Register Interest for a Teaching Position

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The Department of Education through Western Cape College is collecting personal information in accordance with Education (General Provisions) Act 2006 in order to register interest for a teaching position. The information will only be accessed by employees of the Department of Education. The information will not be given to any other person or agency unless prior consent is obtained.

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Title *

Surname *

Given name *

Preferred name

State *

Postcode *

Postal address

Postal state

Postal postcode

Previous surname (if applicable)

Date of birth *

Primary phone *

Alternative contact number

Email address *

Have you ever been employed with Western Cape College?

Yes

No

Outline your reasons for applying to work at Western Cape College.

Are you currently registered with the Queensland College of teachers?

Yes

No

If yes, please provide the registration number and expiry date.

Are you an Australia citizen or permanent resident of Australia? *

Yes

No

Are you currently on leave from any Commonwealth, State government department or private sector organisation? If yes, please provide a statement giving details. *

Your present employer and position

Your present work status

Full time

Part time

Term time

Contract

Your present position period (from/to)

Your previous teaching employment history

Please provide the information of the employer name, position held, work status, (e.g. permanent, temporary, relief), dates (from/to), line manager.

Other relevant employment history

Please provide the information of the employer name, position held, work status, (e.g. permanent, temporary, relief), dates (from/to), line manager.

Educational qualifications

Please provide your academic institution, qualification type, majors, years commenced, years attended, completed (month/year).

Your final practice-teaching location (recent graduate only)

Other relevant qualifications

Qualification, academic institution, qualification type, majors, years commenced, years attended, completed (month/year).

Educational qualifications (not listed above)

Additional courses undertaken (not listed above).

Professional referee 1 *

Full name, position/organisation, contact numbers.

Professional referee 2 *

Full name, position/organisation, contact numbers.

Professional referee 3 *

Full name, position/organisation, contact numbers.

Preferred co-curricular activities

Membership of organisations

Professional, religious, cultural, social, sporting.

Outside activities, hobbies, interests

Is your present employer aware of this application/enquiry?

Yes

No

Not applicable

By what date would you be able to take up a new appointment? *

Do you have a known health condition which could prevent you from competently and efficiently carrying out the duties of this position in a manner which is safe to yourself, your co-workers, the public and Western Cape College?

If yes, please provide details.

Applicant's declaration *

Yes

I certify that the information contained in this application is a true and correct statement of my particulars, qualification, training, experience and competencies. I understand that statements found to be false within my knowledge may make me liable for immediate dismissal.

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