Primary School Substitute Teacher Registration Form SECTION 1: PERSONAL DETAILSPLEASE ENTER YOUR FULL NAME:PrefixMr.Mrs.Ms.Mx.MissDr.Prof.First Name *Middle NameLast Name *PLEASE ENTER YOUR COMPLETE ADDRESS:House/LP Number:Street Address: *City/Town: *PLEASE ENTER YOUR CONTACT INFORMATION:Primary Contact Number: *Primary Email Address: *PLEASE PROVIDE AN EMERGENCY CONTACT:First Name *Last Name *Relation:Primary Contact Number: *Primary Email Address: *PLEASE ENTER YOUR DATE OF BIRTH AND OTHER RELEVANT INFORMATION:Date of Birth *Place of Birth:Nationality:Passport Sized Photo: *Choose FileNo file chosenDelete uploaded fileMust have a solid background and be in JPG or JPEG format and cannot exceed 100MB.Birth Certificate: *Choose FileNo file chosenDelete uploaded fileMust be in PDF Format and cannot exceed 100MBSECTION 2: ADDITIONAL INFORMATIONTeacher Registration Number: *NIS Number: *BIR Number: *Assessment: *Subject Area: *Choose File: *Choose FileNo file chosenDelete uploaded fileMust be in PDF Format and cannot exceed 100MBLetter of Acknowledgement of Teaching Application: *Choose FileNo file chosenDelete uploaded fileMust be in PDF Format and cannot exceed 100MBCertificate of Good Character: *Choose FileNo file chosenDelete uploaded fileMust be in PDF Format and cannot exceed 100MBSECTION 3: QUALIFICATIONSACADEMIC QUALIFICATIONS:Please upload the relevant certificate for each academic qualificationSchool / Institution Attended: *Qualification / Certification Recieved: *Year Obtained:Certificate / Degree: *Choose FileNo file chosenDelete uploaded fileMust be in PDF Format and cannot exceed 100MBWORK EXPERIENCE:Employer Name: *Employer Address: *Position Held: *Have you ever been refused permission to register as a Teacher or have had your name removed from the Teacher's Register? *YESNOSECTION 4: RECOMMENDATIONSPLEASE ENTER THE DETAILS OF YOUR RECOMMENDER'SRECOMMENDATION:First Name *Last Name *Current School: *Post / Position Held: *Teacher Registration Number: *Recommendation Letter: *Choose FileNo file chosenDelete uploaded fileMust be in PDF Format and cannot exceed 100MBSECTION 5: ADDITIONAL UPLOADSMarriage Certificate:Choose FileNo file chosenDelete uploaded fileFor married women only. Must be in PDF Format and cannot exceed 100MBAffidavit:Choose FileNo file chosenDelete uploaded fileOnly if applicable. Must be in PDF Format and cannot exceed 100MBDeed Poll:Choose FileNo file chosenDelete uploaded fileOnly if applicable. Must be in PDF Format and cannot exceed 100MBSECTION 6: DECLARATIONI hereby affirm and certify that all the information provided on this application is complete, true and correct. I understand and accept that any misrepresentation, falsification or omission of any information requested in this application may result in this application being rejected and/or deferred. *Yes, I agreeSubmit Application