Application Form:
OISE/UT Principal Qualification Program
(Cambridge, Ontario)





I am applying for . . .      Part 1: ___     Part 2: ___

I wish to study during . . .    Spring Session: ___     Fall Session: ___

Part A: Personal Information

Surname: ____________________     First Name: __________     Second Name: __________

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


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