TEACHER TRANSFER FORM
This form is to be completed by teachers who wish to be transferred to another school.
A. Name: _ _ _ _ _~ (first) _ _ _ _ _ _ _ (middle) _ _ _ _ _ _,(Iast)
Date of Birth: _ _ _ _ _ _ __
Married: YeslNo if yes, number of children: _ _ _ _ _ _ _ _ _ __
B. Year you started to teach: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
C. Teaching Subject: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
D. Previous School you taught at:
School Years
From To
I.
2.
3.
4.
5.
6.
E. Year started in the present school: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
F. Three (3) Schools you want to be transferred to in order of priority
I. 2. 3. _ _ _ _ _ _ _ _ __
Give reason(s) for your request: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Principal's Comments: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Decision by PEO (Education Authority): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
TEACHERS INFORMATION
GENERAL
1 School Name 2 Education Authority
1 1
3 School Location and Type (Remote, Urban, Etc)
1 1 1 1
Rural or
Island Area Urban
4 School Statistics
1
Total Student Enrol. .. No. Of Studenttaught Contact hours
SOCIAL
5 Surname 6 Given Name
(Must be the same surname used in any
academic transcripts, birth cerificate or passport)
7 Date of Birth 8 Place of Birth
1 1 1
Day Month Year
9 Home Island 10 Gender
1 1 1
Male Female
11 Marital Status (Please tick the most appropriate;:...b:..:o:..::x,-)_ _--,
~~I 1 1 ,-I_---'
Single Married Divorced
widowed Defacto
12 Name of Spouse
1
13 Spouse Employment
Name of Work
Name of Company Place
14 Number of Chidren
1
15 Children Information (Children currently attending school)
Child. 1 rC=h:.::il.::::d'c::2~_ _--, Child. 3
I ~I______~
Name Name Name
Age Age Age
[ I
School School School
I [
Class Class Class
[ [
Medium Medium Medium
Child. 4 Child. 5 Child. 6
[ I
Name Name Name
Age Age Age
School School School
Class Class Class
Medium Medium Medium
16 Type of Current Accomodation (Please tick the most appropriate box)
[ I L - [_ _- - ' [ I
School
Rent own House
17 Social Status in Community (Please tick the most appropriate box)
[ I L - [_ _- - ' [ I
Chief Chairman Sports Organiser
of Organ
I I
Pastor Elder Other
18 Denomination
I
TECHNICAL
19 Period of service in the current school/community
[
20 Field of expertise (Subjects)
[
21 Status (Please tick the most appropriate box)
[ I I I CJ
Temporary Probation Permanent L/Contract
22 Current Post
1
(Principal, Head Teacher or Teacher)
23 Transfer information within the last five (5) years - Insert school namr-e_ _ _ _ _--,
1 1 1 1 ,-I_ _---'
Last Year Last 3 Years Last 5 Years
Last 2 Years Last 4 Years
24 Years of experience
25 Educational Background
Year Institution Qualification
26 Training
Year Courses Institution
27 Language (Please tick the most appropriate box)
English French Bislama Vern .......................... .
1 1
Write Write Write Write
1 1
Speak Speak Speak Speak
1 1 1
Both Both Both Both
28 Discipline information
Term of
Year School Type of discipline discipline
29 Declaration
To be completed and signed by the applicant
I, L I_ _ _ _ _ _ _ _ ---.l
Name of applicant
do solemnly declare that:
The information provided in this application is correct.
Signature of the applicant Date
