: ( ) ) ( ) ( ) ( ) SUPPLY TEACHING FORM > FORMULAIRE DE

Commission scolaire Western Québec
Western Québec School Board
15, rue Katimavik, Gatineau QC J9J 0E9
Supply Teaching Form - Formulaire de suppléance
Secondary - Secondaire/Adult Education - Éducation aux adultes
Date: Select/sélectionnez
Dec/déc
Nov/nov
Oct/oct
Sept/sept
Aug/août
July/juil
Jun/juin
May/mai
Apr/avril
Mar/mars
Feb/févr
Jan/janv
Given name(s)/prénom(s): Select Select/sélectionnez
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2017
Family name/nom de famille: Address/adresse: Apartment/Unité #: City/ville: Postal Code: Province: Telephone/téléphone: Email/courriel: Teaching Diploma, Certificate (copies required) / Diplôme, certificat (copies requises):
Brevet (Quebec Teaching Certificate)
University/université
OTC (Ontario Teachers College)
Other: Please specify/autre: CEGEP/College None/aucun
Secondary Schools where you would like to offer your supply teaching services/Écoles secondaires où vous aimeriez offrir vos
services de suppléances:
Gatineau:
Hadley Junior/Philemon Wright High (Hull)
Symmes Junior/D’Arcy McGee High (Aylmer)
Maniwaki Woodland (Maniwaki)
Namur Intermediate (Namur)
Outaouais:
St. Michael’s (Low)
Dr. Wilbert Keon (Chapeau) Pontiac (Shawville)
Pontiac:
G. Theberge (Témiscaming)
Golden Valley (Val d’Or)
North/Nord:
Noranda (Noranda)
Adult Education Centres/Centres d’éducation aux adultes: (Specialty/spécialité)
(
Hull Adult Education Centre (Hull -Gatineau) Golden Valley Cont. Education Centre (Val d’Or)
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Maniwaki Adult Education Centre (Maniwaki)
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Pontiac Adult Education Centre (Shawville)
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Western Québec Career Centre (Aylmer-Gatineau)
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Teaching subjects/matières d’enseignement::
History_English
French SL
Math_Science French Immersion
Phys Ed
Language of instruction / langue d’enseignement:
English/anglais: French/français: Both/les deux
Québec Qualified
Office Use Only
Qualified Outside Québec
No Teaching Qualifications
Verified by: ________________________
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