projected) 8. Personal data Current salary: Additional salary (please indicate management points or London allowance etc): Total salary: 8. Referees Please provide the contact details of two referees (covering the last three years), one of whom should be your current employer (see process flow chart for an indication of when your referees will be contacted) Name Name Job title Job title Organisaion Organisaion Relationship to you Relationship to you Address Address Tel Tel Mobile Mobile Email Email OK to contact? Yes No OK to contact? Yes No 9.Confidential Information Reach Academy Ltd requires all employees to undertake an enhanced CRB. You are required, before appointment, to disclose any conviction, caution or binding over including ‘spent convictions’ under the Rehabilitation of Offenders Act 1974 (Exemptions) Order 1975. Non-disclosure may lead to termination of employment. However, disclosure of a criminal background will not necessarily debar you from employment – this will depend upon the nature of the offence(s) and when they occurred. In relation to the above, if you have any convictions or cautions (including spent convictions) you are obliged to detail these below: - - - - Do you have any convictions (including cautions and bind-overs)? Yes No I can confirm that I am not on List 99, disqualified from working with children or subject to sanctions imposed by a regulatory body such as the General Teaching Council. Date: Signature: 10. Where did you hear about the vacancy? Where did you hear about the vacancy? 11. Declaration Information from this application may be processed for purposes registered by the Employer under the Data Protection Act 1984 and 1998. Individuals have, on written request and on payment of a fee of £10 the right of access to personal data held about them. I hereby give my consent to Reach Academy Feltham processing and retaining the data supplied in this application form for an appropriate period of time for the purpose of recruitment, selection and employment. I declare that the details given by me on this application form are correct to the best of my knowledge and belief. I understand that if I give any information is false, or I withhold any relevant information, this may lead to my application being rejected, or if I am already appointed, to termination of employment.