application for a teacher's license

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APPLICATION FOR A TEACHER'S LICENSE Your completed application form and all documents to support your application must be sent to: Office of the Registrar Certification and Standards Section Department of Education, Early Learning and Culture Suite 101, Holman Centre, Suite 101 250 Water Street Summerside, Prince Edward Island C1N 1B6 Tel:(902) 438-4130 Fax:(902) 438-4062 [email protected] Effective August 20, 2016 &Žƌŵ TL-CAN-Eng for persons who completed their teacher education program in a Canadian province or territory outside of PEI.

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APPLICATION FOR A TEACHER'S LICENSE

Your completed application form and all documents to support your application must be sent to:

Office of the Registrar Certification and Standards Section

Department of Education, Early Learning and Culture Suite 101, Holman Centre, Suite 101

250 Water Street Summerside, Prince Edward Island

C1N 1B6 Tel:(902) 438-4130 Fax:(902) 438-4062

[email protected]

Effective August 20, 2016 TL-CAN-Eng

for persons who completed their teacher education program in a Canadian province or territory outside of PEI.

GUIDELINES FOR APPLYING FOR A PEI TEACHER'S LICENSEFOR APPLICANTS WHO COMPLETED A TEACHER EDUCATION WITHIN CANADA Please read the instructions carefully and follow the directions diligently when completing and submitting this application.

WHY APPLY FOR A PEI TEACHER’S LICENSE?

Under Section 67. (1) of the Education Act, an education authority shall not employ a person as a teacher unless the person holds a teacher’s license. A person who applies for a teacher’s license must apply in accordance with section 98 of the Education Act. You must provide the supporting documents in the form and content as outlined below with your application. There are two education authorities in PEI: the Public Schools Branch and the Commission scolaire de langue française.

Attention Out-of-Province Applicants!This application form is for persons who completed a pre-service professional teacher education program at a university located in a Canadian jurisdiction outside of Prince Edward Island. All applicants must provide proof that they were licensed to teach first in the province or territory where they completed their teacher education program; even if you never taught there.

1.HOW DO I APPLY FOR A PEI TEACHER'LICENSE?The following is a checklist of items required bythe Registrar under the authority of theEducation Act for use when assessing andprocessing your application for a P.E.I.Teacher’s License. Please note that there is: aPart One regarding documents you enclosewith the application form, and a Part Tworegarding documents you must order.

PART ONE: Enclose the following with your completed application and mail to the address shown on the application cover page.

i a copy of your Birth Certificate to verify your

identity (See Section E on the kinds ofdocuments that can be used to verifyidentity.)

a copy of your Social Insurance Number card oryour SIN confirmation letter as s proof of youreligibility to work in Canada (See Section F on thedocuments that can be used to prove that youhold a Canadian work permit.)

a copy of a Criminal Record BackgroundCheck current to within three (3) months of thesubmission

a copy of a Vulnerable Sector Screen current towithin three (3) months of the submission of yourapplication

a copy of your teacher’s certificate as proof thatyou were certified to teach in the Canadianjurisdiction in which you completed your pre-service teacher education program such as a copyof your teacher’s certificate

a copy of your teacher’s certificate for allother jurisdictions where you have beenlicensed to teach

the $125.00 evaluation fee in the form of acheque or money order made out to theMinister of Finance. The $125.00 fee must be paidin Canadian funds.To pay by credit card, complete the Request toPay Over the Phone form, found at the linkbelow and call 902-438-4850 or 438-4130. Yourcredit card information will taken over the phoneand your payment processed. Include thecompleted Request to Pay Over the Phone formwith your completed application.

PLACE ALL OF THE ABOVE IN AN ENVELOPE AND MAIL TO OUR ADDRESS AS SHOWN ON THE

COVER PAGE OF THIS APPLICATION PACKAGE.

INCLUDE YOUR PAY-OVER-THE PHONE FORM WITH YOUR APPLICATION

PART TWO: Request that the following documents be mailed directly to our office at the address shown on the application cover page.

an official transcript of marks mailed directlyto our office from the university where youcompleted your pre-service professionalteacher education program

official transcripts from all other post-secondary institutions where you havecompleted university studies mailed directlyto our office

a Statement of Professional Standing maileddirectly from the regulator for teachercertification in the jurisdiction where youcompleted your pre-service professionalteacher education program confirming thatyour teacher’s certificate has neverbeen suspended or revoked and that yourteaching license is in good standing in thatjurisdiction, even if you never taught there

a Statement of Professional Standing maileddirectly from the regulator for teachercertification from all other jurisdictionswhere you have been certified to teachstating your teacher’s certificate hasnever been suspended or revoked and thatyour teaching license is in good standing inthat jurisdiction, even if you never taughtthere When we receive the above documents that you

have ordered from postsecondary institutions and from teacher regulators, we will match them to the identification information provided and file them with your application. Your file is held in our Pending Folder until such time as we have received all required documents.

B. WHAT ABOUT LANGUAGE PROFICIENCYREQUIREMENTS? Teachers are language models for students. Teachers must be effective communicators in order to offer effective instruction. A strong command of the language is a requirement of licensing under the Education Act. You should be aware that proof of a satisfactory level of language proficiency in English and/ or in French may be required of applicants who were educated in a language other than English or

French. Proof of language proficiency may be requested by the Registrar if you completed one or more of your educational levels in a language other than English or French.

Language Proficiency Requirements are prescribed by the Teacher Certification and Standards regulations under the authority of the Education Act. They are applicable to persons who completed one or more levels of formal education in a language other than English or French.

Satisfactory results must be demonstrated on the TOEFL or IETS tests for English language applicants and TESTCan for French language applicants. as prescribed by the Minister.

C.WHAT IS THE DEPARTMENT'S POLICYON DOCUMENTS SUBMITTED?

All documents received by the Registrar become the property of the Department of Education. You are therefore advised to make a copy of each document that you submit to keep with your own personal records. Applications and supporting documents are held in our Pending Folder for a maximum of two years then are destroyed if there has been no activity on the file for one full year.

Please note: While the Office of the Registrar will accept a copy of the Criminal Record Check/ Vulnerable Sector Screen, the education authorities on PEI will require the original. Hold on to your original and make a copy to submit with your application. It is always wise to make an additional copy for your personal files. D.WHAT ABOUT DOCUMENTS THAT ARENOT IN ENGLISH OR FRENCH?

If you completed your formal education in a non-English-speaking or non-French-speaking country, your documents may be issued in a foreign language.Official translations from an accredited translation service must be provided where documents not in English or French.

We will provide you a copy of the original document. You must then arrange to take this copy to an accredited translator for translation. The official translation must be returned with the copy of the original to the Registrar.

E.WHAT KINDS OF DOCUMENTS AREACCEPTABLE TO VERIFY IDENTITY? PROOF OF IDENTITY: Alternatives to a copy of a Birth Certificate include, a Canadian or Foreign Passport (must include middle names), a Certificate of Baptism if born in Quebec, a Certificate of Baptism if born in Newfoundland and Labrador prior to January 1994, a Permanent Resident Card (front and back required), a Canadian Immigration Record and Visa Record of Landing (front and back required). Driver’s Licenses, Provincial Health Cards and Canadian Citizenship Cards are not acceptable as proof of identity. PROOF OF NAME CHANGE (IF APPLICABLE): If your name changed throughout your educational or work experiences, please provide a copy of a legal document which supports this change of name such as a copy of a Marriage Certificate.

F.WHAT KINDS OF DOCUMENTS AREACCEPTABLE TO VERIFY ELIGIBILITY TO WORK IN CANADA? A Teacher’s License will not be issued until proof of eligibility to work in Canada has been provided to the Registrar. For out-of-country applicants, a valid work permit issued by the federal government indicating that the application is not restricted from working in a school environment is required on the front and back of your Permanent Resident Card or Record of Landing Form. If you otherwise qualify for a PEI Teacher’s License, there will be a condition placed upon your application. This will remain in effect until such time as you provide proof that you have permission to work in Canada.

G.WHAT DOCUMENTS ARE ACCEPTABLEFOR A POLICE RECORD CHECK? You must submit an original, or a copy of an original, of a signed, Canadian Criminal Record Check report including a Vulnerable Sector Screen. The report must be current to within three (3) months of the date of submission of your application. The report must include your current and past full names.

These will have to match your proof-of-identity documents. You can obtain a criminal record check from a local, regional or national police service.

REQUETING A LETTER: Sometimes police agencies will require a letter from the employer or from the regulator explaining the reason as well as the statutory authority for the Police Record Check. If you find that this is the case, you should e-mail the Registrar and provide the details. We can arrange to have an explanatory letter sent to the police agency.

It is your duty to report within 48 hours to the Registrar any charges or convictions under the Criminal Code of Canada or the Controlled Drugs and Substances Act of Canada.

H.WHAT DOCUMENTS ARE REQUIRED TOSUPPORT ACADEMIC AND PROFESSIONAL CREDENTIALS?

OFFICIAL TRANSCRIPTS You should provide official transcripts to support Section 4 on your Academic Background in of the Application Form.

1.OFFICIAL TRANSCRIPTS TO VERIFY YOUR POST-SECONDARY UNIVERSITY STUDIES

Official transcripts, bearing the institution’s name and the educational institution’s Registrar’s signature, must be mailed directly from the post-secondary institution to the Office of the Registrar in a sealed envelope. Faxed, e-mailed or hand-delivered copies of transcripts will not be accepted. The official transcript must contain the title of the degree that you were awarded and the date when you successfully completed your degree. It must outline the courses and credit hours completed, the completion date as well as the length of the program. You should include a transcript for each post-secondary institution at which you completed credited coursework.

PLEASE NOTE: Do not fax, e-mail or hand deliver transcripts. Transcripts transmitted in these fashions are not considered official. Transcripts must be mailed directly from the university to the Office of the PEI Registrar for Teacher Certification.

2.OFFICIAL TRANSCRIPTS TO VERIFYCOMPLETION OF YOUR PRE-SERVICEPROFESSIONAL TEACHER EDUCATION PROGRAMYou must provide proof that you have completedan approved and recognized pre-serviceprofessional teacher education program. Theofficial transcript must contain the name of thedegree that you were awarded and the date whenyou successfully completed your degree. It mustoutline the courses and credit hours completed aswell as the length of the supervised practicum. Anacceptable pre-service teacher education programmust include completion a minimum of thirty (30)credit hours and a supervised practicum of aminimum length of twelve (12) weeks or sixty (60)days.DO NOT APPLY FOR A PEI TEACHER’S LICENSEUNTIL SUCH TIME AS YOU HAVE SUCCESSFULLYCOMPLETED YOUR PRE-SERVICE PROFESSIONALTEACHER EDUCATION PROGRAM.

3.STATEMENT OF PROFESSIONAL STANDINGIf you completed a teacher education program in aCanadian jurisdiction, you would have mostlikely applied for and have been granted ateacher’s certificate in that jurisdiction. You mustrequest that an official Statement of ProfessionalStanding be mailed on your behalf to theRegistrar from the certification authorities in alljurisdictions where you held a teacher’s certificateeven if you have never taught there. Thisincludes the jurisdiction where you completedyour teacher education program. Thestatement(s) must confirm that your teacher’scertificate is valid and in good standing in thejurisdiction(s). Please note that the Statement ofProfessional Standing is not a copy of yourteacher’s certificate nor is it an evaluation of yourteaching. The Statement of Professional Standingmust be issued by the Ministry or Collegewho holds the authority to license teachersfor that jurisdiction. The SOPS must be maileddirectly to the Office of the Registrar.THE ONTARIO EXCEPTIONOntario is an exception as Ontario College ofTeachers posts teacher's Statement of ProfessionalStanding on their web site. This is acceptable forcertification purposes in PEI. You must providethe Registrar with your OCT registrationnumber so that your Statement of ProfessionalStanding can be accessed online.

I.WHAT WILL MY PEI TEACHER’SLICENSE LOOK LIKE? The Registrar will examine your academic credentials including all official transcripts and copies of degrees and diplomas. If you qualify for a PEI Teacher’s license, you will be assigned an a Qualification Level and a Basic Designation to your teacher's license.

BASIC DESIGNATIONS: Your Basic Designation will reflect the teacher education program that you completed. In PEI, this is Primary/Elementary and Intermediate/ Senior.

QUALIFICATION LEVELS The PEI Registrar evaluates the credentials submitted by each applicant and assigns a qualification level according to the following criteria.

A Qualification Level 4 may be granted to an applicant who has successfully completed an approved pre-service teacher education program and a minimum of one-hundred and twenty (120) approved credit hours of post-secondary study. This could include: an approved ninety (90) credit hour undergraduate degree along with an approved thirty (30) credit pre-service teacher education program or an approved one hundred and twenty (120) credit hour bachelor of education program.

A Qualification Level 5 may be granted to an applicant who has successfully completed an approved pre-service teacher education program and a minimum of one hundred and fifty (150) approved credit hours of post-secondary study. This could include an approved one hundred and twenty (120) credit hour undergraduate degree plus an approved teacher education program of a minimum of thirty (30)credit hours or a consecutive bachelor and bachelor of education program of a minimum of one hundred and fifty (150) credit hours. A teacher education program may be counted to a maximum of 30credit hours regardless of its duration beyond one year.

Qualification Level 5-A may be granted to an applicant who has successfully completed a minimum of an approved one full academic year of study totalling hirty (30) credit hours beyond the Certificate 5 where theadditional coursework did not result in a completion of amaster's degree.

A Qualification Level 6 may be granted to an applicant who has successfully completed an approved one full academic year of study, a minimum of thirty (30) credit hours beyond the Academic Teacher’s Certificate Level 5 of an approved master’s degree program. This master's degree must be beyond any master degree completed as part of a pre-service teacher education program that was recognized for initial certification.

A Qualification Level 7 may be granted to an applicant based upon the achievement of an approved doctoral degree or approved additional masters degree resulting in a minimum of two hundred and ten (210) credit hours. The additional degree must be in an area related to the authorized PEI Public School system curriculum. There are currently no salary implications associated with the Level 7.

J.WHEN DOES MY TEACHER’S LICENSEBECOME EFFECTIVE?

A Teacher's License becomes effective from the date when the Office of the Registrar has received all of the required documentation and in the event that all documentationhas been approved by the Registrar and meets the requirements outlined in the Teacher Certification and Standards regulations under the Education Act. A PEI Teacher's License remains valid from the date of issue unless suspended, cancelled or revoked.

IF, UPON RECEIVING YOUR PEI TEACHER’S LICENSE, YOU FEEL THAT YOU WERE NOT ASSIGNED THE CORRECT QUALIFICATION LEVEL OR DESIGNATION, YOU SHOULD CONTACT THE REGISTRAR ASAP.

K.IS THERE AN APPEAL POLICY?

Under subsection 101(1) of the Education Act, aperson may commence an appeal of a refusal toissue a teacher’s certificate or a refusal to issue aqualification level by sending a written notice ofappeal and the $200 appeal fee to theMinister, not later than 15 business days fromwhen you receive your certificate.

APPLYING FOR ALLIED WORK EXPERIENCE RECOGNITION You may qualify for work experience recognition for salary placement purposes for service that is related to teaching under the Allied Work Experience Program. Allied Work Experience may be recognized on the basis of one year for two years of allied work experience. All service must be verified by a letter from a former employer.

M. HOW DO I APPLY FOR EMPLOYMENTIN PRINCE EDWARD ISLAND? Although Teacher Certification is handled by the Registrar’s Office at the Department of Education, Early Learning and Culture, all employment matters are dealt with by the education authorities. When seeking employment, you will need to contact the appropriate education authority at the contact information shown here below.

PLEASE NOTE APPEAL POLICY BELOW:

L.WHAT ABOUT RECEIVING RECOGNITIONFOR TEACHING EXPERIENCE OUTSIDE OF PEI? You may qualify for recognition of your teaching experience for salary placement purposes.

FOR RECOGNITION OF TEACHING EXPERIENCE Recognition for teaching experience (contractual, short-term contractual and substitute) outside of a Prince Edward Island school board not exceeding 185 days in each school year may be granted upon application to applicants who qualify. This applies to teaching service with a school board outside of Prince Edward Island, or for service within PEI not with a PEI school board. Service must be verified with letters from former employers.

You may include your application for teaching service recognition with your application for a teacher' s licesne

Applying for a Teaching Assignment in PEI Teaching positions are posted to the employers’ web site. If you would like to have us send your certification information to an employer, please indicate this in Section 6 of this application package.

Applying for Substitute Teacher Authorization Teachers who have been licensed to teach on Prince Edward Island may apply to substitute teach and will receive a Certified Rate of Pay. You must, however, be issued a verification letter first. If you wish to substitute right away, please indicate on this form that you wish to receive a Verification of Eligibility to Substitute for a Teacher. Indicate in Section 6 as well the school board(s) where you wish to have your Verification Letter sent. Applying for Substitute Teacher Authorization at a Later Time If you prefer to apply for a substitute teacher authorization at a later date, you will be required to complete and submit an form found on our web site.

The Verification Letter may be valid for both education authorities; the Public Schools Branch and the Commission scolaire de langue française. Certified substitute teachers are required to notify the education authority employer each year when they wish to substitute teach.

PUBLIC SCHOOLS BRANCH 2-234 Shakespeare Drive Stratford,

PE C1B 2V8Mailing Address: P.O. Box 8600

Charlottetown, PE C1A 8V7 Tel. 902 368-6990 Tel. Toll Free 1-800-280-7965 Fax 902 368-6960

E-mail: [email protected]

N. FEE POLICYThe required fee of $125.00 as well as thecompleted application form and requireddocumentation must be received by the Office of theRegistrar before an application for a teacher’scertificate will be evaluated or issued. The fee isnon-refundable unless the application iswithdrawn and in the event that no staff time hasbeen invested in processing the application. Theapplication fee must be paid by cheque, or bymoney order made out to: The Minister ofFinance. Or, by credit card over the phone bycontacting the Office of the Registrar.

O. ON PROCESSING TIME:Applications are processed on a first in, first outbasis. Please allow three (3) weeks from the datewhen all required documentation has beenreceived by the Office of the Registrar.

P. INQUIRING ABOUT THE STATUSOFYOUR APPLICATIONIf you have any questions concerning the receipt bythe Office of the Registrar or transcripts and/orother documentations or to inquire about thestatus of your application, you are kindly askedto contact the Office of the Registrar via e-mail at: [email protected]. In the subject lineof your e-mail please write “Status UpdateRequested”. In the body of your e-mail clearlyidentify yourself, the nature of yourapplication and your inquiry.

Q. OBTAINING ASSISTANCE:Other inquiries may be directed to the Registrar’sAdministrative Assistant by calling (902)438-4130

R. FOR FORMS, RESOURCES AND FURTHERINFORMATION, VISIT OUR WEB SITE.

LA COMMISSION SCOLAIRE DE LANGUE FRANÇAISE 1596, route 124 Wellington Station, Abram-Village (PEI) C0B 2E0 Telephone : (902) 854-2975 Fax : (902) 854-2981 E-mail : [email protected]

PEI SCHOOL BOARD/ AUTHORITY EMPLOYERS

Application Form for a PEI Teacher's License for applicants who completed their Teacher Education Program in a Canadian province or territory outside of PEI

SECTION 1: REQUIRED DOCUMENTATION Please indicate the documents you areenclosing (Enclosed) with this application form, the documents which you have requested (Requested) to be sent on your behalf and any documentation which is not applicable to your application (N/A).

Enclosed Requested N/A

1. Proof of Identity such as a copy of your birth certificate

2. Proof of eligibility to accept employment in Canada such as a copy ofyour social insurance card

3. Copy of a Criminal Background Check current to within three (3)months of the date of submission of the application.

4. Copy of a Vulnerable Sector Screen current to within three (3)months of the date of submission of the application.

5. Official transcript of marks mailed directly from the university whereyou Pre-Service Professional Teacher Education Program.

6. Official transcripts mailed directly from the postsecondaryinstitutions where you completed your academic studies.

7. A copy of your teacher’s license from the jurisdiction where youcompleted your Pre-Service Teacher Education Program.

8. A Statement of Professional Standing from the jurisdiction where youcompleted your teacher education program mailed directly from theRegistrar for Teacher Certification for that jurisdiction.

9. A copy of your teacher’s license from every jurisdiction whereyou have been licensed to teach, even if you never taught there.

10. A Statement of Professional Standing from every jurisdiction whereyou have been licensed to teach, mailed directly from the Registrar forTeacher Certification for the jurisdiction, even if you never taughtthere.

11. $125.00 evaluation fee in the form of a cheque or money ordermade out to the Minister of Finance. To pay by credit card, call ouroffice 902 438-4130.

I AM PAYING BY: CHEQUE MONEY ORDER

CREDIT CARD

12. Proof of Language Proficiency in English or French may be required in some instances.Indicate here if you have enclosed the results of a language proficiency test, if you haverequested them, or if this is not applicable to you.

SECTION 2: IDENTIFICATION First Name Middle Name Surname*

Date of Birth Place of Birth

Social Insurance Number:

*If you were educated or previously certified in a name other than that used above please indicate your former name below. Also, please provide copies of documentation to support this legal name change such as a copy of your Marriage Certificate, Divorce Certificate, Certification of Name Change, Court Order

Other Name:

Describe the document you are providing to support the name change:

SECTION 3: CONTACT INFORMATION

MAILING ADDRESS:

Telephone Number: E-mail Address:

SECTION 4: EDUCATION

HIGH SCHOOL EDUCATION Name and Address of High School:

Grade Completed Year Completed

POST SECONDARY EDUCATION Official transcripts are required for ALL post secondary studythat you completed. Official Transcripts must be sent directly to the Office of the Registrar at the above address from the Post-Secondary Institution.

TEACHER EDUCATION PROGRAM Indicate here the program that you completed that isrecognized for Teacher Certification in the jurisdiction where it is offered.

Name and Address of Post Secondary Institution Where You Completed Your Pre-Service Teacher Education Program:

Name of Credential Achieved:

Dates Attended: From:

M h Y

To:

M h OTHER UNIVERSITY

Name and Address of Post Secondary Institution Name of Credential Achieved:

Dates Attended: From:

M th Y

To:

M thName and Address of Post Secondary Institution: Name of Credential Achieved:

Dates Attended: From:

M h Y

To:

M hName and Address of Post Secondary Institution: Name of Credential Achieved:

Dates Attended: From:

M h Y

To:

M hInclude additional studies on separate sheet.

LANGUAGE OF INSTRUCTION Indicate your language of instruction for each level.

Primary Secondary Postsecondary Undergraduate Postsecondary teacher education

English English English English

French French French French

Other Other Other Other

SECTION 5: PREVIOUS TEACHING EXPERIENCE Please include name of school(s) and schoolboard(s)/ district (s) where you taught, number of years. Do NOT include your teaching practicum (s). To obtain recognition for out -of-province experience, you must apply using the form and provide verification from former employers.

Name & Address of school/school board

From: To:

Name & Address of school/school board

From: To:

Name & Address of school/school board

From: To:

Name & Address of school/school board

From: To:

*To obtain service recognition for your previous teaching experience at a school or with a school board outside of PrinceEdward Island, you must apply using the application form found on our web site. Verification letters from former employerswritten on must be submitted to the Registrar in order to be eligible for out-of-province service recognition.

SECTION 6: APPLYING FOR EMPLOYMENT IN PRINCE EDWARD ISLAND (i)APPLYING FOR A TEACHING ASSIGNMENT IN PEI Please indicate below the employer where youauthorize the Registrar to send your certification information.

Public Schools Branch Commission scolaire de langue française

Department of Education Other

(ii) APPLYING TO SUBSTITUTE TEACH Holders of a valid PEI Teacher’s Certificate are eligible to substituteteach in PEI public schools. Please indicate if you wish to be issued a Verification Letter.

Yes, please issue a Verification of Eligibility to Substitute Teach.

No, I do not wish to be issued a Verification of Eligibility to Substitute Teach at this time.

If yes, please indicate by checking the box the education authority or education authorities where you would like your Verification of Eligibility to Substitute Teach to be sent.

Public Schools Branch Commission scolaire de langue française

I hereby authorize the Prince Edward Island Registrar for Teacher Certification to send the above school employer(s) my certification information as indicated in Section 6 (i) and (ii)

DATE SIGNED SIGNATURE:

7. PERSONAL BACKGROUND DISCLOSURE QUESTIONS All questions in thissection must be answered unless otherwise indicated. For every affirmative answer (yes), please attach awritten explanation on a separate piece of paper referencing the question number

1. Have you ever been convicted, given an absolute or conditional discharge, or received a pardon for acriminal offence or are there any outstanding charges against you?

NO YES

2. Have you ever had an application for a teacher’s certificate in any other jurisdiction rejected?

NO YES

3. Have you ever been found guilty of misconduct by a teaching authority or other educationalorganization?

NO YES

4. Have you ever, for any reason other than non-payment of fees had a teacher’s certificate suspended orrevoked in another jurisdiction?

NO YES

5. Have you ever had an application for an Authorization to Substitute for a Teacher suspended orrevoked?

NO YES

Submission of an application that is misleading or false, in whole or in part, may lead to the denial of certification.

DECLARATION I declare that all information given on this application is true, correct and complete to the best of my knowledge and I hereby authorize the Department of Education, Early Learning and Culture to verify the above information. I accept responsibility for advising the Department of Education, Early Learning and Culture for advising, in writing, of any change to the information contained in the Personal Background Information or any other section of this application.

Signature Date

Personal information on this form is collected under sections 98 and 100 of the Education Act R.S.P.E.I. 1988, Cap. E-02 and will be used for the purpose of verifying identity and educational credentials. If you have any questions about this collection of personal information, you may contact the Office of the Registrar, Certification and Standards Section, Department of Education, Early Learning and Culture, Holman Centre Suite 101, 250 Water Street, Summerside, PEI C1N 1B6 Telephone 902-438-4130

LAST UPDATED AUGUST 20, 2016

Under Section 98 of the Education Act, the Registrar may refuse or suspend a teacher's license to a person who misrepresents his or her qualifications in an application for a teacher’s license or who fails to possess the qualifications required under the Act at the time the teacher’s license was issued.