Summer Centre applicant form

Please make sure you have read the job description fully for the position you are applying for

Position * Roving Manager Centre Manager Director of Studies Assistant Director of Studies Teacher Assistant Centre Manager Activity Manager Assistant Activity Manager Activity Leader Administrative Assistant

When are you available for work?

Available from

Available to

Do you need any specific days off during this employment?

Dates

Reason

If you have worked for Churchill House before, please give details

Centre

Year

Which centre would you prefer to work in?

Please list three in order of preference. All sites are residential positions.

First choice * Churchill House Junior Summer Courses, Ramsgate Aldenham School, Elstree, Hertfordshire Ampleforth College, York, North Yorkshire HLC Harrogate Hooke Court, Nr Beaminster, Dorset Prior Park College, Bath, Somerset Frensham Heights School, Farnham, Surrey Royal Russell School, Croydon, Surrey Trent College, Long Eaton, Nottingham St. Lawrence College, Ramsgate, Kent

Second choice * Churchill House Junior Summer Courses, Ramsgate Aldenham School, Elstree, Hertfordshire Ampleforth College, York, North Yorkshire HLC Harrogate Hooke Court, Nr Beaminster, Dorset Prior Park College, Bath, Somerset Frensham Heights School, Farnham, Surrey Royal Russell School, Croydon, Surrey Trent College, Long Eaton, Nottingham St. Lawrence College, Ramsgate, Kent

Third choice * Churchill House Junior Summer Courses, Ramsgate Aldenham School, Elstree, Hertfordshire Ampleforth College, York, North Yorkshire HLC Harrogate Hooke Court, Nr Beaminster, Dorset Prior Park College, Bath, Somerset Frensham Heights School, Farnham, Surrey Royal Russell School, Croydon, Surrey Trent College, Long Eaton, Nottingham St. Lawrence College, Ramsgate, Kent

Contact details

Title (Mr, Mrs, Ms...) *

First name *

Surname *

Date of birth *

Nationality *

Email *

Telephone number *

Mobile number

Skype name

Permanent address *

Post Code *

Other address

Post Code

Further information

Churchill House is unable to assist in any way regarding applying for work permits or travel visas for its employees. Are you eligible to work in the UK?

Yes No

Do you hold a full, current and clean EU driving license?

Yes No

If you consider yourself to be disabled under the Equality Act (2010), how can we best support you if you are short listed for interview?

Please detail

Are you aware of any health conditions or disability which may impair your ability to carry out the manual handling and / or active tasks detailed in the job description?

Yes No

Do you have any food allergies? Or dietary requirements?

Please give details below regarding your academic achievements. Please post us photocopies of your qualifications, or email scanned images to recruitment@churchillhouse.co.uk.

Please note you will need to bring the original certificates to the centre you are working at in order to commence work (so please make sure you have access to them). Please do not send original certificates by post as we cannot guarantee their safe return.

TEFL Qualifications (if applying for a teacher or academic position)

Please ensure your qualifications meet the requirements stated in the job description.

Name of Institution
Qualification awarded
Awarding Body
Grade if applicable
Date awarded

Name of Institution
Qualification awarded
Awarding Body
Grade if applicable
Date awarded

Other Qualifications (all candidates)

Please include relevant GCSE, A-Level, Degree, etc.

Name of Institution
Qualification / Subject
Awarding Body
Grade if applicable
Date awarded

Name of Institution
Qualification / Subject
Awarding Body
Grade if applicable
Date awarded

Name of Institution
Qualification / Subject
Awarding Body
Grade if applicable
Date awarded

Name of Institution
Qualification / Subject
Awarding Body
Grade if applicable
Date awarded

Name of Institution
Qualification / Subject
Awarding Body
Grade if applicable
Date awarded

Non-academic qualifications

First Aid Qualification

Lifesaving Qualification

Other non-academic qualifications

Teaching experience (if applying for a teaching or academic position)

How much experience do you have (months, years) teaching the following students?

Juniors (8-11)

UK Overseas

Young Learners (12-15)

UK Overseas

Adults (18+)

UK Overseas

Under 8 years old

UK Overseas

Employment history and relevant experience

Please include details of experience in summer schools, management positions; supervision of children; organisation of sporting and social activities etc. If you haven’t already sent us your CV, please do so. You may email it to recruitment@churchillhouse.co.uk. Please explain any gaps in employment.

Name and Address of Employer
Position Held
Main Duties
Reason for Leaving
From
To

Name and Address of Employer
Position Held
Main Duties
Reason for Leaving
From
To

Name and Address of Employer
Position Held
Main Duties
Reason for Leaving
From
To

Name and Address of Employer
Position Held
Main Duties
Reason for Leaving
From
To

Name and Address of Employer
Position Held
Main Duties
Reason for Leaving
From
To

Please give the names of two professional referees who may be contacted.

Name
Position
Address
Telephone
Email
May be approached prior to interview
Please do not approach prior to interview

Name
Position
Address
Telephone
Email
May be approached prior to interview
Please do not approach prior to interview

Churchill House will approach referees in all cases where the applicant is accepted for one of these positions. Your personal details will be recorded on our computers in accordance with our registration under the Data Protection Act 1998.

Managers do not have to complete this section

During the summer you are expected to take part in and/or lead afternoon, evening and weekend activities. Please complete the form below rating your ability. This information helps us assign you more appropriately to the summer activities. If you are applying for a teaching position, you will usually be placed on the half day excursion.

Sports

Team games Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Basketball Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Football Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Tennis Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Badminton Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Volleyball Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Netball Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Rounders Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Table tennis Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Cricket Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Swimming Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Ice skating Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Other (Please detail)

Performing Arts

Drama workshops Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Singing Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Street dancing Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Salsa dancing Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Other dancing (Please detail)

Can you play any musical instruments?

Piano

Guitar

Bass

Drums

Other instruments (Please detail)

Arts and Crafts

Bracelet making Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Face painting Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Drawing Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Painting Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Origami Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Card making Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Mask making Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Fabric painting Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Paper maché Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Tie dying Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Model making Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Scrapbook Making Please select... Qualified/highly experienced to do this activity Experience of doing this activity Able to supervise Little to no experience of this activity

Other (Please detail)

Child Protection and Children Act 1989 Declaration

Churchill House operates its own Child Protection Policy in accordance with UK legislation. We take the recruitment of all personnel very seriously in order to safeguard the well being of all our staff and students. Please answer these questions carefully in accordance with Children Act 1989.

Have you ever:

1. been convicted of any offence against a child?
Yes No

2. had a child removed from your care by the Order of a Court?
Yes No

3. had a prohibition imposed on you at any time?
Yes No

4. been disqualified from acting as a foster parent?
Yes No

5. been proven negligent whilst supervising under 16’s on activities/courses organised by any other organisation?
Yes No

If you have answered ‘yes’ to any of the above questions, please supply the dates and circumstances in the additional information box below.

Section 70(a) of the Children Act 1989 provides that a person who makes any statement in this notice or gives information which he knows to be false or misleading, shall be guilty of an offence and liable on summary conviction to a fine not exceeding level 5.

Type your name below. This will count as an electronic signature to this Children Act declaration.

Type your name *

Do you hold a Criminal Records Bureau (CRB) disclosure certificate?
If yes, please give date and reference number and bring it to the centre:

Date

Reference

Additional information

Please use this space to tell us about anything else which might support your application

Please enter the text you see in the image *

• I agree that a CRB (Criminal Records Bureau) disclosure may be requested prior to or during employment.
• I declare that the information I have provided here and in any other form throughout my application is true and correct and that any misleading statements may be sufficient grounds for cancelling any agreements made.
• Churchill House is an equal opportunities employer and does not discriminate on the basis of sex, race, marital status, disability, age, sexual orientation or religion in the allocation of duties between employees employed at any level with comparable job descriptions.
• If you are offered employment with Churchill House, we will hold and process your data in accordance with the Data Protection Act 1998.
• I confirm my information may be held by Churchill House in accordance with the Data Protection Act 1998, as detailed above.
• I understand that my email will be taken as my agreement to this declaration if I submit my application electronically.
• I authorise Churchill House to carry out reference checks and verify information I have provided.

Type your name below. This will count as an electronic signature to the above terms.

Type your name *