Teacher Application Form An application for a teaching role at Christian Brothers Lewisham Step 1 of 3 33% 1. Application DetailsWhat position are you applying for?(Required)How did you find out about this position?2. Personal InformationName(Required) First Last Email Address(Required) Enter Email Confirm Email Address(Required) Street Address City State Post code Mobile Phone(Required)Date of Birth(Required)Religion 3. EligibilityAre you a permanent resident of Australia, or an Australian Citizen?(Required) YES NO Are you legally permitted to work in Australia?(Required) YES NO If 'YES", please provide details of your passport OR visa4. Secondary EducationSchool AttendedYear Completed5. Tertiary EducationPlease list your completed Degree or Diploma information belowPlease list your completed Degree or Diploma information belowName of Degree / DiplomaInstitution AttendedLength of Degree / DiplomaYear Completed Add RemoveIf you are still studying, please provide details below:Name of Degree / DiplomaInstitution AttendingLength of Degree / DiplomaExpected Year of Completion Add RemoveAdditional Educational, Professional or Technical Qualifications (incl. short courses, relevant to the position you are applying for) Add Remove6. Employment RecordYour Previous EmployersPlease list your previous employers, the dates you worked and the position you heldEmployerPosition HeldDates of EmploymentTeaching Areas (NESA Approved) & Year Levels Add Remove 7. Co-curricular InvolvementPlease outline any co-curricular involvement you had in schools (including any sports or cultural activities) Add Remove8. LanguagesDo you speak a language other than English? YES NO If 'YES', please list language(s) and fluency levels below Add Remove9. Secondary EmploymentDo you have Secondary Employment? YES NO If 'YES' please provide details below:10. Accreditation LevelsNESA Accreditation Number(Required)NESA Accreditation Level(Required)PendingConditional ProvisionalProficientHigh AccomplishedLea11. Membership of Professional / Community OrganisationsAre you a member of any Professional or Community Organisations? If YES, please provide details below.12. Child Protection & SuitabilityWorking With Children Check Number(Required)Have you ever been subject to a bar, interim bar, or any other prohibition from engaging in child-related work in any Australian or international jurisdiction?(Required) YES NO If 'YES', please provide details:Have you been convicted of an offence that would prevent you from engaging in child related work?(Required) YES NO If 'YES', please provide details:Are you currently subject to any criminal proceedings that, if proven, would prevent you from engaging in child related work?(Required) YES NO If 'YES', please provide details:Have you ever been the subject of an allegation of reportable conduct – that is: sexual offence, sexual misconduct, assault, ill-treatment, neglect or psychological harm of a child as defined by the Children’s Guardian Act 2019?(Required) YES NO If 'YES', please provide details:Have you ever been the subject of a serious allegation involving your conduct with a child or young person, (e.g. sexual offence, sexual misconduct, assault, ill-treatment, neglect or psychological harm) that resulted in a notification to a statutory authority under child protection legislation?(Required) YES NO If 'YES', please provide details:Have you ever been the subject of a complaint, allegation or investigation relating to a breach of professional boundaries and/or breach of a Code of Conduct?(Required) YES NO If 'YES', please provide details:Are you aware of any reason or concern, held by another person, that may make you unsuitable to work in child-related employment?(Required) YES NO If 'YES', please provide details:Have you ever been the subject of an Apprehended Violence Order (AVO) in NSW, or any other protection order in another state or territory?(Required) YES NO If 'YES', please provide details:13. Further Background informationHave you ever been charged with any criminal offence?(Required) YES NO If 'YES', please provide details:Have you ever been convicted of any criminal offence?(Required) YES NO If 'YES', please provide details:During the last 5 years have you been the subject of formal performance management or disciplinary proceedings, or any action that might have led to such proceedings, in relation to your employment?(Required) YES NO If 'YES', please provide details:As a result of such proceedings, or for any other reason, have you ever been suspended, dismissed or asked to resign from a position?(Required) YES NO If 'YES', please provide details:Have you ever been refused registration, accreditation, licensing or classification as a teacher in Australia or any other country?(Required) YES NO If 'YES', please provide details:14. Health CheckDo you have an illness, injury, chronic condition, psychological or emotional condition, or require regular medication that may affect your ability to carry out the full requirements of the position, or that may be aggravated by the duties of the position?(Required) YES NO If 'YES', please provide details:Do you need any reasonable adjustments to be made in the workplace?(Required) YES NO If 'YES', please provide details:Have you ever received workers compensation payments or benefits (e.g. wages, medical expenses, or lump sum compensation) for a workplace injury or illness?(Required) YES NO If 'YES', please provide details:Is there any other information regarding your health history that should be considered in relation to your application for employment?(Required) YES NO If 'YES', please provide details:Pre-Employment Health DeclarationThe School may require you to complete a Pre-Employment Health Declaration in accordance with its Medical Information Guidelines. This declaration and any related examinations are designed to assess whether an applicant can fulfil the physical requirements of the position.Do you agree to complete the Pre-Employment Health Declaration and any related examinations if required?(Required) YES NO 15. RefereesPlease list two referees who are able to comment on your current professional position, educational ability, and overall suitability for employment in the position for which you are applying. As a matter of course, where an applicant is currently employed in a school, Christian Brothers Lewisham will contact that school’s Principal to obtain a referee report, whether or not the Principal has been nominated as a referee. Referees will not be contacted without your prior consent. REFEREE 1Name(Required)Employer(Required)Work Relationship(Required)Email(Required) Phone(Required)REFEREE 2Name(Required)Employer(Required)Work Relationship(Required)Email(Required) Phone(Required)16. DocumentationPlease upload the following documentation in support of your application.Cover Letter(Required)Upload your Cover Letter in .pdf format Drop files here or Select files Max. file size: 2 MB. Resume/CV(Required)Upload your Resume/CV in .pdf format Drop files here or Select files Max. file size: 3 MB. Academic TranscriptsUpload your Academic Transcripts in .pdf format Drop files here or Select files Max. file size: 3 MB. Testamurs (Degrees or Diplomas)Upload your Testamurs in .pdf format Drop files here or Select files Max. file size: 3 MB. 19. Application DeclarationApplication Declaration(Required)I confirm that, to the best of my knowledge, the information provided in this application is accurate and complete. I understand that any false or intentionally misleading statements, or omission of material facts, may result in disqualification from employment with the School or, if already employed, immediate termination of my employment. I CONFIRM Signature(Required)DateCAPTCHA
