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Joseph Leckie Academy

  • Develop, Inspire, Promote, Encourage & Respect

Teaching Staff - Online Application Form

The post you are applying for is EXEMPT from the Rehabilitation of Offenders Act (1974). This means that you are required to give details of any ‘spent’ and ‘unspent’ convictions or pending cases, cautions, bind-over orders, reprimands and final warnings, including dates, the offence(s), sentences, and the court or police force which dealt with the offence. This Academy is committed to safeguarding and promoting the welfare of children and young people and expects all staff and volunteers to share this commitment.

How to complete this form:
♦ Read all the information and guidance notes before you complete this application form
♦ Do not attach a CV, as the Academy will not consider it
♦ Answer all the questions. All boxes marked with an * are required fields.
♦ Please ensure that you complete the declaration in Section 7 of this form.

All data is held in accordance with the Data Protection Act 2018 and will be kept on file for at least 6 months from the date of application.

Once completed, please return this form to: Keith Whittlestone, Joseph Leckie Academy Walstead Road West, Walsall, WS5 4PG.

Guidance Notes for Applicants

Applicants are requested to read carefully the following notes and any further particulars for the post before signing the declaration in Section 7.

(i) Acknowledgement of Applications
Your application for this post will only be acknowledged if you enclose with it a stamped addressed envelope.

(ii) Notification of Result
It is the policy of Joseph Leckie Academy that, in order to keep administrative costs to a minimum, notice of the result of an application shall not be sent to an unsuccessful candidate who is not called for interview for any post. If, therefore, you do not hear within 6 weeks of the closing date for applications for this post, you should normally assume that an appointment has been made.

(iii) Disclosure of Relationship
A candidate for any post at Joseph Leckie Academy who knows that he/she is related to any governor or Employee of Joseph Leckie Academy, must disclose the relationship. A candidate who fails to disclose such a relationship is disqualified from appointment and if appointed is liable to dismissal without notice.

Section 1 - Employment

a.) Present Employment (or most recent)

b.) Previous Teaching Appointments (in chronological order, beginning with the first).

 Title of PostFull-time or Part-timeEstablishment & name of LEA or other employerSex & No. of pupils on rollPeriod of Service (From & To)
 Title of PostFull-time or Part-timeName and Address of EmployerSalaryPeriod of Service (From and To)

Section 2: Education

a. Post 16 qualifications, in chronological order.

For Teaching Qualifications please include details of any special areas of study, including student age ranges.

 Name and Address of EstablishmentFrom (mm/yy)To (mm/yy)Full-time or part-timeQualificationDate Awarded
 CourseDateQualification Achieved (if applicable)

Section 3: Other Information


Are you in receipt of a pension*
Please specify which fund(s):
Have you opted out of the teachers' Superannuation Scheme?*

Driving Licence

Do you hold a valid Driving Licence?*

Disclosure of Relationships

Are you related to any employee or governor of Joseph Leckie Academy?*

If 'Yes', please state the individual's:

d. Candidates with Disabilities

Joseph Leckie Academy will guarantee an interview for any disabled candidate that meets the criteria for the job. In order to help us fulfil this commitment, if you have a disability please tell us about any special requirements or equipment which may assist you:

Whilst we would encourage you to complete this section in order that we can meet any requirements you may have, completion is optional.

d. Personal Statement

In support of your application you are invited to attach a statement giving your reasons for applying for this post. Please include any information which you consider relevant to this application. This is a very important part of the information you supply to us.

Section 4: References

Reference 1:

Reference 2:

If either of your references know you by a different name, please state it below:

Section 5: Criminal Disclosure and Rehabilitation of Offenders Act (1974)

The post you are applying for is exempt from the Rehabilitation of Offenders Act (1974). Joseph Leckie Academy requires you to give details of all current (unspent) and ‘spent’ convictions or pending cases, cautions, bind-over orders, reprimands and final warnings, including dates, the offence(s), sentences, and the court or police force which dealt with the offence. Any offer of employment will be made on a conditional basis, subject to the relevant checks being carried out.

Failure to make a full and accurate declaration may result in withdrawal of a job offer or, if subsequently discovered, to disciplinary action and/or dismissal.

You are required to complete the following declarations:

Section 6: Personal Details

Section 7: Declaration

Having read the contents of this form, I hereby apply for the post at Joseph Leckie Academy in accordance with the conditions stated therein. I declare that information I have given on this form is correct and I understand that failure to complete the form fully and accurately could result in an incorrect assessment of salary and/or exclusion from shortlisting.


Joseph Leckie Academy is committed to a policy of ensuring equality of opportunity in employment for all, and to taking action to avoid discrimination. Job applicants are considered only on their ability to do the job for which they are applying. To see whether this policy is having any effect we need to monitor the sex, marital status, age, ethnic origin and disabilities of job applicants and you are therefore requested to provide personal details on this tear-off slip.

The information will be used ONLY to monitor practices and will be treated confidentially. It will not be revealed outside the Academy except as part of an overall equal opportunities statistical report which could not identify individuals. All unsuccessful application forms are destroyed after six months.

Please tick as appropriate:



Asian or Asian British
Black or Black British
Chinese and Other Groups
Do you need a work permit to work in the UK*

Under the Disability Discrimination Act 1995, the definition of disability is:

‘A physical or mental impairment which has substantial and long-term adverse effect on a person’s ability to carry out normal day-to-day activities.’

Do you have such a disability?
Did you see the job advertised on Walsall Council Website/Jobshop?
Did you see the job advertised in TES/TES website?
Did you see the job advertised in another publication or on another website?*