Join us application form

Personal details

Teacher reference number:

Please enter your teacher reference number if known

Title: *

Surname: *

Firstname(s):

Previous surname:

Date of birth: *

Format: DD/MM/YYYY

Home address: *

Postcode: *

Please ensure you provide us with at least one method of contact: *

Personal email address:

Work email address:

Home telephone:

Mobile telephone:

Qualification detailsThe NUT only takes into membership qualified teachers, or those who are on courses or in posts that will lead to teacher qualification.

Please state your qualification: *

If you selected 'Other' from the above list please state here:

If you obtained this qualification abroad please state in which country:

When did/will you obtain this qualification:

Format: DD/MM/YYYY. Please note, you must enter this field unless you have not yet qualified.

When did/will you start your first teaching post (including supply):

Format: DD/MM/YYYY. Please note, you must enter this field unless you have not yet qualified.

Employment Based Teacher Training

Please tick if you are employed in a school or sixth form college while on one of the following programmes:

Please provide start date:

Format: DD/MM/YYYY

Please provide anticipated completion date:

Format: DD/MM/YYYY

Appointment details

Full name of school/college/service/educational establishment: *

Enter supply in all three fields if appropriate

Address: *

Postcode: *

Employment terms

Tick the box showing your working week commitment: *

Up to and including 0.3

Above 0.3 to 0.6

Above 0.6

(0.3 = 1.5 days or equivalent per week) (0.6 = 3 days or equivalent per week)

Contractual employment status: *

Permanent

Fixed term contract

Supply

Anticipated duration of employment: *

3 terms or more

2 terms

1 term

Please select any additional employment details:

If other please specify:

Enter the prize draw

Recruiter and recruited prize draw

If a colleague has encouraged you to join make sure that you are both in the prize draw sponsored by Aviva by providing your colleague's details below. We're offering two winners a weekend break for two at Stoke Rochford Hall. Closing date 30/11/13. Prize to be taken by 30/06/14 subject to availability.