Education Jobs London & Essex - Application Form

Agency Operative Application Form

Forenames *

Maiden/other name

Surname *

Date of Birth (copy) *

Proof of Identity Provided? (Passport, Driving Licence - both sides, other photo ID) (copy) *

House Number *

Address Line 2

County *

Address Line 1 *

Town/City *

Postcode *

If you have lived at the above address for less than 5 years, please provide list of previous address and dates below

Proof of Address x 2 Provided? (within last 3 months - Bank Statement, Utility Bill, Driving licence (both sides), Council Tax) *

Home Phone Number

National Insurance Number *

Mobile Phone Number *

Nationality *

Email Address *

Have you lived of worked outside of the UK in the past 10 years? *

If you have answered yes, we will require a Police Check from where you were living/working.

P45 provided? *

Permission given to access DBS/Update Service? *

Proof of Permission to work in the UK provided? (Passport, Visa, BRP - both sides, Right to Work Code/Police Check, Birth Certificate) *

Pay Information - Name of Bank

Sort Code

Name of Bank Account Holder

Account Number

Emergency Contact - Name *

Emergency Contact - Address *

Emergency Contact - Email *

Emergency Contact - Relationship *

Emergency Contact - Phone (Home)

Emergency Contact - Phone (Mobile) *

Emergency Contact - Phone (Work)

Post applying for *

Qualifications/Training - State appropriate Qualifications and Training (most recent first) *

Please provide 3 references - 2 must be a manager/headteacher from your most recent employer.

Referee 1 - Name *

Referee 1 - Contact Phone *

Referee 1 - Company *

Referee 1 - Contact Email *

Referee 1 - Position *

Date known from *

Referee 1 - Address *

Can we contact them immediately? *

Referee 2 - Name *

Referee 2 - Contact Phone *

Referee 2 - Company *

Referee 2 - Contact Email *

Referee 2 - Position *

Date known from *

Referee 2 - Address *

Can we contact them immediately? *

Referee 3 - Name *

Referee 3 - Contact Phone *

Referee 3 - Company *

Referee 3 - Contact Email *

Referee 3 - Position *

Date known from *

Referee 3 - Address *

Can we contact them immediately? *

Referee Consent - Signature *

I hearby give my consent to Harton Search to contact the referees given above.

Date *

Do you have any unspent convictions? *

REHABILITATION OF OFFENDERS ACT: As of 29 May 2013 you are no longer required to disclose information about any information about any ‘filtered’ offences. Additional guidance in can be provided which sets out the filtering rules for criminal record check certificates. You are not required to disclose on any part of this form any convictions or cautions that have been ‘filtered’. Guidance and criteria on the filtering of these cautions and convictions can be found on the Disclosure and Barring Service website. Subject to the filtering rules failure to declare a conviction that you must disclose mat require us to exclude you from our register or terminate and assignment if the offence is not declared but later comes to light.

If yes, please list your criminal convictions and their dates subject to the filtering rules. The information you give will be treated in confidence and only taken into account where, in the reasonable opinion of Harton Search Limited, the offence is relevant to the post for which you are applying.

*A conviction will become spent after a ‘rehabilitation period’. A list of these periods can be provided if needed.

As an exception to the Rehabilitation of Offenders Act 1974, for certain roles and professions you are required to disclose all spent and unspent convictions. The DBS checks: eligibility guidance (attached) explains who is eligible for DBS checks but anyone doing such work must disclose spent and unspent convictions (subject to the filtering rules). If this is relevant to work that you are seeking please list all criminal convictions (spent and unspent) and their dates below, subject to the filtering rules. If this section does not apply to you please write ‘not applicable’. *

As per 221 KCSIE Candidates may be subject to an online search. Teachers will be subject to a Prohibition Check as per 232 of KCSIE.

Harton Search Ltd is committed to a policy of equal opportunities for all employees, workers and applicants and shall adhere to such a policy at all times and will review on an on-going basis all aspects of recruitment to avoid unlawful or undesirable discrimination. Harton Search Ltd will treat everyone equally irrespective of sex, sexual orientation, gender reassignment, marital or civil partnership status, age, disability, colour, race, nationality, ethnic or national origin, religion or belief, political beliefs or membership, pregnancy and maternity or non-membership of a Trade Union or spent convictions, and places an obligation upon all staff to respect and act in accordance with the policy. Harton Search Ltd is committed to providing training for all its’ staff in equal opportunities practice. As part of our commitment to equal opportunities, we need to obtain information about the ethnic origins, age, sexual orientation, religion and belief, disability, marriage or civil partnership and sex of our employees and job applicants. This information enables us to examine, by ethnic origin and sex, the distribution of employees across the organisation, and the success rate of candidates for jobs, training, transfer and promotion, according to the type of job. We hope that employees and job applicants will co-operate by completing the information overleaf, which will help us to assess whether the distribution of staff and the success rate of applicants is fair and equal. Any information provided will be kept confidential and will only be used for monitoring diversity and equality of opportunity. The following questions are optional. Information you do provide will be kept confidential.

Do you have a disability?

The Equality Act 2010 defines a person as having a disability if he/she has a physical or mental impairment, and that impairment has a substantial and long-term adverse effect on his/her ability to carry out normal day-to-day activities

If yes, what support may you need?

DATA PROTECTION - The information that you provide on this form and on any CV given will be used by Harton Search Limited to provide you with work finding services. In providing this service to you, you consent to your personal data being included on a computerised database and consent to us transferring your personal details to clients. We may check the information collected with third parties or with other information held by us. We may also use or pass to certain third parties information to prevent or detect crime, to protect public funds, or in other ways permitted or required by law. *

I confirm that I have read this information

Please tick to confirm you have read this information.

AGENCY OPERATIVE DECLARATION - I hereby confirm that the information given is true and correct. I consent to my personal data and CV being forwarded to clients. I consent to my data being audited by Harton Search Ltd and/or clients. I consent to references being passed onto potential employers. If, during the course of a temporary assignment, the Client wishes to employ me direct, I acknowledge that Harton Search Ltd will be entitled either to charge the client an introduction/transfer fee, or to agree to an extension of the hiring period with the client (after which I may be employed by the Client without further charge being applicable to the Client). *

I confirm that I have read this information

Please tick to confirm that you have read this information.

Signature *

Date

Phone

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