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EMPLOYMENT APPLICATION Teaching Position Unit 4 – 75 Thornhill Street Morden, Manitoba R6M 1P2 Phone (204) 822-4448 Fax (204) 822-4262 P a g e 1 | 2 Email : [email protected] Given Name Last Name (Underline Name Used) Mailing Address ______________________________________________________________________________ (No.) (Street) (City/Town) (Prov.) (Postal Code) Telephone No. Email (Primary) (Alternate) Have you been employed previously by this Division? No Yes If yes, when____________________ MANITOBA PROFESSIONAL SCHOOL PERSONNEL CERTIFICATION (please check all that apply) Permanent Certification # Provisional Certificate Type General Professional Technical Vocational School Clinician School Leadership/Administrator School Leadership School Counsellor Special Education Special Education Coordinator TEACHING PREFERENCE (please rank in order of preference) Choose an item. Early Years Choose an item. Middle Years Choose an item. Senior Years Choose an item. Adult Education Choose an item. Administration Choose an item. Substitute SUBJECT AREAS French (Basic) Music (Band) Aboriginal Studies French (FSL) Music (Choral) Arts French (Immersion) Physical Education & Health Business Studies Guidance & Counselling Science – Biology Computer & Technology History Science – Chemistry Early Childhood Home Economics Science – Physics English as a Second Language Industrial Arts (Specify) Social Studies & Humanities English & Classical Studies Mathematics Vocational (Specify) SPECIAL EDUCATION AND RESOURCE Behavioural Needs Emotionally disturbed Physical Disability Intellectual Disability Language Disability Visual Impairment Hearing impaired Learning Disability Resource LANGUAGE(S) (Please indicate which languages in which you are able to fluently…) Language Speak Read Write Language Speak Read Write English Russian French German Other__________________ _ Other__________________ _

EMPLOYMENT APPLICATION Teaching Position...SUBJECT AREAS ☐ French (Basic) ☐ Music (Band) ☐ Aboriginal Studies ☐ French (FSL) ☐ Music (Choral) ☐ ☐Arts French (Immersion)

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  • EMPLOYMENT APPLICATION Teaching Position

    Unit 4 – 75 Thornhill Street Morden, Manitoba R6M 1P2 Phone (204) 822-4448

    Fax (204) 822-4262 P a g e 1 | 2 Email : [email protected]

    Given Name Last Name

    (Underline Name Used) Mailing Address ______________________________________________________________________________ (No.) (Street) (City/Town) (Prov.) (Postal Code)

    Telephone No. Email (Primary) (Alternate)

    Have you been employed previously by this Division? No ☐ Yes ☐ If yes, when____________________

    MANITOBA PROFESSIONAL SCHOOL PERSONNEL CERTIFICATION (please check all that apply)

    ☐ Permanent Certification # ☐ Provisional Certificate Type

    ☐ General Professional ☐ Technical Vocational ☐ School Clinician ☐ School Leadership/Administrator

    ☐ School Leadership ☐ School Counsellor ☐ Special Education ☐ Special Education Coordinator

    TEACHING PREFERENCE (please rank in order of preference) Choose an item. Early Years Choose an item. Middle Years Choose an item. Senior Years

    Choose an item. Adult Education Choose an item. Administration Choose an item. Substitute

    SUBJECT AREAS ☐ French (Basic) ☐ Music (Band)

    ☐ Aboriginal Studies ☐ French (FSL) ☐ Music (Choral)

    ☐ Arts ☐ French (Immersion) ☐ Physical Education & Health

    ☐ Business Studies ☐ Guidance & Counselling ☐ Science – Biology

    ☐ Computer & Technology ☐ History ☐ Science – Chemistry

    ☐ Early Childhood ☐ Home Economics ☐ Science – Physics

    ☐ English as a Second Language ☐ Industrial Arts (Specify) ☐ Social Studies & Humanities

    ☐ English & Classical Studies ☐ Mathematics ☐ Vocational (Specify)

    SPECIAL EDUCATION AND RESOURCE ☐ Behavioural Needs ☐ Emotionally disturbed ☐ Physical Disability

    ☐ Intellectual Disability ☐ Language Disability ☐ Visual Impairment

    ☐ Hearing impaired ☐ Learning Disability ☐ Resource

    LANGUAGE(S) (Please indicate which languages in which you are able to fluently…) Language Speak Read Write Language Speak Read Write

    English ☐ ☐ ☐ Russian ☐ ☐ ☐

    French ☐ ☐ ☐ German ☐ ☐ ☐

    Other__________________ _ Other__________________ _

    mailto:[email protected]

  • EMPLOYMENT APPLICATION Teaching Position

    Western School Division welcomes and encourages applications from people with disabilities. Accommodations are available on request for candidates taking part in all aspects of the selection process.

    Unit 4 – 75 Thornhill Street

    Morden, Manitoba R6M 1P2 P a g e 2 | 2 Phone (204) 822-4448 Fax (204) 822-4262 Email : [email protected]

    Please append the following documents to this application:

    □ Cover Letter □ Manitoba Teacher’s Certificate (applicants without a certificate will not be given further consideration)

    □ Resume □ Educational Philosophy

    REFERENCE CHECK RELEASE

    I, , hereby give permission to Western School Division to contact the

    persons listed below for the purposes of obtaining reference information. These persons are aware that you will

    contact them and have my permission to discuss information regarding my current and/or previous employment.

    Name Phone Number /Email Address Relationship

    I hereby consent to your conducting a personal investigation in connection with this application under the terms of the Personal Investigations Act and acknowledge that any offer of employment by the Division is subject to a satisfactory criminal records check, vulnerable sector search, and child abuse registry check I also declare that I have a valid Manitoba Teaching certificate and that I am not precluded from working in Canada. Furthermore, once employed, should I ever be charged with a criminal or other offense excluding Highway Traffic Act offenses, I will divulge this to the Division within three working days. I understand that the information provided by me in this application for employment to the Western School Division (”the Division”) constitutes material and important representations by me intended to induce the Division to enter into a contract of employment with me. I therefore understand and agree that the giving by me of false, misleading or incomplete information in this application for employment will constitute just cause for dismissal of me from any employment entered into with me by the Division and will also fully justify the Division in treating any contract entered into by it with me to be null void. If employed, I agree to abide by the policies, procedures and working conditions established by the Western School Division

    Name (Please print) Signature of Applicant Date

    mailto:[email protected]

    Given Name: Last Name: Mailing Address: Telephone No: Email: Alternate: undefined: MANITOBA PROFESSIONAL SCHOOL PERSONNEL CERTIFICATION please check all that apply: undefined_2: Permanent Certification: OffProvisional: OffGeneral Professional: OffTechnical Vocational: OffSchool Clinician: OffSchool LeadershipAdministrator: OffSchool Leadership: OffSchool Counsellor: OffSpecial Education: OffSpecial Education Coordinator: OffAboriginal Studies: OffArts: OffBusiness Studies: OffComputer Technology: OffEarly Childhood: OffEnglish as a Second Language: OffEnglish Classical Studies: OffFrench Basic: OffFrench FSL: OffFrench Immersion: OffGuidance Counselling: OffHistory: OffHome Economics: OffIndustrial Arts Specify: OffMathematics: OffBehavioural Needs: OffIntellectual Disability: OffHearing impaired: OffEmotionally disturbed: OffLanguage Disability: OffLearning Disability: OffMusic Band: OffMusic Choral: OffPhysical Education Health: OffScience Biology: OffScience Chemistry: OffScience Physics: OffSocial Studies Humanities: OffVocational Specify: OffPhysical Disability: OffVisual Impairment: OffResource: OffREFERENCE CHECK RELEASE: Early Years Preference: [Choose an item]Middle Years Preference: [Choose an item]Senior Years Preference: [Choose an item]Adult Ed Preference: [Choose an item]Administration Preferences: [Choose an item]Substitute Preference: [Choose an item]English: 0: Off1: Off2: Off

    French: 0: Off1: Off2: Off

    Russian: 0: Off1: Off2: Off

    German: 0: Off1: Off2: Off

    Other: 1: 0:

    Cover Letter: OffMB Teacher's Certificate: OffResume: OffEducational Philosophy: OffName 1: Name 2: Name 3: Name 4: Name Please print: Date: Previous emplyment with WSD: Off