Head of Epsom College application form

Thank you for your interest in becoming the 16th Head of Epsom College. To submit your application, please complete the form below.

A copy of Epsom College’s Recruitment, Selection and Disclosure Policy and Procedure is available here. Please take the time to read it.

1Your Details

2Education & Training

3Further/Higher Education

4Training, Skills & Employment

5Gaps in Employment

6Suitability for the Role

7References

8Safeguarding

9Declaration

Personal details
Your name*
Title First Name
Last name*
Hidden
First Name
Former surname (if applicable)
National Insurance Number*
Date of birth*

Day
Month
Year
Address*
Street Address Town/City County Postcode Country
Home telephone number
Mobile telephone number*
Hidden
Work telephone number
Email address*
What is your ethnic group?*
Which of the following best describes your 'White' background?*
Which of the following best describes your 'Mixed or Multiple ethnic groups' background?*
Which of the following best describes your 'Asian or Asian British' background?*
Which of the following best describes your 'Black, African, Caribbean or Black British' background?*
Which of the following best describes your background?*
Are you eligible to work in the UK in the job for which you have applied?*
- Yes, permanently
- Yes, on a temporary basis
- No
Please provide details*
Are you related to, or do you maintain a close relationship with an existing employee, volunteer, Governor or Trustee?*
- Yes
- No
Please provide details*

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Education and vocational qualifications/training
Please start with the most recent
Do you have Qualified Teacher Status?*
- Yes
- No
Teacher's TR Number*
Please select the number of schools you have attended*
Education institution one
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of school
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.
Education institution two
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of school
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.
Education institution three
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of school
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.
Education institution four
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of school
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.
Education institution five
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of school
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.
Education institution six
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of school
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.
Education institution seven
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of school
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.
Education institution eight
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of school
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.
Education institution nine
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of school
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.
Education institution ten
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of school
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.
Education institution eleven
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of school
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.
Education institution twelve
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of school
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.

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Further and Higher Education
When entering the details, please start with the most recent.
Please select the number of Further or Higher Education establishments you have attended*
Education institution one
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of Further/Higher Education establishment
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.
Education institution two
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of Further/Higher Education establishment
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.
Education institution three
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of Further/Higher Education establishment
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.
Education institution four
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of Further/Higher Education establishment
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.
Education institution five
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of Further/Higher Education establishment
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.
Education institution six
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of Further/Higher Education establishment
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.
Education institution seven
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of Further/Higher Education establishment
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.
Education institution eight
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of Further/Higher Education establishment
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.
Education institution nine
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of Further/Higher Education establishment
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.
Education institution ten
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of Further/Higher Education establishment
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.
Education institution eleven
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of Further/Higher Education establishment
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.
Education institution twelve
Attended from

Day
Month
Year
Attended to

Day
Month
Year
Name of Further/Higher Education establishment
Qualifications received*
Please include date received, type of exam and grade awarded. If you did not achieve any qualifications please state this.

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Vocational qualifications, skills or training
Please provide details of any vocational qualifications or skills that you possess or training that you have received which you consider to be relevant to Epsom College
Employment
Current, or most recent, employer*
Current, or most recent, employer's address*
Street Address Town/City Postcode Country
Current, or most recent, job title*
Date started*

Day
Month
Year
Date ended (if applicable)

Day
Month
Year
Brief description of responsibilities*
Please select the number of previous posts and responsibilities undertaken with current employer*
Previous role one
Date started

Day
Month
Year
Date ended

Day
Month
Year
Description
Previous role two
Date started

Day
Month
Year
Date ended

Day
Month
Year
Description
Previous role three
Date started

Day
Month
Year
Date ended

Day
Month
Year
Description
Previous role four
Date started

Day
Month
Year
Date ended

Day
Month
Year
Description
Previous role five
Date started

Day
Month
Year
Date ended

Day
Month
Year
Description
Previous role six
Date started

Day
Month
Year
Date ended

Day
Month
Year
Description
Previous role seven
Date started

Day
Month
Year
Date ended

Day
Month
Year
Description
Previous role eight
Date started

Day
Month
Year
Date ended

Day
Month
Year
Description
Previous role nine
Date started

Day
Month
Year
Date ended

Day
Month
Year
Description
Previous role ten
Date started

Day
Month
Year
Date ended

Day
Month
Year
Description
Please state when you would be available to take up employment if offered

Day
Month
Year
Previous employment
Please include all previous roles since leaving secondary education, including details of any gaps in your employment history, along with the dates relevant to the gaps. Please start with the most recent first.
Please select the number of previous roles you would like to list here*
Previous role one
Date started*

Day
Month
Year
Date ended*

Day
Month
Year
Job title*
Employer's name*
Employer's address*
Street Address Town/City Postcode Country
Employer's phone number
Employer's email address
Reasons for leaving*
Previous role two
Date started*

Day
Month
Year
Date ended*

Day
Month
Year
Job title*
Employer's name*
Employer's address*
Street Address Town/City Postcode Country
Employer's phone number
Employer's email address
Reasons for leaving*
Previous role three
Date started*

Day
Month
Year
Date ended*

Day
Month
Year
Job title*
Employer's name*
Employer's address*
Street Address Town/City Postcode Country
Employer's phone number
Employer's email address
Reasons for leaving*
Previous role four
Date started*

Day
Month
Year
Date ended*

Day
Month
Year
Job title*
Employer's name*
Employer's address*
Street Address Town/City Postcode Country
Employer's phone number
Employer's email address
Reasons for leaving*
Previous role five
Date started*

Day
Month
Year
Date ended*

Day
Month
Year
Job title*
Employer's name*
Employer's address*
Street Address Town/City Postcode Country
Employer's phone number
Employer's email address
Reasons for leaving*
Previous role six
Date started*

Day
Month
Year
Date ended*

Day
Month
Year
Job title*
Employer's name*
Employer's address*
Street Address Town/City Postcode Country
Employer's phone number
Employer's email address
Reasons for leaving*
Previous role seven
Date started*

Day
Month
Year
Date ended*

Day
Month
Year
Job title*
Employer's name*
Employer's address*
Street Address Town/City Postcode Country
Employer's phone number
Employer's email address
Reasons for leaving*
Previous role eight
Date started*

Day
Month
Year
Date ended*

Day
Month
Year
Job title*
Employer's name*
Employer's address*
Street Address Town/City Postcode Country
Employer's phone number
Employer's email address
Reasons for leaving*
Previous role nine
Date started*

Day
Month
Year
Date ended*

Day
Month
Year
Job title*
Employer's name*
Employer's address*
Street Address Town/City Postcode Country
Employer's phone number
Employer's email address
Reasons for leaving*
Previous role ten
Date started*

Day
Month
Year
Date ended*

Day
Month
Year
Job title*
Employer's name*
Employer's address*
Street Address Town/City Postcode Country
Employer's phone number
Employer's email address
Reasons for leaving*
Previous role eleven
Date started*

Day
Month
Year
Date ended*

Day
Month
Year
Job title*
Employer's name*
Employer's address*
Street Address Town/City Postcode Country
Employer's phone number
Employer's email address
Reasons for leaving*
Previous role twelve
Date started*

Day
Month
Year
Date ended*

Day
Month
Year
Job title*
Employer's name*
Employer's address*
Street Address Town/City Postcode Country
Employer's phone number
Employer's email address
Reasons for leaving*
Previous role thirteen
Date started*

Day
Month
Year
Date ended*

Day
Month
Year
Job title*
Employer's name*
Employer's address*
Street Address Town/City Postcode Country
Employer's phone number
Employer's email address
Reasons for leaving*
Previous role fourteen
Date started*

Day
Month
Year
Date ended*

Day
Month
Year
Job title*
Employer's name*
Employer's address*
Street Address Town/City Postcode Country
Employer's phone number
Employer's email address
Reasons for leaving*
Previous role fifteen
Date started*

Day
Month
Year
Date ended*

Day
Month
Year
Job title*
Employer's name*
Employer's address*
Street Address Town/City Postcode Country
Employer's phone number
Employer's email address
Reasons for leaving*
Hidden
Reasons for applying for this role
Hidden
Please give a written statement, outlining why you are applying for this role.*

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References
Please supply the names and contact details of two people who we may contact for references. One of these must be your current or most recent employer. If your current/most recent employment does/did not involve work with children, then your second referee should be from your employer with whom you most recently worked with children. None of the referees should be a relative or someone known to you solely as a friend. The School intends to take up references from all shortlisted candidates before interview. The School reserves the right to take up references from any previous employer.
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References Disclaimer
Please supply the names and contact details of two people who we may contact for references. One of these must be your current or most recent employer. If your current/most recent employment does/did not involve work with children, then your second referee should be from your employer with whom you most recently worked with children. None of the referees should be a relative or someone known to you solely as a friend. The School intends to take up references from all shortlisted candidates before interview. The School reserves the right to take up references from any previous employer.
Referee 1
Name*
Organisation*
Address*
Street Address Town/City Postcode Country
Job title*
Telephone number*
Email*
Referee 2
Name*
Organisation*
Address*
Street Address Town/City Postcode Country
Job title*
Telephone number*
Email*

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Recruitment
It is Epsom College’s policy to employ the best qualified personnel and to provide equal opportunity for the advancement of employees including promotion and training and not to discriminate against any person because of their race, colour, national or ethnic origin, sex, sexual orientation, marital status, religion or religious belief, disability or age. All new posts within Epsom College are subject to a probationary period.
Appointment as a Head of Department is an additional responsibility and therefore attracts a supplementary emolument. The Head of Department role is tenable for 7 years and may be extended by a further 3 years, subject to review and agreement by the Head.
Epsom College is committed to safeguarding and promoting the welfare of children and young people and expects all staff and volunteers to share this commitment.
If your application is successful, Epsom College will retain the information provided in this form (together with any attachments) on your personnel file. If your application is unsuccessful, all documentation relating to your application will normally be confidentially destroyed. However, please indicate below if you would like Epsom College to retain your details on file so that you can be notified of future vacancies which may be of interest to you.
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Recruitment Disclaimer
It is Epsom College’s policy to employ the best qualified personnel and to provide equal opportunity for the advancement of employees including promotion and training and not to discriminate against any person because of their race, colour, national or ethnic origin, sex, sexual orientation, marital status, religion or religious belief, disability or age. All new posts within Epsom College are subject to a probationary period. Appointment as a Head of Department is an additional responsibility and therefore attracts a supplementary emolument. The Head of Department role is tenable for 7 years and may be extended by a further 3 years, subject to review and agreement by the Head. Epsom College is committed to safeguarding and promoting the welfare of children and young people and expects all staff and volunteers to share this commitment. If your application is successful, Epsom College will retain the information provided in this form (together with any attachments) on your personnel file. If your application is unsuccessful, all documentation relating to your application will normally be confidentially destroyed. However, please indicate below if you would like Epsom College to retain your details on file so that you can be notified of future vacancies which may be of interest to you.
Criminal Records
An offer of employment is conditional upon the School receiving an Enhanced Disclosure from the Disclosure and Barring Service (DBS) which the School considers to be satisfactory. The School applies for an Enhanced Check for Regulated Activity from the DBS (which includes a check of the Children’s Barred List) in respect of all positions at the School which amount to regulated activity. It is unlawful for the School to employ anyone who is barred from working with children.
In addition, the School will also undertake other statutory checks required to comply with legislation when working within a school. It is a criminal offence for any person who is barred from working with children to attempt to apply for a position at the School.
If you are successful in your application you will be required to complete an enhanced DBS Disclosure Application Form. Any information disclosed will be handled in accordance with any guidance and/or code of practice published by the DBS.
If you are successful in being shortlisted for this role you will be required to provide information about your suitability to work with children by completing a self-declaration form. In this form you will be required to provide details of all spent and unspent convictions and cautions.
The School is exempt from the Rehabilitation of Offenders Act 1974 and therefore all convictions, cautions, reprimands and final warnings (including those which would normally be considered “spent" under the Act) must be declared. You are not required to disclose a caution or conviction for an offence committed in the United Kingdom if it has been filtered in accordance with the DBS filtering rules. If you have a criminal record this will not automatically debar you from employment. Instead, each case will be assessed fairly by reference to the School’s objective assessment procedure set out in the School’s Recruitment, Selection and Disclosure Policy and Procedure.
Hidden
Criminal Record Disclaimer
An offer of employment is conditional upon the School receiving an Enhanced Disclosure from the Disclosure and Barring Service (DBS) which the School considers to be satisfactory. The School applies for an Enhanced Check for Regulated Activity from the DBS (which includes a check of the Children’s Barred List) in respect of all positions at the School which amount to regulated activity. It is unlawful for the School to employ anyone who is barred from working with children. In addition, the School will also undertake other statutory checks required to comply with legislation when working within a school. It is a criminal offence for any person who is barred from working with children to attempt to apply for a position at the School. If you are successful in your application you will be required to complete an enhanced DBS Disclosure Application Form. Any information disclosed will be handled in accordance with any guidance and/or code of practice published by the DBS. If you are successful in being shortlisted for this role you will be required to provide information about your suitability to work with children by completing a self-declaration form. In this form you will be required to provide details of all spent and unspent convictions and cautions. The School is exempt from the Rehabilitation of Offenders Act 1974 and therefore all convictions, cautions, reprimands and final warnings (including those which would normally be considered “spent" under the Act) must be declared. You are not required to disclose a caution or conviction for an offence committed in the United Kingdom if it has been filtered in accordance with the DBS filtering rules. If you have a criminal record this will not automatically debar you from employment. Instead, each case will be assessed fairly by reference to the School’s objective assessment procedure set out in the School’s Recruitment, Selection and Disclosure Policy and Procedure.
Have you received a caution for, or been convicted of, any criminal offence whether in the United Kingdom or in another country? You are not required to disclose a caution or conviction for an offence committed in the United Kingdom which is subject to the DBS filtering rules.*
- Yes
- No
Details*
Is there any relevant court action pending against you?*
- Yes
- No
Please provide details on a separate email marked 'Strictly Confidential' to the Director of HR, denise.regan@epsomcollege.org.uk

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Declaration
A copy of Epsom College’s Recruitment, Selection and Disclosure Policy and Procedure is available here. Please take the time to read it.
- I confirm that the information I have given on this application form is true and correct to the best of my knowledge.
- I confirm that I am not on the Children's Barred list or disqualified from work with children.
- I understand that providing false information is an offence which could result in my application being rejected or (if the false information comes to light after my appointment) summary dismissal and may amount to a criminal offence.
- I confirm that I am not subject to a prohibition order from teaching within the UK.
- I confirm that I am not prohibited from being involved in the management of an independent school.
- I understand that the College will collect and process personal information relating to my application for employment with the College, in accordance with the Recruitment Privacy Policy.
- I confirm I have read the College's Child Protection Policy; Code of Conduct For Staff; Whistleblowing Policy; Recruitment, Selection and Disclosure Policy; Recruitment Privacy Policy; and the Government's Keeping Children Safe in Education guidance on the College's website.
Epsom College is committed to safeguarding and promoting the welfare of children and young people and expects all staff and volunteers to share this commitment. Where this form is submitted electronically and without signature, electronic receipt of this form by the School will be deemed equivalent to submission of a signed version and will constitute confirmation of the declaration above.
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Tick below to confirm you have read and understood the above declaration*
- Yes, I have read and understood the declaration
Tick below to confirm you have read and understood the above declaration*
Yes, I have read and understood the declaration
A copy of Epsom College’s Recruitment, Selection and Disclosure Policy and Procedure is available here. Please take the time to read it.
- I confirm that the information I have given on this application form is true and correct to the best of my knowledge.
- I confirm that I am not on the Children's Barred list or disqualified from work with children.
- I confirm that I am not prohibited from being involved in the management of an independent school.
- I understand that providing false information is an offence which could result in my application being rejected or (if the false information comes to light after my appointment) summary dismissal and may amount to a criminal offence.
- I understand that the College will collect and process personal information relating to my application for employment with the College, in accordance with the Recruitment Privacy Policy.
- I confirm I have read the College's Child Protection Policy; Code of Conduct For Staff; Whistleblowing Policy; Recruitment, Selection and Disclosure Policy; Recruitment Privacy Policy; and the Government's Keeping Children Safe in Education guidance on the College's website.
Epsom College is committed to safeguarding and promoting the welfare of children and young people and expects all staff and volunteers to share this commitment.

Where this form is submitted electronically and without signature, electronic receipt of this form by the School will be deemed equivalent to submission of a signed version and will constitute confirmation of the declaration above.
Would you like Epsom College to retain your details if your application is unsuccessful?
- Yes
- No

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Important Safeguarding & Recruitment Policies

All candidates should read the following School policies

Recruitment ID Documentation Requirements Keeping Children Safe in Education Child Protection and Safeguarding Policy Staff Code of Conduct Recruitment, Selection & Disclosure Policy Whistleblowing Policy Recruitment Privacy Notice Self Declaration & Criminal History Form

Head of Epsom College

Personal details

Education and vocational qualifications/training

Education institution one

Education institution two

Education institution three

Education institution four

Education institution five

Education institution six

Education institution seven

Education institution eight

Education institution nine

Education institution ten

Education institution eleven

Education institution twelve

Further and Higher Education

Education institution one

Education institution two

Education institution three

Education institution four

Education institution five

Education institution six

Education institution seven

Education institution eight

Education institution nine

Education institution ten

Education institution eleven

Education institution twelve

Vocational qualifications, skills or training

Employment

Previous role one

Previous role two

Previous role three

Previous role four

Previous role five

Previous role six

Previous role seven

Previous role eight

Previous role nine

Previous role ten

Previous employment

Previous role one

Previous role two

Previous role three

Previous role four

Previous role five

Previous role six

Previous role seven

Previous role eight

Previous role nine

Previous role ten

Previous role eleven

Previous role twelve

Previous role thirteen

Previous role fourteen

Previous role fifteen

Reasons for applying for this role

Gaps In Employment

Suitability for this role

Interests

Covering letter

References

Recruitment

Criminal Records

Declaration

Important Safeguarding & Recruitment Policies

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