Assessment-Only Application Form Essex, Southend and Thurrock

First Name (s)*

Surname*

Previous surname (s), if changed (N/A if not applicable)*

Email Address:*

Phone Number*

Address*

Date of Birth:*

Nationality:*

Country of birth:*

Country of permanent residence*

Do you need a visa to live and work in the UK?*

Date of first entry to the UK

Date of most recent entry to the UK (excluding holidays)

If you are a non-British EU National who is not living in the UK, will you have been resident in the EU for 3 years prior to the 1st of September of the year in which the AO period begins?*

Do you want to declare any safeguarding issues such as a criminal record or professional misconduct?*

Yes
No

Details of safeguarding issue if applicable?

Disability support - Do you want to ask for help to become a teacher?*

Yes
No
Maybe

COURSE DETAILS

School Setting*

Age Range to be assessed in*

3 - 7
5 - 11
7 - 14
11 - 16

Have you taught across 4 consecutive year groups (and the 2 key stages) within the chosen age range.

Yes
No

If Applying for Primary have you taught all subjects in the National Curriculum for primary schools (this includes: English ,Math, Science, Art and design, Computing, Design & technology, Geography, History, Languages, Music, Physical education)*

Yes
No
Not Applicable (please select if secondary applicant)

If Applying for Secondary please advise which subject you will be assessed in:*

Have you taught in 2 different schools?*

Yes
No

Have you been employed for 2 years or more on the unqualified teachers’ pay scale or equivalent?*

Yes
No

Employment

Please enter your most current role first, we have given you 6 boxes for prior experience if you have further experience you wish to include please send via email to info@ete.org.uk. Please enter N/A in any unused boxes.

Current Role*