I wish to study during . . . Spring Session: ___ Fall Session: ___
Social Insurance Number: _______________ Ont. College of Teachers # _______________
Address to which ALL correspondence should be forwarded:
Street: _______________________________________
Apt / Unit: __________ City: ___________________
Province: _____ Postal Code: __________
(N.B.: Please inform us at OISE, in writing,
of any change of address.)
Telephone: (home) _______________ (school) _______________ E-mail: ______________
Name of School: (or office if applicable): ______________________________________________
Panel: Elementary _____ Secondary _____ School District: ________________________
Part 1 of the Principal Qualification Course: (if applicable)
Institution: _______________________________
Date: ________________________________
Part B: Professional Qualifications and Experience
Please forward a photocopy of your updated Ontario
Teacher Certificate of Qualification, along with the completed
application form. Any qualifications must be confirmed by an
entry on the Certificate of Qualification or
by official transcript.
Divisional Areas of Concentration: (3 required, one of which must be intermediate)
Primary: _______ Junior: _______ Intermediate: _______ Senior: ________
Specialist Qualifications:
1. _______________________________________ 2. _______________________________________
3. _______________________________________ 4. _______________________________________
Part C: Academic Qualifications
Degree Date Conferred University Major
_____________________________________________________________________________________
_____________________________________________________________________________________
Additional University Courses: (list additional courses on separate sheet if necessary)
Teaching Experience in Ontario: Total Number of Years: ________
SIGNATURE OF SUPERVISORY OFFICER CERTIFYING EXPERIENCE:
_____________________________________________________________________________________
(name) (title)
Please Note: This application MUST be accompanied by your
Ontario
Certificate of Qualifications
and both the non-refundable application fee of $50.00 and the
course fee of $750.00. (Cost includes text
and all materials!) Please make cheques payable to OISE
/ UT.
ADDRESS ALL CORRESPONDENCE REGARDING THIS COURSE TO:
Dr. Paul Begley Department of Theory and Policy Studies, OISE
/ UT, 252 Bloor St. W. Toronto,
Ontario M5S IV6. TEL. (416) 923-6641 ext 2406
FAX (416) 926-4741