Fill - Free fillable School Governor Application Form (Stockton-on-Tees Borough Council) PDF form

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School Governor Application Form

Thank you for considering volunteering for the role of a school governor. If you could please

complete all sections of the form to ensure we find you the right school for you. If you are

having difficulty completing the application, please contact School and Governor Support on

01642 526420.

SECTION A: Personal Details

Surname: Title:

Forename(s):

Address:

Email Address:

Daytime Contact Number:

Evening Contact Number:

SECTION B: Employment details

Employment status:

Occupation:

Employer:

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SECTION C: Experience of being a governor

Are you currently, or have you ever been a school governor? Yes No

If yes, please indicate below:

1. School: Dates from/to:

Type of governor: Positions held:

2. School: Dates from/to:

Type of governor: Positions held:

3. School: Dates from/to:

Type of governor: Positions held:

4. School: Dates from/to:

Type of governor: Positions held:

SECTION D: Supporting experience

What interests you in becoming a school governor? (Your statement should be no more than

100 words).

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SECTION D: Supporting experience continued

Please provide details of any experience, skills, knowledge and interests you have that you

believe would support your application. This should include any experience in a professional

capacity and personal.

SECTION E: Preferences

I would like to be considered for appointment as:

E.g. Parent, Community, Local Authority, or Sponsor Governor

(Please specify which school(s) you are interested in)

Which school would you like to be considered for?

Please state if there is a school you would NOT like to be considered for:

How did you hear about becoming a School Governor?

E.g. local press, school, Stockton on Tees Borough Council website

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SECTION F: Declaration

School and

Governor Support Service use your data in accordance with the General Data

Protection Regulations (GDPR) which is in line with our privacy notice and can be accessed via

the following link https://www.stockton.gov.uk/children-and-young-people/information-for-

school-governors/.

I confirm that:

I consent to

School and Governor Support Service recording and processing the

information provided in this form.

My commitment to the 7 Nolan Principles of Public Life (Appendix 1).

I have read and understood ‘Qualifications and Disqualifications’ and I am not

disqualified from selection as a governor (Appendix 2).

Name:

Signature:

Date:

Please return

your completed form either by email to governor.admin@stockton.gov.uk

or in the post to:

School and Governor Support Service

Education Centre

Bishopton Road West

Stockton Sixth Form College

Stockton-on-Tees

TS19 0QD

If you require any further assistance, you can call us on 01642526420.

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Appendix 1: The seven Nolan Principles of Public Life

The seven principles are outlined below:

1. Selflessness – Holders of public office should act solely in terms of the public interest.

They should not do so in order to gain financial or other benefits for themselves, their

family or their friends.

2. Integrity – Holders of public office should not place themselves under any financial or

other obligation to outside individuals or organisations that might seek to influence them

in the performance of their official duties.

3. Objectivity – In carrying out public business, including making public appointments,

awarding contracts, or recommending individuals for rewards and benefits, holders of

public office should make choices on merit.

4. Accountability – Holders of public office are accountable for their decisions and

actions to the public and must submit themselves to whatever scrutiny is appropriate to

their office.

5. Openness – Holders of public office should be as open as possible about all the

decisions and actions they take. They should give reasons for their decisions and

restrict information only when the wider public interest clearly demands.

6. Honesty – Holders of public office have a duty to declare any private interests relating

to their public duties and to take steps to resolve any conflicts arising in a way that

protects the public interest.

7. Leadership – Holders of public office should promote and support these principles by

leadership and example.

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Appendix 2: School governor qualifications and disqualifications

General

 A governor must be aged 18 or over at the time of their appointment.

A person is disqualified from being a governor if the following apply:

 The person is a registered pupil;

 Has failed to attend the Governing Body meetings for a continuous period of sixth

months, beginning with the first meeting they had failed to attend, without apologies

being accepted.

Bankruptcy

 His/her estate has been sequestrated and the sequestration had not been discharged,

annulled or reduced or he/she is the subject of a bankruptcy restrictions order or an

interim debt relief restrictions order.

Disqualification of company directors

 Is subject to a disqualification order or disqualification undertaking under the Company

Directors Disqualification Act 1986, a disqualification order of the Companies Directors

Disqualification (Northern Ireland) Order 2002, a disqualification undertaking accepted

under the Company Directors Disqualification (Northern Ireland) Order 2002 or to an

order made under section 429 (2) of the Insolvency Act 1986 (failure to pay under

county court administration order).

Disqualification of charity trustees

 Has been removed from the office of charity trustee for a charity by an order made by

the Charity Commissioners or High Court on the grounds of any misconduct or

mismanagement, or under section 34 of the Charities and Trustees Investment

(Scotland) Act 2005 from being concerned in the manage mentor control of anybody;

Persons whose employment is prohibited or restricted

 Is included in the list kept under section 1 of the Protection of Children Act 1999(b) (list

of those considered by the Secretary of State as unsuitable to work with children);

 Is disqualified from working with children under sections 28 and 29 or 29A of the

Criminal Justice and Court Services Act 2000;

 Is disqualified from registration under Part 2 of the Children & Families (Wales)

Measure 2010 for childminding or providing day care; or

 Disqualified from registration under Part 3 of the Childcare Act 2006(e);

 Is barred from regulated activity relating to children in accordance with section 3(2) of

the Safeguarding Vulnerable Groups Act 2006;

 Is subject to a direction of the Secretary of State under section 142 of the Education Act

2002 (or any other disqualification, prohibition, or restriction which takes effect as if

contained in such a direction);

 Is subject to a direction of the Secretary of State under section 128 of the Education

and Skill Act 2008.

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Criminal Convictions

 Has been sentenced to 3 months or more in prison (whether suspended or not and

without the option of a fine) within the last 5 years before becoming a governor or since

becoming a governor (whether in the UK or elsewhere);

 Has received a prison sentence of 2½ years or more within the last 20 years before

becoming a governor;

 Has at any time received a prison sentence of 5 years or more;

 Has been convicted and fined for causing a nuisance or disturbance on education

premises during the5 years prior to or since appointment or election as a governor and

has been sentenced to a fine;

 A conviction for an offence given by a court outside the UK, which would not have

constituted an offence in the UK must be disregarded.

Refusal to make an application for a criminal records certificate

 He/she refuses a request by the clerk to the governing board to make an application for

a criminal records certificate.

Disqualification criteria for categories of governor

 A person eligible to be a staff governor in a school is disqualified from being a Local

Authority appointed governor.

 A person who is an elected member of the Local Authority or paid to work at a school

for more than 500hours in any school year cannot be elected or appointed as a parent

governor at that school.

 A person is disqualified from nomination or appointment as a partnership governor of a

school if he/she is;

 a parent of a registered pupil at the school;

 eligible to be a staff governor of the school;

 an elected member of the local education authority, or

Employed by the Local Authority in connection with its functions as a local education

authority.

Upon ceasing to work at the school, a staff governor of a school will be disqualified from

continuing to hold office as such a governor.

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