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