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Scoil Dara

Church Street,


Kilcock

Co Kildare

Phone: 01-6287258

Fax: 01-6284075

www.scoildara.ie

info@scoildara.ie




APPLICATION FORM



For Official Use Only: Called To Interview:


Not Shortlisted:








TITLE OF POST:
PERSONAL DATA:


Name:

Address:




Home Phone:

Mobile Phone:

Email:

P.P.S. Number:




























QUALIFICATIONS:


Award (Degree, Diploma, etc.)

Year of Award

Grade Awarded

Awarding Authority


Name of University,Training College, I.T., College of Technology, etc., attended.

Pass

Honours


2.2

2.1

1.1

(a)






















(b)






















(c)





















Length of Course(s) (a) ______________ (b) _____________ (c) __________



Subjects Taken in Course(s) and Examinations:





PRIMARY DEGREE

(b)

(c)




First Year:







Second Year:







Other Year(s):







Final Year:






























































Other Qualifications

Year of Award

Full-time

Part-time

Grade Awarded

Awarding Authority

PASS

HONOURS

2.2

2.1

1.1

Higher Diploma in Education/Post-Graduate:

















































































Teaching Council Registration Number:




Indicate subjects which you are recognised by Teaching Council to teach:













TEACHING EXPERIENCE:


From

To

Category


(PWT, TWT, PRPT, PT)

School

Teaching Activity













































































OTHER EMPLOYMENT:


From

To

Employer

Nature of Employment


















































OTHER INFORMATION (Interests, etc.) – (You may use a separate sheet)


















NAMES AND ADDRESSES OF TWO REFEREES FROM WHOM REFERENCES MAY BE SOUGHT:

NAME


ADDRESS:




PHONE NO







MOBILE NO




NAME

ADDRESS:




PHONE NO







MOBILE NO





If appointed, I can take up duty on _________________________(Date)
DECLARATION:In applying for this Post,I declare that the particulars given are correct.
SIGNATURE: _______________________________ DATE:
Please note if you have any special requirements, contact the school office (01-6287258)) and we will endeavour to facilitate you.
Scoil Dara is an equal opportunities employer


APPLICANTS SHOULD NOTE THE FOLLOWING



  1. Application form (original together with 3 copies) will be accepted up to closing date. It is the responsibility of the Applicant to ensure that a hard copy of this form reaches Scoil Dara before the closing date of 5pm on 24 January 2014. Late Applications will NOT be considered.

  2. Short-listing may apply and candidates must be available for interview on the date

specified.


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