Staff Registration

1Personal Details

2Education & Employment

3Experience

4Health & Disability

5Regulatory Requirements

6Declaration

Data Protection Statement*
- Addysg Seren Education Limited provides work-finding services to its clients and work-seekers. We must process personal data (including sensitive personal data) so that we can provide these services – in doing so, we act as a data controller. This is why we have asked for your personal data on this form. When we process your personal data we must do so in accordance with data protection laws. Those laws require us to give you a Privacy Statement to explain.
Please review all policy documents related to this form:

Data protection policy

Equal Opportunities and Diversity Policy

Recruitment Selection and Vetting Policy

Privacy Policy
Personal Details
Title*
Name*
Surname*
Gender*
Address*
Post Code*
Home Telephone Number*
Mobile Phone Number*
Email Address*
Enter Email Confirm Email
Nationality*
Visa (if applicable)
Language(s) Spoken*
National Insurance No.*
Contact in case of Emergency
Emergency Contact Name*
Emergency Contact Number*
Relationship to you*
Emergency Contact Address*
Additional Languages
Do you speak any other languages as well as English? Please click on the + icon to add more languages
Additional Languages
Language Written Ability Spoken Ability
How did you hear about Addysg Seren Education?
How did you hear about us?
Please give details

Education & Employment (Any gaps in employment or Education to be explained)
Please tell us about the school/college/university you attended, starting with the most recent. You will be asked to provide evidence of this qualification at interview stage.
Education
Education*
Name of Institution (inc. address) Qualifications & Grades Start date (mm/yy) End date (mm/yy)

Please start with your most recent qualification.
Employment History
Employment History*
Job Title Organisation Dates of Employment Reason for leaving?

Please start with your most recent employment.
References
- Please provide the names, email addresses and telephone numbers of your referees.
- All current/most recent academic or employment positions.
- All relevant academic and employment references within the last 3 years.
- A character reference, someone who has known you for the last 3 years and is not a family member or a close friend.
If the candidate is not currently employed as a teacher the agency should check with the school, college or local authority at which they were most recently employed to confirm details of their employment and reasons for leaving. Open/testimonial references will need to be independently verified to ensure that are genuine and the content is satisfactory. To enable us to process your registration as quickly as possible, please note that we will contact referees once we receive your Staff Registration Form. Please confirm that you are happy for us to contact your current employer to obtain a reference.
Obtain reference consent*
- I am happy for Addysg Seren Education to contact all referees to obtain a reference.
Referee 1
Referee Name*
Job Title*
Start date (mm/yy)*
End date (mm/yy)*
Organisation*
Organisation Address*
Referee Telephone*
Referee Email*
Referee 2
Referee Name*
Job Title*
Start date (mm/yy)*
End date (mm/yy)*
Organisation*
Organisation Address*
Referee Telephone*
Referee Email*
Time Spent Overseas

View our Overseas work-seekers policy
Have you, during the past five years for a period of 6 months or more any time residing overseas on either a permanent or semi-permanent basis.*
Information in Support of Your Application
Please use this space to inform us of any additional information about your skills, experience and knowledge that would support your application.

Rehabilitation of Offenders Act 1974 and Exception Order 1975
The amendments to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (2013 and 2020) provides that when applying for certain jobs and activities, certain convictions and cautions are considered ‘protected’. You are not required to provide any information about protected (filtered) offences. This means that they do not need to be disclosed to employers, and if they are disclosed, employers cannot take them into account.
We will seek to put forward/supply the best possible candidates to our clients. Having a criminal conviction will not necessarily exclude you from the process.
Failure to declare a conviction may require us to exclude you from our register if the offence is not declared but later comes to light. If you are working in an assignment with a client at the time that we are made aware of a conviction(s) that have not disclosed to us, we may be legally required to inform our client of that information and your assignment may be terminated.
Do you have any convictions, cautions, reprimands or final warnings that are not "protected" (filtered) as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013 and 2020)*
Have you been barred from working with vulnerable adults and children by the ISA?*
Do you have any convictions or cautions (excluding youth cautions, reprimands or warnings) that are not ‘protected’ as defined by the Ministry of Justice?*
If you have declared any convictions you are welcome to provide us with any additional information that you think may be relevant and which will help us to determine your suitability to be put forward for roles with our clients. This could include for example information about the circumstances of the offence, any work (paid or voluntary) or training that you have undertaken since, change in your circumstances etc.
Childcare Act (2006) and Childcare Disqualification Regulations (2009)
Have you been disqualified on any grounds set out in the Department for Education guidance; The Childcare Act (2006) or The Childcare Disqualification Regulations (2009)?*
Safeguarding Children*
I understand my responsibility to safeguard children and I am aware that I must notify Addysg Seren Education immediately of anything that may affect my suitability. We request that you visit the below link for further information on the disqualification guidelines.*
Disclosure and Barring Service - Update service checks
DBS Consent*
Please confirm that to register with Addysg Seren Education, your role is likely to require a DBS. You may supply us with an Update Service enabled disclosure (processed by another company) Please note it must be an enhanced DBS with appropriate barred list checks. Alternatively, the cost of an Addysg Seren Education DBS must be paid in advance and is non-refundable once the application has been processed. Our policy is that we accept an Enhanced DBS Certificate, dated within 12 months of issue or/and registered onto the Update Service. If your DBS is older than 12 months from issue date and isn't on the update service*
Please complete this DBS Application Form if a new DBS is required, you can also view our DBS policy.

Addysg Seren Education will provide a work-finding service on the basis that all-sufficient documentation is provided. Addysg Seren Education uses the services of Atlantic Data to process a new Enhanced Disclosure & Barring Service (DBS) Certificate for an Agency Worker when required at the cost of £57.66 paid by the Agency Worker.

Payment can be made to Addysg Seren Education by online BACS transfer.

Reference DBS (Agency Workers Name)
Account Number 23627896
Sort Code 20-45-45
Cancellation policy
The Agency Worker has the right to cancel or withdraw from the service within 12 hours of payment being paid in writing. 50% of payment is refunded only and will be reimbursed by credit transfer.
Update Service Checks

The Disclosure and Barring Service have now introduced the 'Update Service'. This allows us to check Update Service enabled DBS Disclosures online without the necessity to complete a new application.

Addysg Seren Education will run an update service check on your DBS disclosure at regulars intervals, usually every 12 months. These checks may be made more frequently to reflect additional guidance provided specific role requirements or due to further information coming to light.

By selecting Yes you consent to Addysg Seren Education completing an Update Service check of your DBS Disclosure at regular intervals for the purpose of ensuring your continuing suitability for placement on assignment.
I consent to Addysg Seren completing ongoing Update Service checks on my DBS Disclosure.*
Data Protection Act 1998 and Inspection

From time to time we may be required to release elements of this information on placing you in assignments; please be assured that we only disclose information that is necessary.
Data Protection Act Consent*
I consent to the disclosure of information required to place me on assignments including references, qualifications and CV's.*
Note: Regulatory bodies such as Social Services, Home Office, Care Standards Inspectorate for Wales and Recruitment 7 Employment Confederation (REC) have the right to access personal files for inspection purposes in order to verify compliance with legislation and regulations.

Mon - Fri: 7.00 - 17.30

Personal Details

Contact in case of Emergency

Additional Languages

How did you hear about Addysg Seren Education?

Education & Employment (Any gaps in employment or Education to be explained)

Education

Employment History

References

Referee 1

Referee 2

Time Spent Overseas

Information in Support of Your Application

Experience

Special Educational Needs (SEN)

Qualification

Health & Disability

Rehabilitation of Offenders Act 1974 and Exception Order 1975

Childcare Act (2006) and Childcare Disqualification Regulations (2009)

Disclosure and Barring Service - Update service checks

Cancellation policy

Update Service Checks

Data Protection Act 1998 and Inspection

Documents

Payment Details

GDPR Privacy Options

Confirmation

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Language	Written Ability	Spoken Ability

Name of Institution (inc. address)	Qualifications & Grades	Start date (mm/yy)	End date (mm/yy)

Job Title	Organisation	Dates of Employment	Reason for leaving?