Formulaire - Western Québec School Board

Transcription

Formulaire - Western Québec School Board
COMMISSION SCOLAIRE WESTERN QUÉBEC
WESTERN QUÉBEC SCHOOL BOARD
15 RUE KATIMAVIK, GATINEAU, QC J9J 0E9
REPLACEMENT BANK FORM – FORMULAIRE REMPLACEMENT OCCASIONNELLE
SUPPORT - SOUTIEN
DATE:
__________________ NAME/NOM :
_____________________________________________
ADDRESS/ADRESSE: ____________________________________________________________________
TELEPHONE/TÉLÉPHONE :_______________________________________________________________
EMAIL ADDRESS/ ADRESSE COURRIEL:_______________________________________________________
DIPLOMA, CERTIFICATE (COPIES REQUIRED) / DIPLOME, CERTIFICAT (COPIES REQUISES):_____
_______________________________________________________________________________________
REFERENCES: (NAMES AND TELEPHONE # REQUIRED / ( NOMS ET # TÉLÉPHONE REQUIS)
1.______________________________________________________________________________________
2.______________________________________________________________________________________
LANGUAGE SPOKEN: ENGLISH/ANGLAIS:___
FRENCH/FRANÇAIS:___
BOTH/DEUX:___
LANGUAGE WRITTEN ENGLISH/ANGLAIS:___
FRENCH/FRANÇAIS:___
BOTH/DEUX:___
Mark appropriate box with an X / Cochez la case appropriée avec un X
Att. Hand
Prép. Hand.
Daycare . Edu.
Édu. Serv.Gard
S. Secretary
Secré. d’Éc.
Spec. Ed. Tech.
Tech. éd.spéc.
Main. Worker
Ouvr. d’entre.
Board Office (Aylmer)
Elementary Schools
Lord Aylmer (Aylmer)
Eardley (Aylmer)
South Hull (Aylmer)
Buckingham (Buckingham)
Chelsea (Chelsea)
Greater Gatineau (Gatineau)
Pierre Elliott Trudeau (Hull)
Wakefield (Wakefield)
Queen Elizabeth (Kazabazua)
Poltimore (Poltimore)
Namur (Namur)
Dr. S. E. McDowell (Shawville)
Onslow (Quyon)
St-John’s (Campbell’s Bay)
Secondary Schools
Philemon Wright High/
Hadley Junior (Hull)
D’Arcy McGee High/
Symmes Junior (Aylmer)
St-Michaels High (Low)
Pontiac (Shawville)
K-11 Schools
Dr. Wilbert Keon (Chapeau)
Golden Valley (Val d’Or)
G.Theberge (Temiscaming)
Maniwaki Woodland
Noranda
ADULT EDUCATION CENTRES
CENTRES D’ÉDUCATION AUX
ADULTES
Western Québec Career
Centre (Aylmer)
Hull Adult Education Centre
(Hull)
Pontiac Adult Education
Centre (Shawville)
Maniwaki Adult Education
Centre (Maniwaki)
Val d’Or Adult Education
Center
Revised 3/09/14
Office use only:
Valid security background check within the past 2 years:____________ Verified by:_____________
Cert. Main. Work
Ouvr.Certifié