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Application Form
Scale A Teaching Position Year 1-3
1. PERSONAL INFORMATION
Given Names
Surname
Neal
Telephone (Daytime)
Telephone (Mobile)
Email Address
stuandgin@xtra.co.nz
119228
19 March 2017
Yes
(If not, please attach a copy of your resident status or current work permit.)
YES
In addition to other information provided are there any other factors that we should know to
assess your suitability for appointment and ability to do the job? NO
If Yes, please detail
Have you had any injury or medical condition caused by gradual process, disease or infection,
such as occupational overuse syndrome, stress or repetitive strain injuries, which the tasks of
this job may aggravate or contribute to? NO
If Yes, please detail
EDUCATION QUALIFICATIONS
Please state your tertiary level qualification/s:
EMPLOYMENT HISTORY
Please outline your employment history beginning with the current or latest employment.
Start Date
End Date
Employer
Position
April 2013
Ashburton College,
Managing Director
December
2013
November
1998
AgRecord
Seddon School,
Marlborough
March 1995
Mid Canterbury
Ward School,
Marlborough
Teaching Principal, U1
Mid Canterbury
http://ginnynealprofessionalportfolio.weebly.com/
Knowledge, skills, attributes
and personal characteristics.
Parental feedback
Professional practice
Evidence and research
Research and theory
Assessment judgements
Appraisal from Principal
Teaching as inquiry appraisal feedback
Literacy in my classroom
Numeracy in my classroom
Photos of teaching in action
Colleague requests for support/ ideas
Analysis of childrens learning
Appreciates our school values and All schools and positions - I have
vision and will continue to support always upheld the values and
vision of the schools I have
these.
worked in.
REFEREES
Please provide the names of at least three people who could act as referees for you.
All of these referees should be able to attest to your work performance and at least two should
complete the attached Referees Report and return it direct to the address on the form.
If you have included written references from people other than those recorded below, please note we
may contact the writers of these references.
Name
Address
Telephone
Relationship (eg
colleague/employee)
Brent Gray
Principal,
03 303 9892
Mt Somers Springburn School (work)
78 Ashburton Gorge Road, RD
1, Mt Somers, Ashburton
03 308 5677
(home)
Sarah Gaskin
Teacher, Mt Somers
Springburn School
Grant Congdon
Principal, Horowhenua
College
65-73 Weraroa Road, Levin,
5510
PO Box 544, Levin
Darren Kerr
AUTHORITY
YES
I authorise the Board, or nominated representative, permission to access any information held
by the Teachers Council, including matters under investigation, to gather information related to
my suitability for appointment to the position.
YES
CHECKLIST
Covering letter
CV
Completed application form
At least two referees are to complete the Referees Report and return direct to the address on
the form
Other written references (optional)
Please Note:
1. Record of service
2. Education qualifications
3. Other qualifications relevant to the position
4. Suitability for the position why do you believe you are suitable for this position?
5. Non paid experience
6. Interests
CERTIFICATION
I certify that:
The information I have supplied in this application is true and correct.
I confirm in terms of the Privacy Act 1993 that I have authorised access to referees.
I know of no reason why I would not be suitable to work with children/young people.
I understand that if I have supplied incorrect or misleading information, or have omitted any
With regard to the Privacy Act and Vulnerable Childrens Act, I give the Albury School Board of Trustees
permission to circulate the information I have enclosed to members of the appointment committee and
to contact any previous employers. We also require Proof of Identity. (refer to attached form if you are
short listed)
Signed _________________________ Date _____________
PROOF OF IDENITITY
Name of Applicant: Virginia Neal (Ginny)
Identification documents must be presented in person and from the lists above (one document from
each category). The documents must be original, current and not expired.
Category A
Tick Category B
Tick
Document Name
Document
Number
Category A
Category B
Drivers licence
Name of Identity Referee(s): _____________________________________ Telephone: _____________
______________________________________Telephone: _____________