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Assessment Only Application FormAbout This FormThis form can only be completed for applications to the Merseyside, Cheshire & Greater Manchester Teacher Training Consortium Assessment Only programme.Please complete the form carefully. The Consortium cannot evaluate your application unless you have provided evidence that you have the necessary qualifications for the Assessment Only route to gaining qualified teacher status.
The information on the form will be stored on a database and is subject to the General Data Protection Regulation (GPDR). The application will be confidentially assessed by a panel of Consortium appointed professional staff who will decide whether you fulfil the entry requirements for the programme.
The form has been designed for clarity of assessment. Each set of questions is followed by a shaded area for assessment. DO NOT WRITE IN THESE BOXES.
Please read the accompanying guidance before completing the Application Form.
Each Section will be assessed as to your qualification for the programme. Areas of eligibility are clearly marked. If you do not score in these areas, your application will not qualify. Guidance on particular points is provided within the Sections.
Complete all relevant parts of the form. Questions providing choices should be ticked.
Extra Pages are allowed where requested. DO NOT STAPLE THIS APPLICATION FORM.
Only include extra documents where requested. Do not include original certificates, CV or any other non-requested material.
Please remember to keep a copy of your application.
Part A – Personal DetailsPlease write in capitals, or type, in black ink.
Title (tick one) Dr Mr Mrs Miss Ms Other
Forenames
Surname
Former surname (if different)
Full Postal Address:
Post CodeTelephone Number: Mobile Number:
E-Mail Address:
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Gender Male Female
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Part A – Personal Details (continued)
Date of birth / / Current age Years Months
Please make sure you give your correct date of birth.
National insurance Number:
Your National Insurance Number indicates evidence of your eligibility to work in the UK. This must be provided.
Do you have a disability? No Yes Details:
Ethnic group
White British Black or Black British, Caribbean
Asian, Indian or Asian British, Indian
White Irish Black or Black British, African
Asian, Pakistani or Asian British, Pakistani
White Other Other Black background Asian, Bangladeshi or Asian British, Bangladeshi
Other ethnic background
Mixed, White & Black Caribbean
Other Asian background
Not known Mixed, White and Black African Chinese or Chinese British
Information refused Other mixed background
Assessment: (do not complete)
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Eligible to work in UK
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Part B – Employment Rights
Under UK law all candidates must demonstrate their eligibility to work in the UK.
A complete photocopy of the following documents must be provided with your application form. Original documents will be required at interview. DO NOT send original documents with your application.
All candidates MUST produce ONE document from List 1 OR TWO documents from either combination of List 2
LIST 1 – Any one document Please
A passport showing that the holder is a British Citizen, or has a right of abode in the UK A document showing that the holder is a national of a European Economic Area country
or Switzerland. This must be a national passport or national identity card. A residence permit issued by the Home Office to a national from a European Economic
Area country or Switzerland A passport or other document issued by the Home Office which has an endorsement
stating that the holder has a current right of residence in the UK as the family member of a national from a European Economic Area country or Switzerland who is resident in the UK.
A passport or other travel document endorsed to show that the holder can stay indefinitely in the UK, or has no time limit on their stay.
A passport or other travel document endorsed to show that the holder can stay in the UK; and that this endorsement allows the holder to teach if they do not have a work permit.
An application registration card issued by the Home Office to an asylum seeker stating that the holder is permitted to take employment.
LIST 2 – FIRST COMBINATION – Document A plus one other document Please
A – A document giving the person’s permanent National Insurance Number and name. This could be a P45; P60; National Insurance Card or letter from a Government Agency. Please note that a temporary National Insurance Number (starting TN) is NOT acceptable.Plus one document from:B – A full birth certificate issued in the UK, which includes the names of the holder’s parents, ORC – A birth certificate issued in the Channel Islands, the Isle of Man or Ireland; ORD – A certificate of registration or naturalisation stating that the holder is a British citizen; ORE – A letter issued by the Home Office to the holder which indicates that the person named in it can stay indefinitely in the UK, or has no time limit on their stay; ORF – An Immigration Status Document issued by the Home Office to the holder with an endorsement indicating that the person named in it can stay indefinitely in the UK, or has no time limit on their stay; ORG – A letter issued by the Home Office to the holder which indicates that the person named in it can stay in the UK and this allows them to teach; ORH – An Immigration Status Document issued by the Home Office to the holder with an endorsement indicating that the person named in it can stay in the UK, and this allows them to teach.
LIST 2 – SECOND COMBINATION – Document A plus one other document Please
A – A work permit or other approval to take employment that has been issued by Work Permits UK.Plus one document from:B – A passport or other travel document endorsed to show that the holder is able to stay in the UK and can take the work permit employment in question; ORC – A letter issued by the Home Office to the holder confirming that the person named is able to stay in the UK and can take the work permit employment in question.
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If you do not satisfy this section then you will not be selected for the programme.Further guidance may be found at www.ind.homeoffice.gov.ukPart C – Previous QTS
The information that is provided in this section is essential to establish the candidate’s eligibility for QTS programmes. Please ensure that this section is completed fully and accurately. All information provided will be treated as confidentialThe Consortium will not accept applications from candidates who have previously failed QTS assessment.The Consortium may however consider those who have withdrawn from a QTS programme due to exceptional circumstances
Have you previously failed a QTS course? YES NO
Have you previously withdrawn from a QTS course? YES NO
If you ticked YES but consider exceptional circumstances forced your withdrawal please use the space below to state the reason ensuring that you attach a supporting statement from your Higher Education Institution and any other supporting evidence e.g. medical certificates:
Comments: QTS Exceptional Circumstances
Assessment: (do not complete)No QTS/Exceptional Circumstances acceptable
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Part D – Teaching Programme
A2.2 All candidates recommended for the award of QTS (Teachers' Standards) are assessed as meeting the standards across two or more consecutive age ranges.
Please select the age range of your programme:
AGE RANGESCHOOL YEARS SECONDARY SUBJECT
State ONE subject only (see guidance)
SELECT()
Ages 3-11(typically 3-7, 5-11 or 7-11)
Primary N/A
Ages 7-14 Middle
Ages 11-19(typically 11-16 or14-19)
Secondary
It is required that all trainees will enhance their programme with experience in the age ranges above and below their teaching range.
A1.4 That all candidates have achieved proficiency in the fundamental skills in English and Mathematics – you may be required to show evidence of this.
Please supply your Teacher Reference Number (TRN)
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Part E – Your Education and QualificationsE1 – GCSE or equivalent qualifications
Please give details of GCSE or equivalent qualifications and when they were obtained. You must have attained the standard required for GCSE grade C in English and Mathematics before you start training. Candidates who will be teaching the primary age range must also have attained the standard required for GCSE grade C in Science.This section must be completed in full by all applicants.
Subject Qualification and awarding body or details of alternative test or assessment Grade
Date of award or assessment
M M / Y Y
Mathematics /English /Science /
Copies of certificates and evidence of equivalency must be provided with this application. Original certificates will be required for interview. It is the candidate’s responsibility to provide evidence of qualifications and/or equivalence.
Assessment: (do not complete)
Maths Grade 4 or above
English Grade 4 or above
Science Grade 4 or above (Primary)
E2 – Other GCSE O-level and A-level qualifications or equivalent
Subject Qualification/Awarding body/Other forms of assessment Grade Date of award
M M / Y Y///////////
Copies of certificates and evidence of equivalency must be provided with this application. Original certificates will be required for interview. It is the candidate’s responsibility to provide evidence of qualifications and/or equivalence.
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E3 – Primary Candidates Only – Subject Qualifications and Knowledge
When you are assessed for QTS, if you are wishing to teach EYFS, Key Stages 1 or 2 you must demonstrate that you have sufficient understanding of a range of work across the following subjects: Literacy, Numeracy, Science, History or Geography, Physical Education, ICT, Art and Design or Design and Technology, Performing Arts, Religious Education and Modern Foreign Languages. You should be able to teach these subjects in the age range for which you are trained with advice from an experienced colleague where necessary. It will be an advantage for candidates planning to teach EYFS/KS1/2 to cover all National Curriculum subjects, and EYFS if applicable. You should detail your depth of knowledge in each of these areas at the time of application. Please read the guidance.
Demonstrate how your subject knowledge and experience matches the National Curriculum requirements of the phases of your application
Assessment: (do not complete)
(Primary Candidates Only) English
Mathematics
Science
History / Geography
Physical Education
Art & Design / Design & Technology
Performing Arts
Religious Education
Modern Languages
EYFS
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E3 – Secondary Candidates Only
QTS places a strong emphasis in the development of your Subject Knowledge for Teaching. Standard 3 states: "A teacher must demonstrate good subject and curriculum knowledge."Assessment Only Requirement A1.2 states: That all candidates hold a first degree of a United Kingdom higher education institution or equivalent qualification.Footnote: A first degree comprises 300 HE credit points of which 60 must be at a level 6 of the national qualifications framework (NQF). Applicants with a foundation degree will need to supplement this qualification with at least 60 credits at level 6 (HE level 3) in order to attain an equivalent qualification. Relating the QTS Standards to the Requirements and demands of the programme for Secondary trainees means that a Secondary Trainee must be able to demonstrate degree-level subject knowledge in the subject that they are training to teach, and that they continue to develop this subject knowledge throughout their career.Please complete the following questions about your Subject Knowledge.(Please note: If you do not have a clear relationship between your degree and the subject of your application, please provide additional information (see guidance).)
Demonstrate how your degree matches the National Curriculum requirements of the subject of your application:
Demonstrate how you have developed your subject knowledge since completing your degree:
Assessment: (do not complete)
(Secondary Candidates Only)Clear relevance of degree with enhancement of SK
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E4 – Higher EducationCandidates must have a UK first degree or equivalent. If you are waiting for degree results, please ask the higher education institution to confirm in writing that a degree will be awarded and if possible to indicate the classification. If you do not have a UK degree, it is your responsibility to provide evidence of equivalence.If you have a Second or Higher degree, please copy this page and provide details of all qualifications.
Institution of Study
Degree awarding body (if different)
Country of study
Title of course
Main subjectPercentage of
Course %
Subsidiary subjects/Modules
Percentage of Course %
Percentage of Course %
Percentage of Course %
Percentage of Course %
Percentage of Course %
Qualification obtained
Degree ClassFirst Class honours Upper
secondLower
secondThird Pass Ordinary
Date of study fromM M / Y Y
toM M / Y Y
Date of awardM M / Y Y
/ / /
For qualifications other than a UK degree, give evidence below that the qualification is equivalent and attach any relevant supporting statements from UK NARIC. Please note that it is the candidate’s responsibility to ensure that this evidence is available at the time of application.
Copies of certificates and evidence of equivalency must be provided with this application. Original certificates will be required for interview.
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Part F – Personal Statement
In no more than 500 words, please write a personal statement in support of your application. Please read the Guidance before completing this section.
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Part G – Your Experience
G1 – Teaching Experience
Please give details of previous employment as a teacher, qualified or unqualified, paid or voluntary, in the UK or elsewhere. Please copy this page and provide details of each school where you have teaching experience.
School/CollegeCountry/LA Post heldDates of service If working part-time,
percentage of time working%
From ToPlease tick the box(es) that best describe the school:
Primary Independent SpecialMiddle deemed
Primary City Technology College Higher Education
Secondary Specialist School City AcademyFurther Education Other (please specify)
Age range of pupils taught Responsible for whole class Yes No
Subjects taught to public examination levelOther subjects taught
Details of Experience(please cover times responsible for:
Short & medium term planning; Solo teaching; working with small groups; working alongside experienced teachers; working with other professionals; familiarisation with schemes of work; subject work/knowledge experience; extra curriculum work; working with parents; field trips; etc.)
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G2 – Experience in an Educational Setting
Please give details of previous employment, paid or voluntary, as a teaching or classroom assistant in the UK or elsewhere.If you have experience in more than one school, please copy this page and provide details of all experience.
School/CollegeCountry/LA Post heldDates of service If working part-time,
percentage of time working%
From ToPlease tick the box(es) that best describe the school:
Primary Independent SpecialMiddle deemed
Primary City Technology College Higher Education
Secondary Specialist School City AcademyFurther Education Other (please specify)
Age range of pupils in class
Responsible for whole class Yes No
Details of Experience(please cover involvement in:
Short & medium term planning; Solo teaching; working with small groups; working alongside experienced teachers; working with other professionals; familiarisation with schemes of work; subject work/knowledge experience; extra curriculum work; working with parents; field trips; etc.); non-teaching work in educational settings (teaching assistant, LSA, LM, etc.) with adults, young people or children
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G3 – Employment History
Please complete the history of your employment since leaving school.Please identify and explain any gaps.
Current Post and Employer Paid or voluntary
Full or Part Time
Dates From - To
Previous posts and activities Paid or voluntary
Full or Part Time
Dates From - To
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Part H – ReferencesPlease provide below the names of two referees who can support your application in terms of your relevant experience. One of the references should be the Headteacher of your employing school.
First Referee Second Referee
Name
Relationship to Candidate / Job Title
Address
Postcode
Telephone
Fax
Part I – Employing School
Please note this information should be your current employing school.The Headteacher and Chair of Governors also need to complete Form089 certifying your employment and their support for your programme
Name of employing SchoolAddress
Town or city Postcode
Contact Person & Title:Telephone: Fax: E-mail:
Schools Unique Reference Number
LA
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Part J – Declaration by Candidate
A The information about my qualifications and experience in this application is true.
B I have enclosed true photocopies of all required documentation and will present all original documents for inspection if invited to interview.
C I agree to prepare and present myself for assessment at the agreed time.
D I understand the terms and conditions of my appointment and my preparation for assessment and agree to abide by them.
E I have not previously failed a QTS programme.
F I have included details of any QTS programme that I have previously withdrawn from or had to withdraw from.
G I do not already have Qualified Teacher Status.
HI agree that the information in this application and any agreed training plan may be made available to Tutors, a TA-approved external assessor or accredited-provider assessor as appropriate to enable them to assess me against the Standards for the Award of QTS.
II agree that the information in this application and any agreed training plan may be made available to the Teaching Agency and Ofsted to enable them to carry out their quality assurance role in teacher training.
J I agree to undertake Identity, Criminal Record and Health checks.
Signed: Date: Applications can be sent by email to: [email protected] A receipt will be issuedThis form must be accompanied by copies of all certificates (Parts E1, E2 & E4), copy evidence of employment eligibility (Part B), School Certification (Form 089) and the appropriate fee.Alternatively, your application can be printed and posted with copy documentation and fee to:Phil DanielsMC & GM TT ConsortiumEverton Nursery School and Family CentreSpencer StreetLiverpool L6 2WFe-mail [email protected]
Comments
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Eligible for Programme
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