Commission scolaire - Riverside School Board

7525, Chemin de Chambly
Saint-Hubert (Québec) J3Y 0N7
Tél/Tel : (450) 672-4010
Télécopieur/Fax : (450) 550-8019
TEACHER APPLICATION FOR SUBSTITUTE TEACHING
Name: __________________________________
First name: _____________________________________________
Address: _________________________________________________________________________________________
City: _____________________________________________ Postal code: ____________________________________
Telephone: ____________________________
Email: ___________________________________________________
Educational level completed: _________________________________________________________________________
Check one of the three (3) boxes: Brevet
4th year in a B.Ed. program:
Permit
Please specify brevet or permit number: ________________
Specify: ______________________________
Please indicate the levels and subject areas you are qualified to teach:
Elementary:
General subjects:
Immersion française:
F.S.L.:
P.E.:
Secondary:
Adult Education:
General Education:
Vocational Education:
Indicate your subject specialties:_____________________________________________________________________
(Ex.: ELA, Math, History, etc.)
Availability (days): _________________________________________________________________________________
Please be advised that some of our schools are not well served by public transit. Please check the appropriate box.
Available only for schools accessible by public transit.
Available for all schools.
References:
Name: _________________________________________ Company: _________________________________________
Title: _____________________________________________________ Phone: _________________________________
Name: _________________________________________ Company: _________________________________________
Title: _____________________________________________________ Phone: _________________________________
I consent and authorize Riverside School Board to contact the above named to verify any references concerning me,
including achievement, performance, attendance, disciplinary information and reason of separation of employment. I
understand that any information given is to be used for purposes of determining my employment.
Signature: ______________________________________
N.B.
Date: __________________________________________
Kindly advise us at [email protected] should you, at some point
during the school year, no longer be available.
…promouvoir un environnement stimulant et enrichissant visant à assurer la réussite personnelle de tous les élèves.
…committed to providing a stimulating and caring environment which enables all students to achieve personal success.
Revised January 29, 2014