JOB APPLICATION COVER SHEETACADEMIC POSITION: Your Details Title (tick one box only): Mr Ms Dr Mrs Miss Prof Other First Name: Last Name: Street Name & No. or PO Box: Suburb/Town: State: Postcode: Country (if not Australia): Daytime Contact No.: Alternative Contact No.: E-Mail Address: Position Information Where did you first see the position advertised (tick one only): Courier Mail www.margarets.qld.edu.au www.mycareer.com.au www.careerone.com.au The Australian www.teachers.on.net.au www.seek.com.au www.agsa.org.au Other: Application Date: / / ST MARGARET’S ANGLICAN GIRLS’ SCHOOL Application for Employment Form – Academic Staff Section 1: Applicant Personal Details Surname: ___________________________ Title: _______ Previous Surname/s: ____________________________ Given Names: _____________________________ Preferred Names: _______________________________ Date of Birth: ___________________ Proof attached (optional information) Yes / No Sex (M or F) _____________________________ Residential Address: _____________________________________________________________ Post code: ___________ Postal Address: _________________________________________________________________ Post code: ____________ Telephone: Home ______________________________ Alternative contact no. ___________________________ Fax _______________________________ Email: _________________________________________ Mobile ____________________________ Pager __________________________________________ Have you ever previously been employed as a teacher with St Margaret’s AGS? (Pls circle) Yes / No If Yes, When ________________________________ If Yes, employed as (Pls circle) Are you currently employed Casual Yes / Temporary Permanent No Section Two: Additional Personal and ID Information Are you currently registered with the Queensland College of Teachers (Pls circle) If yes, registration no ___________________________________ Yes / No / Exempt Were you registered before 1998 Yes / No Expiry Date: ______________________________ Citizenship / residency status Are you an Australian citizen or a permanent resident of Australia If no, attach a statement giving details Yes / No Criminal convictions Have you ever been convicted in a court of law for an offence, other than a traffic offence or an offence which you do not have to disclose by virtue of the provision of the Criminal Law (Rehabilitation of Offenders) Act 1986? Yes / No If yes, you will be required to submit details in an enveloped marked Confidential Other Employment Are you currently on leave from any Commonwealth, State Government department or Private sector organization? Yes / No If yes, attach a statement giving details Section Three: Professional Record (documentation is essential) Please list Tertiary Qualifications. Please supply your application, certified copies of relevant documentation Qualification Name of Institution Major Study Areas Section Four: Teaching Experience Teaching Service (documentary evidence must be provided. Attach a separate sheet if there is insufficient space) Employer State / Independent Work Status F/P/T/C From To Subject areas Section Five: Relevant Professional Development attended in the past 3 years (fully detailed in Curriculum Vitae) Year Course Section Six: Membership of Organisations (Professional, Religious, Cultural, Social, Sporting etc.) Section Seven: Preferred Extra-curricular activities Section Eight: Preferred teaching subjects and level you prefer to teach Description Section Nine: Outside Activities / Hobbies / Interests Section Ten: Professional Referees Referee 1 Full name_______________________________ Address________________________________ Mobile__________________________________ Position / organisation ________________________________ Telephone____________________ Fax___________________ Email_______________________________________________ Referee 2 Full name_______________________________ Address________________________________ Mobile__________________________________ Position / organisation ________________________________ Telephone____________________ Fax___________________ Email_______________________________________________ Referee 3 Full name_______________________________ Address________________________________ Mobile__________________________________ Position / organisation ________________________________ Telephone____________________ Fax___________________ Email_______________________________________________ Section Eleven: Certified copies of qualifications (including academic results) and Teacher Registration to be attached (if not previously sent) Section Twelve: Is your present employer aware of this application / enquiry? Yes / No Section Thirteen: By what date would you be able to take up a new appointment? Section Fourteen: Current salary scale _____________________________________________________________ (certified verification required) Section Fifteen: Applicant’s Declaration __________________________ I certify that the information contained in this application is a true and correct statement of my particulars, qualification, training, experience and competencies. I understand that statements found to be false within my knowledge may make me liable for immediate dismissal. Signature: …………………………………………………………………………………………………………………………………… Date: …………………………………………………………………………………………………………………………………… PLEASE SEND THIS FORM COMPLETED WITH YOUR CURRICULUM VITAE AND APPLICATION