Please give details of your education and any qualifications obtained with most recent first. This should include any qualifications which you are currently studying for. You will be required to produce original documents, a certified copy, or letter of confirmation from the awarding authority for all your qualifications and accreditations at your registration interview.
Qualifications obtained overseas must be supported by NARIC accreditation.
All qualified and un-qualified teachers must be registered with the Teaching Agency (TA) or formally known as the General Teaching Council.
Are you registered with the TEACHING AGENCY? Yes No
If yes, date of registration:
Registered in: England Scotland Ireland
Teacher Reference Number:
Do you have Qualified Teacher Status (QTS)? Yes No
Date QTS attained
If you qualified as a teacher after 7th May 1999, have you successfully completed your NQT Induction? Yes No
(Swimming awards, music certificates, coaching awards, etc.)
You will be required to present original and valid evidence of eligibility to work in the UK at your interview.
This appointment is exempt from the Rehabilitation of Offenders Act 1974 and subject to an enhanced DBS check in accordance with the Disclosure and Barring Service and the Police Act 1997. You must declare all convictions, cautions or bind-overs you may have, even if they would otherwise be regarded as “Spent” under this Act. In the event of Cumbria Teaching Agency placing you to work, failure to disclose a conviction, caution or bind-over could result in dismissal or disciplinary action by the Local Authority and possible referral to the Police.
Have you ever been convicted of a criminal offence or been given a caution; reprimand; warning or bind-over? Yes No
If yes, please provide the details below:
Candidates must give names and addresses of at least two work references and one personal reference. (Work referees must not be relatives, friends or people who you live with)
Please provide Work References of work references for the last 3 years of employment as well as a Personal Reference who will have known you for at least 5 years.
Any voluntary which you have conducted in an educational establishment must be referenced if within the last 3 years.
May we contact your references now? Yes No
If no, which references are we not to contact? Referee 1 Referee 2 Referee 3 Personal Referee
I declare that the information I have provided is correct and any changes to my circumstances, I will inform Cumbria Teaching Agency at the earliest opportunity.
I understand that full registration with Cumbria Teaching Agency is subject to successful references and an Enhanced DBS Disclosure.
I also understand that the information provided on this application form will be used to form basis of a personnel file and a computerized personnel record.
Please Tick This Box To Indicate You Are Satisfied With the Information You Have Provided (required)