Confidential Applica

Application Form
Part 1 - Personal Details
PLEASE COMPLETE IN FULL OTHERWISE YOUR APPLICATION WILL NOT
BE CONSIDERED

Safeguarding Statement

Safeguarding is everybody’s responsibility. At JESS, we are committed to

safeguarding and promoting the welfare of children and young people.
Candidates must therefore be willing to undergo safer recruitment and pre-
employment screening, including reference checks with current and previous
employers, online searches and a criminal record check to include spent
cautions/convictions, enhanced DBS and/or ICPC and police checks for all
countries in which they have resided/worked and their home country. All
candidates who have worked as adults and who have resided in the UK will be
subject to prohibition and barring checks.

Candidates are referred to the Safeguarding and Child Protection policy and
Safer Recruitment Policy on our website.

Your Details - Please type only, no handwriting.

Position applied for: Teacher Title: Full Name (as per passport):
Assistant Rose Angelu Santiago
Mr. ✘ Ms. Mrs. Dr.
School:

Preferred name: Rose Angelu Maiden Name: Adel List other names you have
Santiago been known by/alias names:
Rose

Gender: Date of birth: April 23 2000 Place of birth (City/Country):

Male ✘ Female Age: 25 Awang,Malinao Albay

Nationality: Filipino Marital status: Singel Religion: Roman Catholic

Telephone Numbers: Email addresses:

Home:
Mobile: Personal:
Work:
Home Country: Work:

If you have resided or worked in UK, it is NI Number:

mandatory you provide your National Insurance
Number:

Full residential address in UAE: Home Country address: Home International Airport:
Passport and Immigration Information – If you have more than one passport, please provide
all passport details

Country issuing Passport: Passport No: Passport Expiry Date:

Emirates ID number: Sponsorship Status: List any other Citizenships or

passports held in your name or any
Husband’s visa alias or other names
Employer’s visa (previous/current):
Golden visa
Mother/Father’s visa
Tourist/on arrival visa
Other – please state

Family Details – Spouse and children

Full Name: Occupation:

Child Name: Date of Birth:

Current School:

Current Year Group:

Are you seeking a school place:

Yes No Already at JESS

Child Name: Date of Birth:

Current School:

Current Year Group:

Are you seeking a school place:

Yes No Already at JESS

Child Name: Date of Birth:

Current School:

Current Year Group:

Are you seeking a school place:

Yes No Already at JESS

Note: Candidates must apply through the online portal for a school place. JESS may provide a contribution
to school fees for dependent children attending JESS as per the school policy as is applicable to the role
applied for and staff salary and benefits policy and completion of Verification of Benefits Form to
support that no other tuition support is available. Please note that places are strictly offered subject
to place availability and meeting the entrance requirements. If a school place is not available JESS will
not provide any financial contribution to school fees in lieu.
Your Health, Absence, Accompanying Dependents Health

JESS is an equal opportunities employer. The purpose of the following questions is to ensure that JESS
complies with its obligations.

Do you consider yourself to have

a disability?
If yes, please provide further
details:

Are there any special

arrangements you might require
attending an interview?
If yes, please provide details:

If offered the position are there

any arrangements or adjustments
that JESS would need to make to
enable you to carry out the role?
If yes, please provide details:

How many days have you taken

off work through illness in the last
3 years?
Please provide details:

Do you have any ongoing chronic

medical conditions or operations
pending?
If yes, please give details for
medical insurance application (if
applicable) and disclosure to
include medication/treatment etc.

Are there any other underlying

reasons why you would not be
able to fulfil your professional
responsibilities to the full?
If yes, please provide details:

Do any of your accompanying

family have a medical condition
which could potentially make it
difficult for you to complete a
fixed term contract?
If yes, please provide details:

Please provide details of any pre-

booked holidays during term time
for the current/next academic
year:

Criminal Convictions and Conduct

All information you provide will be treated as confidential and managed in accordance with relevant data
protection legislation and guidance. You must declare all summonses, arrests, convictions, cautions,
warnings, reprimands, current investigation or pending criminal proceedings and professional misconduct
proceedings (past or current) irrespective of whether they are considered ‘spent’. In the event of
employment, failure to disclose any summonses, arrests, convictions, cautions, warnings, reprimands,
current investigation or pending criminal proceedings or professional misconduct proceedings (past or
current) may result in disciplinary action and termination of employment.

JESS will require as part of safer recruitment require you to submit a police clearance
certificate for each country you have worked or resided in and an enhanced DBS and ICPC if
you have worked or resided in the UK before you can commence employment. A Prohibition
check will also be carried out.

Please answer all questions below

Have you ever been arrested or

convicted of a criminal offence
(in any country) or are there any
criminal proceedings or
investigations pending against
you?
If yes, please provide details:

Have you ever been known to any

children’s services department or
to the police as being a risk or
potential risk to children and
young people? If yes, please
provide details:

Have you been the subject of any

disciplinary investigation and/or
sanction by any organization due
to concerns about your behavior
towards children and young
people? If yes, please provide
details:

Have you ever been subject to

disciplinary procedures where the
disciplinary sanction is still current
or where proceedings are
ongoing?
If yes, please provide details:

Have you been prohibited from

teaching or working in a nursery,
school, college or university in any
country or jurisdiction? If yes,
please provide details:

Have you been barred from

working with children or young
people? If yes, please provide
details:

Have there been any low-level

concerns raised against you or
have you self-referred yourself to
your employer? If yes, please give
details:

Is there anyone in your household

who has been or is currently under
investigation or has been
convicted of any offences against
 children or young people? If yes,
please provide details:

Part 2 - Qualifications and Employment

History
QUALIFICATIONS

Secondary/College/University Degree

Please give details of secondary and university/tertiary education and qualifications obtained with the most
recent first. This should include any qualifications you are currently studying for. You will be required to
produce attested copies of your relevant qualifications together with transcripts of all modules studied as part
of your degree for visa and/or KHDA approval. These documents are to be translated into English. The original
certificates are to be brought to HR for verification purposes.

University/College/School and From: To: Qualification Title Class of

address (dd-mm-yy) (dd-mm-yy) Degree
Please state if open
university

Masters/NPQ

Please give details of Masters/NPQ qualifications obtained with the most recent first. This should include any
qualifications you are currently studying for. You will be required to produce attested copies of your relevant
qualifications together with transcripts of all modules studied as part of your degree for visa and/or KHDA
approval. These documents are to be translated into English. The original certificates are to be brought to
HR for verification purposes.

University and address Qualification Obtained Year

Please state if open university Awarded

Professional Qualifications and Memberships

Please give details of your professional qualification(s) obtained. This should include any qualifications you
are currently studying for. You will be required to produce attested copies of your relevant qualifications
together with transcripts of all modules studied as part of your degree for visa and/or KHDA approval. These
documents are to be translated into English. The original certificates are to be brought to HR for verification
purposes.

Institute Attended and Dates Qualification Year Expiry Date:

address: attended: Awarded (if
Please state if open applicable)
university

Membership of Professional Association Membership Number Date:

(if applicable) (dd-mm-yy)

Teacher Registration Number (TRN) - MANDATORY

Please list below all the teacher registration numbers you have for each country you have worked in:

Teacher Registration Number (TRN): Country:

Courses/Workshops and additional achievements

Please provide all the related certificates of attendance related to CPD and other I workshops/courses in
last 5 years. Please continue on a separate sheet if needed.

Title of training program/course Course Provider Date: (dd-mm-yy)

SECONDARY CANDDATES ONLY – additional information

 UK National American British/IB Other – please
IB World
Curriculum Curriculum Hybrid specify

School Curriculum
GCSE IGCSE MYP A-Level IBDP HL IBDP SL BTEC
Qualifications Taught

Please provide the names

details of the qualifications
you have taught on E.G. IB
Maths Applications (HL);
Further Maths IGCSE

UAE EDUCATION AUTHORITIES INFORMATON

Evidence of Meeting KHDA Specific Requirements

Do you have KHDA approval? Yes No
Have you passed the Ministry of Education Yes No
Pedagogy Test
Have you passed the Ministry of Education Yes No
Specialization Test in your cycle and for
your subject
Have you received a Transitional Licence Yes No
Have you received a Certified Licence Yes No

LEISURE ACTIVITIES
LEISURE/NON-WORK ACTIVITIES – Please list your leisure interests, sports and hobbies, other non-work-
related activities:

EMPLOYMENT HISTORY including gaps in employment

Current or Most Recent Employment

Employers name/Self Employed
Address
Telephone number:

Dates of appointment: From: To:

Type of Employment: Full Time Part Time Supply

Current Notice Period or End date of Contract:

All position(s) held and corresponding dates:
Age range of school (if applicable):
Reason for leaving:
Monthly Salary excluding benefits listed below:
Other Benefits received: (Housing Allowance, Living Housing Allowance (amount):
 Allowance, Accommodation:
Medical Insurance:
Flight Allowance (amount):
School Places (how many, discounted or free):
Annual Leave Entitlement:
What is your monthly salary expectation for the role applied AED
excluding benefits?
What is your monthly salary expectation for the role applied AED
including benefits?

Previous Employment

List all paid employment, voluntary work since leaving university. Please continue on a separate
page if required.

We reserve the right to approach any of the previous employers/organizations listed in this
section to confirm the details you have supplied.

Name, address and telephone number of school or employer/Self Employed:

Full Time Part Time Supply Early Years ☐ Primary ☐ Secondary ☐

Dates employed from: Dates employed to:
Position held: Final salary excluding benefits:
Reason for leaving:

Name, address and telephone number of school or employer/Self Employed:

Full Time Part Time Supply Early Years ☐ Primary ☐ Secondary ☐

From: To:
Position held: Final salary excluding benefits:
Reason for leaving:

Name, address and telephone number of school or employer/Self Employed:

Full Time Part Time Supply Early Years ☐ Primary ☐ Secondary ☐

From: To:
Position held: Final salary excluding benefits:
Reason for leaving:

Name, address and telephone number of school or employer/Self Employed:

Full Time Part Time Supply Early Years ☐ Primary ☐ Secondary ☐

From: To:
Position held: Final salary excluding benefits:
Reason for leaving:

Name, address and telephone number of school or employer/Self Employed:

Full Time Part Time Supply Early Years ☐ Primary ☐ Secondary ☐

From: To:
Position held: Final salary excluding benefits:
Reason for leaving:

Name, address and telephone number of school or employer/Self Employed:

Full Time Part Time Supply Early Years ☐ Primary ☐ Secondary ☐

From: To:
Position held: Final salary excluding benefits:
Reason for leaving:
 Gaps in Education or Employment History

Please explain each period where there has been a gap in your education or employment history of
more than 3 months.

From (Month & Year) From (Month & Reasons for gap in employment history
Year)

Part 3 – References, HR Contacts and

Background Checks
Please provide the name and email contact details for three (3) professional referees from whom we will
request a reference on your suitability for the role applied for. One must be your current or most recent
employer and if a teacher your current or most recent two (2) Headteacher or School Principals within the last
6 years. References from friends/relatives will not be accepted. It is our policy to take up email references
prior to the interview. Please ensure the email provided is current.

It is part of our safer recruitment and vetting policy to contact referees prior to interview. Please indicate if we
can contact any one or more of your referees prior to the interview.

I give permission to contact my references prior to the interview.

I give permission to contact my references prior to the interview excluding my current employer.

I do not give permission to contact my references prior to the interview.

Signed: ________________________ Date: _______________________

REFERENCE 1
THIS MUST BE YOUR CURRENT OR MOST RECENT EMPLOYER
FOR ACADEMIC ROLES TTHIS MUST BE YOUR CURRENT HEADTEACHER

Name: Surname: Title:

Mr. Ms. Mrs. Dr.

Relationship to candidate: Organization: Position:

Mobile telephone number: Work email address:

(Please include country code + area code):

Work telephone number:

Personal email address:
(Please include country code + area code):
HR representative name and email address for
pre-employment checks is required:

REFERENCE 2
FOR ACADEMIC ROLES THIS MUST BE AN ADDITIONAL HEADTEACHER IN LAST 6 YEARS OR
PREVIOUS LINE MANAGER WHOSE REFERENCE IS TO BE COUNTERSIGNED BY THE HEADTEACHER

Name: Surname: Title:

Mr. Ms. Mrs. Dr.

Relationship to candidate: Organization: Position:

Mobile telephone number: Work email address:

(Please include country code + area code): Personal email address:

Work telephone number: HR representative name and email address for

pre-employment checks is required:
(Please include country code + area code):

REFERENCE 3

Name: Surname: Title:

Mr. Ms. Mrs. Dr.

Relationship to candidate: Organization: Position:

Mobile telephone number: Work email address:

(Please include country code + area code): Personal email address:

Work telephone number: HR representative name and email address for

pre-employment checks is required:
(Please include country code + area code):

ONLINE and SOCIAL MEDIA SEARCHES:

Online and Social Media searches are required as part of our shortlisting process. If you are shortlisted for
interview an appropriate online search will be undertaken. Any information will be treated as confidential and
will only be used in relation to the role for which you have applied. I understand that online and Social Media
searches will be conducted on my name (s) if I am shortlisted for the role I have applied for. I am also aware
that JESS may want to explore anything they find with me.
The following are my account details
Instagram: _______________________________________________ (insert account name)
Facebook:_________________________________________________ (insert account name)
X (formerly Twitter):_________________________________________ (insert X handle)
LinkedIn: ___________________________________________________(insert name)
TikTok:______________________________________________________( insert account name)
Snapchat:__________________________________________________(insert public profile name)
Signed: ________________________ Date: _______________________

PROHIBITION CHECKS:
As part of our safeguarding and vetting checks we will undertake a prohibition and barring check s. Any
information will be treated as confidential and will only be used in relation to the role for which you have
applied.
I understand that prohibition and barring checks will be conducted if I am shortlisted for the role I have
applied for and I have provided all relevant information such as my National Insurance number, Full
name(s), Date of Birth and Teacher Registration Numbers for each country in which I was registered as a
teacher. I am also aware that JESS may want to explore anything they find with me.

Signed: ________________________ Date: _______________________

DECLARAION
 I declare that the information I have provided is complete and true to the best of my knowledge
and belief.
 I understand that any offer of appointment and subsequent employment is strictly subject and
conditional on this declaration and safer recruitment checks and if my application is incomplete,
untrue, or inaccurate then JESS shall be entitled to withdraw any offer of appointment or
terminate any contract of employment. prior to or after contract commencement date or
thereafter.
 I understand that the information provided on this application form will be used to form the basis
of a personnel file and computerized personnel record should an offer of appointment be made.
 I confirm that there is no information in the public domain or on social medial platforms that
could bring my name or the school’s name into disrepute.
 I acknowledge that I have an ongoing duty to inform the school immediately if I or a member of
my household is arrested or investigated by any regulatory authority into any matters relating to
behaviors or concerns towards children and young persons.
 I understand that the information contained in my application form(s), the results of any police
certificates of good conduct. Enhanced DBS and/or ICPC and information provided by third
parties (referees, previous employers) may be supplied to other persons or organisations in
circumstances where the school considers this necessary to safeguard children and young
persons.
Signed: ________________________ Date: _______________________

Should I not be successful in my application I confirm that I

 Consent
  Do not consent

To my details being retained by JESS after six months from date of notification of unsuccessful
application.

Signed: _______________________ Date: ________________________