Registration Form Registration Form Personal Details Title* First Name* Middle Name Last Name* Address* Date of Birth* Nationality Phone Number* Mobile Number Email* TRN Number (if applicable) Are you happy for Ortus Recruitment to carry out regular and ongoing checks of your teaching status? YesNo Emergency Contact Name* Emergency Contact Number* Relationship* Referees Please provide your two most recent & most relevant employers, prioritising schools and then childcare based employers. (If applicable) Employer 1 Employer 1 Position Held Start Date End Date Number of days worked per week Address Referee name Referee Position Reason for leaving Phone Number Email Were you subject to any disciplinary proceedings? YesNo Are you happy for us to contact this referee? YesNo Employer 2 Employer 2 Position Held Start Date End Date Number of days worked per week Address Referee name Referee Position Reason for leaving Phone Number Email Were you subject to any disciplinary proceedings? YesNo Are you happy for us to contact this referee? YesNo Additional Information Previous Names (If Applicable) First Name Middle Name Last Name Date used from Date used till Have you been a permanent UK resident for the last five Years?* YesNo If no please give details UK residency date for overseas candidates Bank Account Details Bank/ Building society Name* Name of Account Holder* Sort Code * Account Number* BS Reference Number National Insurance Number Rehabilitation of offenders Act 1974 (Exception Order 1975) Assignments with Ortus Recruitment Ltd will involve close contact with pupils under the age of 18. This means that we require all applicants to undergo a criminal background check and your engagement is exempt from the relevant provisions of the Rehabilitation of Offenders Act 1974 and its supporting regulations. Consequently you are not entitled to withhold information about criminal background outside of the current filtering rules (available at www.gov.uk/dbs). A criminal record will not necessarily bar you from working with Ortus Recruitment but a review of criminal background will take place prior to your engagement with the agency. All information disclosed as part of criminal record checks completed will be discussed with schools prior to any assignments. Ortus Recruitment Ltd operate in accordance with the DBS code of practice. I do not have any unspent convictions, cautions, reprimands, or warnings* AgreeDisagree DBS Update Service Are you currently registered with the DBS update service?* YesNo If you do register with the update system please confirm that you are happy for Ortus Recruitment to complete regular and ongoing Status Checks? Ortus Recruitment may also require a copy of your DBS Disclosure for our records. YesNo I have never been subject to any disciplinary proceedings, investigations, suspension or dismissal from an education or childcare post. In cases where an allegation was proven to be unsubstantiated, unfounded or malicious there is no need to disclose this. If however you answer ‘Disagree’ please could you bring a written statement with you to your registration meeting detailing what happened. This would enable us to make an informed decision. AgreeDisagree Qualifications and authorisations Insert details of any relevant professional qualifications: Confidential Declaration of Health The Education (Health Standards) (England) Regulations 2003 require that employers must ensure that a person has the health and physical capacity to teach. These regulations fall within an exception of the Equality Act 2010 legislation which permits health questions to be asked in so far as this is necessary to determine the ability of the applicant to undertake an intrinsic function of the work. I confirm I have no mental or physical health conditions that may affect my ability to work as a teacher or support worker. AgreeDisagree If you have chosen disagree, please outline the full details: Please note that we may need to advise clients of specific conditions to ensure that they can make reasonable adjustments for you to work in safety at their premises. If you are happy for Ortus Recruitment Ltd to do this please indicate here. AgreeDisagree If your personal health circumstances change at any time which may in turn impact your ability to work as a teacher or support worker for Ortus Recruitment Ltd, then please advise us immediately. Equal opportunities Ortus Recruitment is committed to a policy of equal opportunities for all work seekers and shall adhere to such a policy at all times and will review on an ongoing basis on all aspects of recruitment to avoid unlawful or undesirable discrimination. We will treat everyone equally irrespective of sex, sexual orientation, gender reassignment, marital or civil partnership status, age, disability, colour, race, nationality, ethnic or national origin, religion or belief, political beliefs or membership or non-membership of a trade union and we place an obligation upon all staff to respect and act in accordance with the policy. Ortus Recruitment shall not discriminate unlawfully when deciding which candidate/temporary worker is submitted for a vacancy or assignment, or in any terms of employment or terms of engagement for temporary workers. Ortus Recruitment will ensure that each candidate is assessed only in accordance with the candidate’s merits, qualifications and ability to perform the relevant duties required by the particular vacancy. GDPR Consent Data Protection Statement Ortus Recruitment 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 how we manage your personal data. Please confirm you have read and fully understand the Privacy Statement, which you can access via our company website at https://ortusrecruitment.com/data-protection/. AgreeDisagree If, during the course of a temporary assignment, the Client wishes to employ me directly, I acknowledge that Ortus Recruitment will be entitled either to charge the client an introduction/transfer fee, or to agree an extension of the hiring period with the Client (after which I may be employed by the Client without further charge being applicable to the Client). AgreeDisagree Keeping Children Safe in Education The government has now published the September 2026 version of ‘Keeping Children Safe in Education’. All staff must ensure that they have read ‘Keeping children safe in Education’ Part One (and Annex A). Please read the document here and confirm you have done so below. I confirm that I have read and understood the 'Keeping Children Safe in Education document * AgreeDisagree Declaration I agree to complete and abide by the terms of my contract* AgreeDisagree I declare that all the information I have provided is accurate, complete and true* AgreeDisagree Date* Signature*
