1964_EDUCATION_REGULATIONS — Page 53

1986 Ed.]

Education Regulations

[CAP. 279

A 53

[Subsidiary]

(k) Details of occupations other than teaching, since completion of educa-

tion

(1) Details of all teaching experience:

Date of

commence-

Date of

leaving

School

ment (month and year)

(month

Classes taught

Subject taught

and year)

(m) Other relevant information

2. The following persons who are are not aware of the statements made on this form may be referred to as regards my character:

(a) Name (Mr./Mrs./Miss)

Address

Occupation

(b) Name (Mr./Mrs./Miss)

Address

Occupation

3. I affix above a signed full face photograph of myself and attach 3 signed copies of such photograph to this form.

4.

I attach-

(a) a medical certificate as to my health; and

(b) my educational certificates.

5. I am aware that if a permit to teach is issued in respect of the above applica- tion, it will apply only to the school specified in paragraph 1 of Part I of this form.

6.

The contents of this Part of this form are true and complete to the best of my knowledge and belief.

Date

NOTE 1:

NOTE 2:

NOTE 3:

NOTE 4:

(Signed)

(Proposed permitted teacher)

If the school is already registered, this should be the address of the school.

To be completed only if the applicant is a married, divorced or widowed

woman.

If the person completing Part II has been convicted of a criminal offence affecting his character, or has been refused previously approval to be a manager, registration as a manager or teacher, or permit to teach as a permitted teacher, or has had his approval to be a manager withdrawn or his registration as a manager or teacher or permit to teach as a permitted teacher cancelled, the full circumstances of such matter must be disclosed.

2 referees are required. They must be persons of standing, e.g, members of the Executive or Legislative Council, Justices of the Peace, barristers- at-law, solicitors, ministers of religion, chartered or incorporated accountants, persons on the list of special jurors, registered teachers, doctors or dentists, etc., and must have known the applicant well for at least 3 years,

See NOTE 3.

See NOTE 4.

See NOTE 5.