APPLICATION FORM
For the position of Head of Tudor House School
PERSONAL DETAILS
Surname
*
Given Names
*
Title
*
Mr
Mrs
Ms
Dr
Prof
Former Name (If Applicable)
Marital Status (optional)
Date of Birth (optional)
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Day
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December
Month
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1926
1925
1924
1923
1922
1921
1920
Year
Religious Denomination
*
Regular practice
*
Yes
No
Which church/parish are you currently involved with?
*
Citizenship
Australian Citizen
*
Yes
No
Residential Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Abkhazia
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
People's Republic of China
Republic of China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana Guyana
Haiti Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Transnistria Pridnestrovie
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
Spain
Sri Lanka
Sudan
Suriname
Svalbard
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Correspondence Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Abkhazia
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
People's Republic of China
Republic of China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana Guyana
Haiti Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Transnistria Pridnestrovie
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
Spain
Sri Lanka
Sudan
Suriname
Svalbard
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Private Phone Number
*
Work Phone Number
Mobile Phone Number
Email Address
*
Current Position
*
Teacher registration/accreditation
INSW Reg. No.
INSW Reg. Level
ISTAA accreditation level
PERSONAL EDUCATIONAL BACKGROUND
Tertiary Education
Degree/Diploma/Certificate Gained
Years Undertaken
Years Awarded
Name of Institution
Current/Recent Professional Development/Research Undertaken
Activity
Duration
Year Undertaken
Provider (Name of Institution, Supervisor)
EMPLOYMENT BACKGROUND - CURRENT
Employer
*
Business Address
*
Current Position
*
Date of Appointment
*
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3
2
1
Day
January
February
March
April
May
June
July
August
September
October
November
December
Month
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
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1991
1990
1989
1988
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1986
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1984
1983
1982
1981
1980
1979
1978
1977
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1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Date of Contract End
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6
5
4
3
2
1
Day
January
February
March
April
May
June
July
August
September
October
November
December
Month
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Notice Required
*
Employer Contact Person
*
Contact Number
*
Other position(s) held in current employment
Position
Duration
Responsibility
Current Remuneration package (include all components)
*
Latest Professional Review (if available)
PAST EMPLOYMENT
Please commence with the most recent position
From Date
To Date
Name and Address of Employment
Position Held
Reasons for Leaving
PROFESSIONAL EXPERIENCE
....
Responsibility
Employer
Years
PROFESSIONAL VISION AND PHILOSOPHY
Please provide a brief statement of your professional vision and philosophy for the role of Head of Tudor House School.
*
SELECTION CRITERIA
Please provide a brief response to the selection criteria.
*
OTHER PARTICULARS
List any professional associations of which you are a member, and, where relevant, positions of leadership/responsibility you hold/have held
Outline your interests (e.g. sporting, religious, cultural) and your involvement in any community or other organisations
Please list any other information you want the panel to know in regard to your general background - family, community involvement, special interests, things you have been recognised for, etc.
REFEREES
Referee 1 (Professional)
Name
*
Occupation
*
Work Address
*
Email Address
*
Contact Phone Number
*
Referee 2 (Professional)
Name
*
Occupation
*
Work Address
*
Email Address
*
Contact Phone Number
*
Referee 3 (Personal/Church)
Name
*
Occupation
*
Work Address
*
Email Address
*
Contact Phone Number
*
Contact Permission
*
I allow Pathways International Consulting Pty Ltd to contact the named referees solely for the purpose of ascertaining eligibility for employment. Referees will not be contacted without your prior knowledge.
CURRICULUM VITAE
Please upload your CV in a document format. Note: Must be less than 10MB
DECLARATION
What is your general state of health?
*
Have you ever been convicted of a criminal offence?
*
Yes
No
If yes, please provide details
Have you ever had any allegations of misconduct made against you?
*
Yes
No
If yes, please provide details
Do you have you any criminal charges pending?
*
Yes
No
If yes, please provide details
Have you ever been declared bankrupt in Australia or any other country or do you have current or outstanding proceedings against you that may result in your being declared bankrupt?
*
Yes
No
If yes, please provide details
Do you have any objection to the employer carrying out appropriate checks?
*
Yes
No
If yes, please provide details
Have you previously applied for a position or worked at Tudor House School?
*
Yes
No
If yes, please provide details
Submit Form
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