Application for a Québec teaching licence

Application for a Québec teaching licence
For holders of a teaching licence issued in Canada but
outside Québec
Ministère file number :
A- Identity of candidate
Mr.
Last name (at birth)
First name
rs
M
Date of birth (yyyy-mm-dd)
Social insurance number
Apartment
Mailing address
City
Province
Country
Telephone (Home)
Other numbers (cell, work)
Postal code
E-mail address
B- Language
Language in which you received your
university education :
Other, specify : ________
French
English
Language of correspondence :
French
Province, territory or country where
you received your teacher training
English
Other, specify : _________
___________________________
In which Canadian province or territory were you granted a teaching licence ? ____________________
In which specialty ? _______________________
For which teaching level ?
Preschool
Elementary
Secondary
Vocational training
The personal information collected by the Ministère is essential to the exercise of its functions, as provided for under the
Regulation respecting teaching licences. This information may also be used for research or statistical purposes. It is treated
confidentially and is accessible only to authorized staff who need it to carry out their duties.You have the right to request access
to your personal information held by the Ministère and to request that it be corrected. To exercise this right, please contact the
person responsible for access to documents and the protection of personal information.
C- Reserved for the Ministère
ÉMISSION D’UNE AUTORISATION D’ENSEIGNER AU QUÉBEC
DÉCISION
REFUS D’UNE AUTORISATION D’ENSEIGNER AU QUÉBEC
Raison(s) du refus : ______________________________________________________________________
Commentaires :
______________________________________________________________________________________
Formation
Champ d’enseignement
Avis d’Admissibilité
N° du document
Examen :
Français
Anglais
Initiales
Ministère de l’Éducation, de l’Enseignement supérieur et de la Recherche
Date d’émission
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Check off if you have mailed the Declaration Concerning a Judicial Record :
I mailed: Declaration Concerning a Judicial Record (see section 2.2.1).
CHECK OFF THE DOCUMENTS ATTACHED TO BOTH SIDES OF THIS FORM (certified copies or original documents, as
applicable). The Ministère keeps all documents. No documents will be returned.
1.
A certified copy of the document authorizing me to teach in a Canadian province or territory.
2.
I have undertaken to have the official letter of attestation confirming the validity of my teaching licence sent to the
Ministère. I understand that this original official letter must be dated less than three months prior to the current
date. Persons who hold an Ontario teaching licence need only submit a certified copy of their certification document
and membership card issued by the Ontario College of Teachers.
3.
A certified copy of each of my diplomas supporting my application for a teaching licence.
4.
Original or certified copy of the transcripts for each successfully completed training program supporting my
teaching licence application. Documents written in a language other than French or English must include an official
translation by a member of OTTIAQ.
5.
A certified copy of my birth certificate or of my valid passport (and marriage certificate, if appropriate).
6.
For all studies completed outside Canada : a certified copy of the Comparative Evaluation for Studies Done
Outside Québec issued by the Ministère de l'Immigration, de la Diversité et de l’Inclusion. I keep the original
document.
7.
A certified copy attesting to my status in Canada: Canadian Citizenship Certificate, permanent resident, work
permit, proof of refugee status, etc. (see section 2.2.2, paragraph 8, information Guide).
8.
A copy of my valid Québec selection certificate, if applicable (see section 2.2.2, paragraph 9, information Guide).
9.
As a candidate for the vocational training sector, a certified copy of the documents attesting to 3 000 hours of
experience in the practice or teaching of the occupation, directly related to the program to be taught.
If certified copies cannot be provided and the candidate presents valid reasons why, the Ministère may, exceptionally, accept
sworn copies.
I request that the Ministère issue a teaching licence in my name. I declare that the supporting documents included with my
application are authentic and that all the information provided above is accurate.
______________________________________________
Signature (compulsory)
___________________________________________
Date
Send your request to one of the following addresses :
Applicants residing in Québec :
Direction de la formation et de la titularisation du
personnel scolaire
Ministère de l’Éducation, de l’Enseignement supérieur et
de la Recherche
1035, rue De La Chevrotière, Suite 600
Québec (Québec) G1R 5A5
Ministère de l’Éducation, de l’Enseignement supérieur et de la Recherche
Applicants residing outside Québec :
Direction de la formation et de la titularisation du
personnel scolaire
Ministère de l’Éducation, de l’Enseignement supérieur et
de la Recherche
e
1035, rue De La Chevrotière, 28 étage
Québec (Québec) G1R 5A5
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