Register

Personal Information

Mr
Mrs
Ms
Miss
Male
Female
Attach your photo here. (Optional)
Yes
No

Who should we contact in case of emergency?

Availability & Supply Information

Teacher
Assistant
Foundation
KS1
KS2
Other
Yes
No
Yes
No
Yes
No
Yes
No
Full Day Mornings Afternoons
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays

Further/Higher Education Qualifications (Inc. Professional Teacher Training)

College/University Date of Qualification Qualification Name Subjects
1. 2.
3. 4.

Experience & References

Please list your last three teaching appointments (NQT's - please state Teaching Practice schools; Supply teachers state schools where you have mainly worked

Position School Name Year Group(s) From To
1.
2.
3.

(you must have completed at least 26 weeks or part of a week in any one year from September to July to qualify as having taught for 1 year)

Please give the names, addresses & telephone numbers of referees covering the last two years. (These should be able to provide an informed and objective opinion as to your professional competence as a Supply Teacher, Nursery Nurse or Classroom Assistant.

Name: Name:
Position: Position:
Address: Address:
Postcode: Postcode:
Telephone: Telephone:
Email Address: Email Address:

Criminal Convictions (Please detail clearly as appropriate)

Yes
No
Yes
No
Yes
No

Data Protection Statement:

The information that you provide on this form and on any CV given will be used by Salford Supply Desk Ltd to provide you 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 our 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 way permitted or required by law.

Attach CV

Candidate Declaration:

I hereby confirm that the information given is true and correct. I consent to my personal data and CV being forwarded to clients on request. 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 Salford Supply Desk Ltd will be entitled either to charge the client an introduction/transfer fee, or to agree 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).

Name:* Date:*