Scale A Teaching Position Application Form

Application
Monrad Intermediate
228 Botanical Rd,
Palmerston North 4412
principal@monrad.school.nz

Positions advertised online Friday 4 October 30 2019
Applications for positions close Friday 18 October, 3.00pm
Shortlisting of applicants Saturday 19 October
Interviews Tuesday 22 or Wednesday 23 October
Offer of appointment made/ Friday 25 October
Position Commences Monday 29 January 2020



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Email *
Surname
Given Names
Preferred name
Address
Date of birth
MM
/
DD
/
YYYY
Home number
Cell number
Work number
Email address
Certified Teacher Status
Clear selection
Present Teaching Position
School
Date Appointed
MM
/
DD
/
YYYY
Type of Appointment
Can we contact your principal about this position?
Clear selection
Educational Qualifications
Type of qualification/s
Confirmation
I certify that the information given in this application is, to the best of my knowledge, true and correct. I understand that the claims made in my application may be checked.I understand that if I have supplied incorrect or misleading information, or have omitted any important information, I may be disqualified from appointment, or if appointed, may be dismissed.
Clear selection
I am currently registered to teach in New Zealand.
Clear selection
In accordance with the Privacy Act, I authorise the board of trustees to:                                    Obtain further information from the referees listed in this application, and I consent to the referees disclosing such information to the boardObtain information in relation to my application from persons not listed as referees, and I consent to these persons disclosing pertinent information to the board.Contact the Education Council.
Clear selection
I have never been the subject of a complaint about the safety of a student.
Clear selection
I have been the subject of a complaint about the safety of a student.
Clear selection
I have been the subject of a complaint about the safety of a student.
Clear selection
I have no pending charges of an offence against the law.
Clear selection
I have been convicted of an offence against the law.
Clear selection
I know of no reason why I would not be suitable to work with children or young people.
Clear selection
Applicants digital signature
Referees
Please provide the names and contact details of two referees below. Referees’ reports are confidential to the board. Referees will only be contacted for candidates who are short-listed.
Full Name (Referee 1)
Position
Relationship to the applicant
Contact Details
Full Name
Position
Relationship to the applicant
Home number
Cell number
Work number
Full Name (Referee 2)
Position
Relationship to the applicant
Home number
Cell number
Work number
Submit
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