lat Seh, conid]
FORM 4
THE EDUCATION ORDINANCE, 1952.
* Application for registration as a teacher,
Address
Director of Education,
Education Department,
HONG KH
Date
[a. 21.
1.
I subrait particulars of myself and request you to register me as
a teacher and to issue me with a certificate of registration.
Particulars
(2) Name in English
(b) Name in Chinese
(c) Aliases
(d) Sept
(c) Whether married or single
(/) Date of birth
(9) Place of birth
(k) Where educated with dater-
School or University
From
To
(1) Educational qualifications
(1) Previous teaching experience-
School
28
Classes taught
Subjects taught
[int Sch, contd.
†3. The following persons may be referred to as to my character-
(*) Name
(6) Name
Address Address
4.
I attach-
(a) two signed photographs of myself;
(b) medical certificate;
(*) educational certificates.
§5. I declare that→
(a) I am a person of good character;
(b) I have never previously been refused registration as a manager of any school or as a teacher or been refused permission to teach or having been so registered or given permission to teach bad my registration or permission. cancelled.
G.
The contents of this application are true to the best of my know- ledge, information and belief.
(Signed)
* Note 1. This form la appropriate only in the cme of persons who possess the aualliantions
pet part in regionalon 87 of the regulations.
↑ Note 2. Two referees sure regained. They must be petsons of standing er. men barn of Executive or Legislative. Consil, Janticas of the Peace, barrister-pt-1ww. Colter, knisters of religion, chartered or incorporadest respontszka, parkona on the specfal Jury Dut, or meltered doctor pq dentkata, and should pay have known the applicant well for at levert three pours.
Mabe 1. T educational certificates are oot vmilable at the time of the application, (c) should be delated and applicant may be required to produce them later for iampreetion.
I Note 4
DE applicant has been convicted of a griminal offenes affecting kla three or refused regluleation etc. the full aircumstancen munt be dibelombo,
FORM 5
[9. 22.
THE EDUCATION ORDINANCE, 1952,
Certificate of registration of teacher.
This is to certify that
whose photograph is affixed hereto has been registered as a teacher under the Education Ordinance, 1852.
Photograph
of
bolder
Director of Education.
Hoa Kor
19......
29