PRIVATE        SECONDARY        SCHOOLS        AUTHORITY

Application    for    registration    to    teach

(Under Section 5 of PSSA Act of 1976 as amended)

 

The Director                                                                                       Date: …………………………

Private Secondary Schools Authority

 

1)         I hereby apply for a Certificate of Registration to Teach in a Private Secondary School.

 

2)         I submit particulars of myself and request you to issue me with this Certificate.

 

3)         PARTICULARS

 

            1.         Name

 

                        (a)        Surname ……………………………………………………………………………

                                    (Block Letters)                         (State Mr/Mrs/Miss or Title)

 

                        (b)        Other Names in full ………………………………………………………………...

                                    (Block Letters)

 

                        (c)        Maiden Names (Where applicable): ………………………………………………

 

            2.         Present Home Address: …………………………………………………………………….

 

                        ……………………………………………………………….. (Tel if any) ………………

3.         Sex:………………………………………

 

            4.         Date of Birth:…………………………….(Birth Certificate to be produced + Photocopy)

 

            5.         Place and Country of Birth:……………………………………………………………….

 

      6.         Nationality: …………………… Identity Number:………………………………………

 

7.         Where educated, with date (an original and a copy of school leaving certificate must be submitted)

	School	From	To	Highest Class/Form Followed
1.       2.       3.

 

            8.         Educational Qualifications (all original Certificates together with one photocopy of

each must be submitted).

- 2 –

 

a)         Academic Qualifications (SC, GCE ‘O’ Level, HSC, degree, Diploma etc)

 

YEAR	NAME OF EXAMINATION	DETAILED RESULTS

 

b)         Professional Qualifications (Diploma or Certificate in Education PGCE etc)

           

YEAR	certificate awarded	place of study

 

Note    (i)         If documents are in languages other than English and French Languages,

attested translation to be submitted.

 

            (ii)        If qualifications are from Institutions other than those recognised by the

Government of Mauritius, equivalence should be submitted.

 

            (iii)       If results of any other examinations are awaited, mention should be made

of the course and the date the results are expected.

 

9)         Previous  Teaching  Experience

           

FROM	TO	SCHOOL	REGISTRATION NUMBER IF ANY

 

10)       I certify that the information furnished above is correct and I am submitting together with

this application two passport size photographs.

 

Fees payable on application : Rs 30.00

 

 

………………………….……………..                     ……………………………………….

(NAME OF APPLICANT)                                        (Signature of applicant)

 

                                                                                    Date:………………………………