Form F

Application for a Letter of Eligibility (Form F)

*Note: The Registered Independent School Director, Principal or Designate are to complete the Application
Package

Policy
Human resource personnel are expected to make an effort to recruit teachers who hold Saskatchewan
Teaching Certificates (Professional A, Professional B, Vocational, or Technical).

When a recruitment effort results in no suitable applicant, the registered Independent School Director may
apply for a Letter of Eligibility on behalf of an individual who does not hold a Saskatchewan Teacher’s
Certificate.

A Letter of Eligibility is valid for five years including the school year in which it is issued. The Letter of
Eligibility permits the holder to perform only those duties for which it was issued. If the applicant changes
schools during the five-year approval, the applicant is required to re-submit a new application and criminal
record check.

A religiously-based registered independent school recognizes that as a religiously-based institution, they

have the freedom and authority to establish the qualifications of their own teachers.

The registered Independent School Director or their designate is expected to collect all of the documents
required of the candidate and submit the complete package to Independent Schools and Home-based
Education, Ministry of Education. Incomplete packages will delay the certification process. Application
packages submitted by the candidate will not be accepted.

Please send completed application package to:

Independent Schools & Home-based Education
409A Park Street
REGINA SK S4N 5B2
Email: programsed@gov.sk.ca
Fax: (306) 787-2029

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 Form F

Please select one:

 New Letter of Eligibility application (or if applicant has changed schools)
 Renewal of Letter of Eligibility (after five years of initial application)

Personal Information
Applicant’s First Name Applicant’s Surname

Former Name(s) Effective Date

School Town

Address Town Province and Postal Code

Email Address Primary Phone Number Secondary Phone Number

Social Insurance Number:

Date of Birth: Day: Month: Year:

Academic Qualifications – Secondary Education (High School)

The applicant:
 graduated from high school.
 has not graduated from high school.

Academic Qualifications – Post-secondary Education (Including CEGEP and/or Junior College)

Official transcripts must be received directly from all post-secondary institutions (technical and vocational
schools, colleges and universities) attended.

The applicant:
 has not completed any post-secondary education.
 completed technical/vocational training and has included a copy of the diploma, certificate or
Journeyperson’s Certificate.
 completed post-secondary education and has requested transcripts to be sent directly to ISHBE from the
following institution(s):

Institution Date ordered:

saskatchewan.ca
 Form F

Confidential Disclosure

*Note: The presence of a record of charges or convictions does not necessarily exclude you from teacher
certification. Each case will be reviewed on an individual basis to determine its pertinence to the
requirements of the teaching profession.

Instructions: Please check Yes or No. For each question that you check yes, attach a signed and complete
explanation that includes identification of the regulatory body, licensing authority, teacher-education program
and/or organization to which the response applies.

Licensing outcomes or action on a license in the teaching profession and other professions:
 Yes Have you ever applied anywhere for authorization and/or certification to teach and had your
 No application denied (for reasons other than meeting academic or professional education
requirements)?
 Yes Has your authorization and/or certification to teach ever been suspended or cancelled in
 No another jurisdiction, including outside of Canada, other than for failure to pay fees?
 Yes Have you ever — for any reason other than failure to pay fees — voluntarily surrendered your
 No authorization and/or certification to teach?
 Yes Has there ever been, or is there now, an investigation or proceeding with respect to your
 No professional conduct, competence, or capacity in relation to the teaching profession, including
in your teacher-education program?
 Yes Have you ever agreed to a settlement or resignation to avoid any proceeding or disciplinary
 No action with respect to your professional conduct, competence, or capacity?
 Yes Have you ever been found guilty of professional misconduct or been found to be incompetent
 No or incapacitated as a member of the teaching or other profession?
 Yes Have any terms, conditions, or limitations ever been placed on your authorization and/or
 No certification to teach in any other jurisdiction?
 Yes Have you ever been subject to an investigation or proceeding relating to working with children
 No or students in capacities other than teaching?
Criminal charges or convictions:
 Yes Have you ever been charged, convicted, given an absolute or conditional discharge, or
 No received a pardon for a criminal offence in Canada or in any other jurisdiction?
 Yes Are there any outstanding criminal charges against you in Canada or in any other jurisdiction?
 No
 Yes Are you subject to any court order, such as a peace bond or a restraining order, in Canada or
 No in any other jurisdiction?
 Yes Are you currently the subject of a criminal investigation?
 No

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 Form F

Employment as a teacher:
 Yes Have you ever, in advance of an investigation or disciplinary proceeding, voluntarily
 No restricted your teaching practice?
 Yes Have you ever agreed to a settlement or resignation to avoid a proceeding or disciplinary
 No action with respect to your professional conduct, competence, or capacity, in relation to
either a teaching position or your professional certification?
 Yes Have you ever been terminated or had restrictions imposed on your employment as a
 No teacher by an employing school district, education authority, or other organization with
respect to your conduct, competence, or capacity?
 Yes Have you ever been disciplined by an employing school district or independent authority
 No or other educational organization?
Teacher-education program:
 Yes Have you ever been asked by a teacher-education program provider to withdraw from a
 No teacher-education program or practicum?
 Yes Have you ever failed or voluntarily withdrawn from a teacher-education program or
 No practicum?

Declaration: I declare that all information given on the Application form and this Confidential Disclosure form is
true, correct and complete to the best of my knowledge. I understand that no qualifications assessment can be
made until the Saskatchewan Ministry of Education receives all required documents and that additional
information may be required.

I authorize the Saskatchewan Ministry of Education to contact the educational institutions I have attended and
to receive any and all information from those institutions, teacher registration/licensing bodies and police
services that relate to my application for registration. I understand that this information may be used by the
Saskatchewan Ministry of Education to determine if I will be certificated or if any terms, conditions, or
limitations are required on my certificate.

I consent to the Saskatchewan Ministry of Education making inquiries and exchanging information with any
jurisdiction or registration authority. I agree that if there are any changes to the information I have provided to
the Saskatchewan Ministry of Education in this application between the time of the submission of the
application and registration, I will immediately advise the Saskatchewan Ministry of Education and provide the
new information.

I declare that all documents submitted by me in relation to my application have not been changed or altered in
any way.

Applicant Name Signature Date

NOTICE: Pursuant to section 26(2) of The Freedom of Information and Protection of Privacy Act, this information is collected for the
purpose of determining the applicant's eligibility for a Saskatchewan teacher's certificate in accordance with section 18 of
The Registered Independent Schools Regulations and for the purpose of assisting any other jurisdiction in Canada to determine the
applicant's eligibility for a teacher's certificate in such other jurisdiction. Personal information will be used only for the purpose for
which it is collected and will not be disclosed except in accordance with the Act.

Your application will not be processed unless (a) all questions on this form have been answered (b) the first page is initialed, and (c)
the second page has been signed and dated.

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 Form F

To be completed by the Registered Independent School Director, Principal or Designate

After making a concerted effort to do so, we have been unable to secure the services of a suitable, certified
teacher for the following teaching position(s):

 substitute teaching  subject/grade teaching

Please provide grade(s) and Grade(s) Subject(s)
subject(s):
Grade(s) Subject(s)

Name of School Address Town/Postal Code

 I have enclosed a copy of the current Criminal Record Check on file in our office.
 I have submitted a Criminal Record Check within the past five years.

Declaration:
We sincerely believe that our registered independent school, as a religiously-based institution, has the
freedom and authority to establish the qualifications of its own registered independent school teachers. I
hereby recommend that a Letter of Eligibility to teach be issued to the above person for the specific teaching
position described above in accordance with The Registered Independent Schools Regulations.

Name of Director / Principal / Signature Title

Designate (please print) (Director / Principal / Designate)

Email address Date

For Ministry of Education Use Only

Approve application:  Yes  No
Comments:

Director, Independent Schools & Home-based Education Date

NOTICE: Pursuant to section 26(2) of The Freedom of Information and Protection of Privacy Act, this information is collected for the
purpose of determining the applicant's eligibility for a Saskatchewan teacher's certificate in accordance with section 18 of
The Registered Independent Schools Regulations and for the purpose of assisting any other jurisdiction in Canada to determine the
applicant's eligibility for a teacher's certificate in such other jurisdiction. Personal information will be used only for the purpose for
which it is collected and will not be disclosed except in accordance with The Act.

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 Form F

Application Package Checklist

The applicant:
 has included a copy of his/her Social Insurance Number card or other document issued by the Government
of Canada that includes his/her Social Insurance Number (i.e., GST refund, Income Tax Notice of
Assessment, or a Child Tax Credit);
 has included a copy of his/her birth certificate (a passport with the full legal name may be accepted);
 has not changed his/her legal name since birth; or,
 has changed his/her legal name since birth and has included a copy of their:
 Marriage Certificate (name change as a result of marriage);
 Divorce Certificate (divorced and cannot provide a marriage certificate as proof of current or
previous surname); or,
 Certificate of Name Change (name changed for reasons other than marriage or divorce);
 is a Canadian citizen or a permanent resident of Canada, therefore, does not require proof of employment
authorization; or,
 is not a Canadian citizen or a permanent resident of Canada and included a copy of one of the following for
proof of employment authorization:
 a work permit issued by the federal government indicating they are not restricted from working in
a school environment with children; or,
 both sides of their permanent resident card or Record of Landing form.

Criminal Record Check

 I have submitted an original signed Criminal Record Check (CRC).
 I have included a current original signed Criminal Record Check (CRC) that includes a Vulnerable Sector
Check.
(Note: CRCs must have been issued within the last three months.)

Confidential Disclosure
 The applicant has answered all the questions, initialed the first page and has included the signed
Confidential Disclosure.

Registered Independent School Director, Principal or Designate

 The Director, Principal or Designate has completed and signed the section entitled “To be completed by
Registered Independent School Director, Principal or Designate.”

Date package completed: Day: Month: Year:

An incomplete application package will delay processing and approving the applicant’s certification.

saskatchewan.ca
 Form F

Educator Separation Form: Letter of Eligibility

To be completed and returned to Independent Schools and Home-based Education for all Letter of Eligibility
teachers who have left the employ of the school.

Personal Information

Name of Teacher Date of Separation

Letter of Eligibility Certificate Number Social Insurance Number (SIN)

Current School

Reason for Separation (please select one):

 Death  Professional misconduct

 Resigned  Illness/disability
 Suspended by the school  Temporary contract expired
 Terminated by the school
Expected Activity Following Separation (please
select one):

 Not seeking employment  Employment in a field not related to

education
 Parenting  Employment in a field related to education
 Self-employment  Employment in another registered
independent school
 Illness/disability  Unknown
 Other
Destination:
If you are moving from your current address, please indicate your destination:

 Another location in  Another province  Another country

Saskatchewan

Signature (Registered Independent School Teacher or Principal or Director) Date

Send the Letter of Eligibility: Educator Separation Form to:

Independent Schools & Home-based Education

409A Park Street
REGINA SK S4N 5B2
Email: programsed@gov.sk.ca
Fax: (306) 787-2029

saskatchewan.ca