Bournemouth School Application Form

Bournemouth School will seek to ensure that all existing and potential employees are given equal opportunities. It is
committed to the elimination of unlawful or unfair discrimination on the grounds of gender, age, marital status, colour,
race, nationality or other ethnic or national origin, disability, sexual orientation, transgender and religious background.
Bournemouth School will seek to ensure that no applicant for employment is disadvantaged by conditions or requirements
which cannot be justified.

Thank you for your application.

JOB TITLE ELIGIBILITY TO WORK IN THE UK

Do you have permission to work in the UK? Yes No
PERSONAL DETAILS If you are not a British National or the holder of an EU or EEA

Surname passport, please indicate in what capacity you are in the UK

Forename
Title Mr / Mrs / Miss / Dr / Other Mr
Date of Birth dd/mm/yyyy
Address
DISABILITY
Bournemouth School encourages applications from disabled
Postcode people who satisfy the recruitment criteria for appointment
Daytime telephone number and will apply the provisions of the Disability Discrimination
Evening telephone number Act 1995. If you consider that the provisions of the Act apply
Mobile telephone number to you, please tick the box.
Email If you require assistance at any stage of the process please
National Insurance Number contact the Headmaster’s PA or provide details below.

REFERENCES
Referees named on this form must be your present (most recent) and previous employer. If you have not previously been
employed, or are returning to work after a substantial career break and are unable to provide previous employment
references, please provide alternatives, e.g. the name of your Course Tutor(s)/Head Teacher or a suitable professional.
It is our policy to contact referees prior to interview.

PRESENT EMPLOYER PREVIOUS EMPLOYER

Name Name
Capacity known to you Capacity known to you
Organisation Organisation
Address Line 1 Address Line 1
Address Line 2 Address Line 2
Address Line 3 Address Line 3
Town Town
County County
Postcode Postcode
Telephone number Telephone number
Email Email
 Employment History
CURRENT EMPLOYMENT

Employer name and address

Job title Full-time/part-time

Current salary Grade
Date appointed Notice period

Main duties

Reason for leaving

May we contact you at work if necessary? Yes No Contact number

PREVIOUS EMPLOYMENT

Please give details of all jobs held including part time and unpaid work, starting with your present/last employer.
Chronologically all years MUST be accounted for since leaving education. Please indicate with a  in the last column,
your consent for additional references to be taken up at the discretion of the School. (This will only be undertaken in
specific circumstances.)

Employer’s name and Job title and brief description of duties Date Reason for 
address (most recent first) from/to leaving

Please continue on a separate sheet if required.

 Supporting Statement
SUPPORTING STATEMENT

Please use the space below to outline how you feel you meet the criteria outlined in the Person Specification. Please
structure your statement as follows:

 Start with how you feel you meet the criteria – detailing any relevant skills, experience or training that you have.
Please try to address each point in the Person Specification in order.
 In separate paragraph(s), please include any other detail that you feel is relevant to your application.
 If additional space is required, please continue on a separate sheet.

The information you provide will be used in assessing your application and will form part of the selection process.
 Education / Training
EDUCATION /QUALIFICATIONS & PROFESSIONAL MEMBERSHIPS

Dates Name of school / college / university / Qualification obtained including grade & level
awarding body/grade of membership (If short listed, you will be required to provide proof of any relevant
qualifications)

OTHER TRAINING/SHORT COURSES

Dates Course title and duration

Please continue on a separate sheet if required.

Are you related to or well known to a member of the Governing Body or to an employee of the School? Yes No

If ‘yes’ please provide Name Relationshi

p

All forms of canvassing will automatically disqualify candidates from appointment, e.g. you must not ask a Governor or employee of the
School to use their influence to help you get a job.

DATA PROTECTION LEGISLATION

By signing this form you agree that the information you have provided can be used in compliance with the Data
Protection Act 2018 – Privacy Notice for Job Applicants.
If you have previous Local Government service or other service which counts as continuous, the School will seek confirmation from
your last employer of your date of employment for continuous service purposes, in the event of you being offered a post. The authority
will also seek details of the number of days sickness absence (not reasons) in the last 12 months, for the purposes of administering the
Local Government Sick Pay scheme. You are deemed to have given your consent by signing this application form.

CERTIFICATION OF INFORMATION

I declare that the information I have provided on this application form is full, accurate and complete and I understand that if I provide
false information, or fail to provide full, complete and accurate information, this may lead to the decision that my application cannot be
considered any further, the withdrawal of the offer of appointment, or to my dismissal, if I have been appointed. Any offer of
employment is subject to receipt of satisfactory references, medical assessment and Disclosure and Barring Service checks, where
applicable.

Signature Date
Bournemouth School
East Way Telephone: 01202 512609
Bournemouth Fax: 01202 516095
BH8 9PY Email: [email protected]

Please return your completed application to Dr D Lewis, Headmaster.

Confidential
Equal Opportunities Monitoring Information

Bournemouth School

Bournemouth School will seek to ensure that all existing and potential employees are given equal opportunities. It is
committed to the elimination of unlawful or unfair discrimination on the grounds of gender, age, marital status, colour, race,
nationality or other ethnic origin, disability, sexual orientation, transgender and religious background. The School will seek
to ensure that no applicant for employment is disadvantaged by conditions or requirements which cannot be justified.
In order to help Bournemouth School monitor the effectiveness of its Equal Opportunities Policy (and for no other reason)
you are asked to provide the voluntary information below. This information is confidential and does not form part of your
application. This sheet will be separated from your application form upon receipt and the information will not be taken into
account when making the appointment.

My Ethnic Origin is:

White My gender is
British

Irish

European
Is there anyone dependent on you
Portuguese
for their day to day care? Yes
Eastern European
No
Any other White background
(Please specify) If 'yes' complete the following:

Mixed A. Children
White & Black Caribbean 0 – 5 years

White & Black African 6 – 10 years

White & Asian 11 – 15 years

Any other Mixed background B. Other

(Please specify) (Please specify)

Asian or Asian British

Indian Do you consider yourself to have a
disability under the Disability
Pakistani Discrimination Act 1995?
Yes
Bangladeshi
No
Any other Asian background If ‘yes’ please specify
(Please specify)

Black or Black British

Caribbean For more details call the Disability Rights Commission
Helpline on 08457 622633.
African

Any other Black background Application for the post of

(Please specify)

Other Ethnic Group Age

Chinese
Where did you see the advert
Korean

Any other ethnic group

(Please specify)
Thank you for your assistance.