7
*5pm Note 1.
* The following persons who ara/are not aware of the stalementa made on this form may be referred to as to my character and suitability to become a manager-n
(0) Name
Address
(0) Name
Occupation
Occupation
MALANDRES PORTRAIT
Address megan-plea-LESTE
†Boy Note 1
†4. I declara that-
flavert *m*
of school of
which appll-
cat dealre
10 beve
SORAJAN, THAN GOOD
18ee Nola I.
6.
(α) 1 am normally resident in the Colony for at least nine months
in each year;
(b) I have never previously been refused registration as s manager of any school or as a teacher or been refused permission to teach or having been so registered or given permission had my registration or permission cancelled;
(c) 1 am able to carry out the duties of a manager of the
B..........
School and that I am familiar with the provisions of the Education Ordinance, 1952, and the regulations.
The contents of this application are true and complete to the best of my knowledge, information and belief,
16. This application is forwarded with the full knowledge and con- went of the supervisor/majority of the registered managers of the School whose signature/signatures is/are appended bereto.
WARNING.
1. Attention is drawn to the provisions of the Education Ordinance, 1952, and particularly to—
Section 19-
"The Director may refuse in register a person as a manager if it appears to him that such applicant—
ון
(h) in making application for the registration of a school or as
menager or a teacher or in any application under section 26 or in any application under the Education Ordinance, 1913 for permis- sion to teach, has made any statement or furnished any informa tion to the Director which is false in any material particular or by reason of the omission of any material particular,”,
and Section $7.
“Any person who-
(*) makes any statement or furnishes any information, whether such statement or information be verbal or in writing, which is talse in a material particular or by reason of the omission of a material particular, which he either knows or has reason to believe to be falsa or which he makes recklessly-
2.
(i) in an application for registration of any nature bereunder; shall be guilty of an offence and shall be liable to a fine of five thousand dollars and imprisonment for two years.".
Chinese translations, if inserted in this form, are for convenience and in the case of any conflict between the translations and the English text, the latter shall prevail.
FORM 4.
[a. 21.1
*Note 1:
†Nate 2:
*Note $:
(Signed)
EDUCATION ORDINANCE, 1952.
*Application for registration as a teacher.
Residential Address
Date
Director of Education,
Two referees are required. They must be persons of standing. Ed. domnya logge of the Executive or Legislative Connell, Justice of the Fusco, bperliter-at-1am, walfeitor, ministers of religion, chartered or incorporsbed. «scountants, persOTHE on the special jury list de registered teachers, doelom or dentista ete., bave known the applicant well for at least three years,
if applicant has ever been convicted of a criminal offence” adfesting bir character pr refused revliteation etc the foli direnmalances munt be disclosed.
l'azyraph d need be completed only when ■pplication la for registration. KUN A MONTANENT Gť a registered school,
Education Department,
HONG KONG.
1. I forward particulars of myself and request you to register me
as a registered teacher and to feste me with a certificate of registration.
Particuları-
2.
(a) Name in English
(6) Name in Chinese
(c) Aliases (d) Sex
*Ses Nota 1.