JOB APPLICATION COVER SHEET- ACADEMIC Your Details

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