Locked Bag 42 Wollongong NSW 2500 • situated at 15 Harbour Street Telephone 4228 6011 • Fax 4229 8555 ABN 70 309 539 954
APPLICAT ION FOR EMPLOYMENT: TEACHING STAFF Pleasereturn your completed form to The Principal, St Mary Star of the SeaCollege, Locked Bag 42, Wollongong 2500, or email it to stmarys@stmarys.nsw.edu.au. Attach your curriculum vitae which should include details of your achievements and experience of working in schools. Please follow the link under Employment on the college website (http://www.stmarys.nsw.edu.au) to complete child protection screening.
APPLICAT ION FOR THE POSITION OF Date of application
PERSONAL DETAILS Surname Title [Mr Mrs Ms Miss Dr] Given names Preferred first name Residential address Postal address Residential phone Businessphone Mobile Email address Date of birth [day/month/year] Country of birth
Nationality*
Marital status Religion
SECONDARY EDUCATION Highest qualification School Year completed
TERTIARY EDUCATION
[include details of institution, years attended, award conferred, date conferred] **
TEACHI NG QUALIF ICAT IO NS
**
Qualified to teach [subjects]
TEACHI NG EXPERIENCE Current teacher classification/level Total number of years teaching [School , position, subjects taught, year, part or full-time, number of terms]
RELIG IOUS EDUCATION QUALIF ICAT IONS
[include Institution, years attended, qualification conferred,
date conferred] **
NSW INSTITU TE OF TEACHERS New scheme teachers (newly-graduated teachers, interstate and overseasteachers) intending to teach for the first time in NSWfrom 1 October 2004 must complete the NSWInstitute’s Form A. Qualified teachers (also deemed new scheme teachers) returning to teaching in NSWafter an absence of five or more years must complete the Institute’s Form B. The forms can be downloaded from the website www.nswteachers.nsw.edu.au .
Are you a member of the NSWInstitute of Teachers? If you are a member, please provide your membership number What is your accreditation level? If you cannot provide a membership number, please indicate the reason below: I was qualified and teaching (BOSsubjects) in NSW, some time in the five years before 1 October 2004 My application is now with the Institute I am unaware of the Institute and its requirements I will be joining the Institute with this application
OTHER TRAIN I NG/ QUALIF ICAT IONS
[include Institution, years attended, qualification conferred, date
conferred] **
OTHER EMPLOYMEN T
[include institution, occupation, dates]
PROFESSIONAL ASSOCIATIONS OF WHICH YOU ARE A MEMBER
NOMINATED PROFESSIONAL REFEREES
DECLARATION : All appropriate documentation is available if requested.
[include name, organisation, position, telephone number]
To the best of my knowledge there is nothing about my health which would prevent me carrying out the full range of duties of a teacher, including student supervision and co-curricular duties. Signed ***
Date
* If not an Australian citizen, you will be required to provide a copy of your current visa ** If your application is successful, you will be required to produce official academic records *** If you do not have an electronic signature, you will be asked to sign this document at interview