2015 Project Overseas Application (COOR-61)

Canadian Teachers’ Federation
Fédération canadienne des enseignantes et des enseignants
CTF INTERNATIONAL PROGRAM “Teachers’ Action for Learning”
PROJECT OVERSEAS 2015
Teachers’ Action for Teaching
(A joint endeavor by the Canadian Teachers’ Federation and its Members to support
the professional development projects of partner organizations overseas)
Please note that the application is divided into two sections. A copy of Section A, containing information of a
general nature and related to academic background and professional experience, will be sent to the
overseas partner organization.
Section B asks for information of a more personal nature and access to it will be restricted to the National
Selection Committee, your Team Leader, and to the staff of CTF’s International Program.
PLEASE BE SURE TO CALL OR LOG ON TO YOUR MEMBER ORGANIZATION
WEB SITE FOR APPLICATION INFORMATION, ADDITIONAL REQUIREMENTS AND DEADLINE
INFORMATION FOR PROJECT OVERSEAS (PO) APPLICANTS.
Please read the following before applying:
1.
All applicants must:







be a member of a provincial or territorial teacher organization that supports PO
hold a valid teachers’ certificate
have completed at least five full years of teaching in Canada before the PO assignment
commences
be a Canadian citizen
be in excellent health and able to work in developing country conditions
show evidence of flexibility, mature judgment, and a strong willingness to put the team and
project needs above personal needs
at the time of application, hold a Canadian passport valid for at least 6 months after the PO
assignment concludes; note - proof that a passport application has been made will be accepted
2.
The travel and living expenses of participants are covered by contributions from CTF Members
(provincial or territorial teacher organizations) and the Canadian Teachers’ Federation.
3.
Travel to the overseas partner country will be arranged by CTF in accordance with the Travel
Guidelines established by the Trustees of the CTF Trust Fund. These guidelines state: “THAT, efforts
be made to apply the lowest possible airfares for travel associated with PO that are consistent with the
objectives of the program.” Consequently, CTF will arrange travel by the most direct and most
economical route and will purchase, whenever possible, excursion air tickets with the limitations that
apply to such tickets.
.../2
2490 Don Reid • Ottawa • ON • K1H 1E1 • Tel./Tél. 613-232-1505 • Fax 613-232-1886 • [email protected] • www.ctf-fce.ca
President/Présidente Dianne Woloschuk • Secretary General/Secrétaire général Dr. Calvin Fraser
Past President/Président sortant Paul Taillefer
Vice-Presidents/Vice-président(e)s Katherine Mackwood, Mark Ramsankar, Heather Smith, Maureen Weinberger
4.
The commitment to PO is considerable both in and out of the classroom while in the partner country.
In addition to long teaching days, you will be expected to participate in activities arranged by the
partner organization. These could include social events as well as meetings with the Ministry of
Education representatives, the Executive of the partner organization, etc.
5.
Because of the nature of the Project, participants are not allowed to be accompanied by friends or
family during the Orientation program or during the placement overseas.
6.
Participants must accept that a project may be cancelled at the last minute due to unforeseen
circumstances. In the event of cancellation, CTF cannot guarantee placement on another team.
7.
For budgetary and safety reasons, it is the usual practice that PO participants share accommodation
with one or more colleagues.
8.
Participants are not permitted to drive a motorized vehicle during their stay abroad. The teachers’
organization overseas is usually responsible for providing transportation in connection with the
Project. Other necessary transportation will be arranged by the Team Leader.
9.
There is considerable benefit to sharing PO experiences upon return to Canada. Participants are
encouraged to speak at meetings of their teacher organization, community groups and school, and to
participate in appropriate consultations and other events. Participants are also encouraged to write
articles about their experiences and submit them for publication wherever possible.
10. PO operates in Africa, Asia, the Caribbean and, occasionally, elsewhere. Participants must be
prepared to be assigned to any location where there is a CTF Project.
11. CTF in not usually able to confirm the program dates until after the teams are formed. Programs
usually take place in July and August, however, the commitment to PO begins in February, as team
members work together to prepare workshop materials (via the internet and teleconferences),
communicate and collaborate with their assigned co-tutor, conduct research on their country of
assignment, etc.
12. Participants will be required to send their valid passport to the designated travel agent in order to
secure required visas as early as May. Passports will be returned during the Orientation Program,
prior to departure for country of assignment.
Sponsoring Member Organizations
Association des enseignantes et des enseignants
franco-ontariens (AEFO)
Phone: 613-244-2336
www.aefo.on.ca
Ontario English Catholic Teachers’ Association
(OECTA)
Phone: 416-925-2493
www.oecta.on.ca
Elementary Teachers' Federation of Ontario (ETFO)
Phone: 416-962-3836
www.etfo.ca
Prince Edward Island Teachers’ Federation (PEITF)
Phone: 902-569-4157
www.peitf.com
New Brunswick Teachers’ Association (NBTA)
Phone: 506-452-8921
www.nbta.ca
Quebec Provincial Association of Teachers (QPAT)
Phone: 514-694-9777
www.qpat-apeq.qc.ca
Newfoundland and Labrador Teachers’ Association
(NLTA)
Phone: 709-726-3223
www.nlta.nl.ca
Saskatchewan Teachers’ Federation (STF)
Phone: 306-373-1660
www.stf.sk.ca
Northwest Territories Teachers’ Association (NWTTA)
Phone: 867-873-8502
www.nwtta.nt.ca
Nova Scotia Teachers Union (NSTU)
Phone: 902-477-5621
www.nstu.ca
Nunavut Teachers’ Association (NTA)
Phone: 867-979-0750
www.ntanu.ca
The Alberta Teachers’ Association (ATA)
Phone: 780-447-9400
www.teachers.ab.ca
The Manitoba Teachers’ Society (MTS)
Phone: 204-888-7961
www.mbteach.org
Yukon Teachers’ Association (YTA)
Phone: 867-668-6777
www.yta.yk.ca
Canadian Teachers’ Federation
Fédération canadienne des enseignantes et des enseignants
PROGRAMME INTERNATIONAL DE LA FCE : Action enseignante pour l’apprentissage
PROJET OUTRE-MER 2015
Action enseignante pour l’enseignement
(Une entreprise commune de la Fédération canadienne des enseignantes et des enseignants et de ses
organisations Membres pour soutenir les projets de perfectionnement professionnel des organisations
partenaires d’outre-mer)
Nous vous signalons que le formulaire de demande de participation comporte deux parties. Une copie de la
partie A, qui renferme des renseignements généraux et relatifs aux antécédents scolaires et à l’expérience
professionnelle, sera envoyée à l’organisation partenaire d’outre-mer.
La partie B contient des renseignements d’ordre plus personnel, auxquels seuls le Comité national de
sélection, votre chef d’équipe et le personnel du Programme international de la FCE auront accès.
VEUILLEZ COMMUNIQUER AVEC VOTRE ORGANISATION MEMBRE OU CONSULTER SON SITE
WEB POUR OBTENIR DES RENSEIGNEMENTS SUR LA PRÉSENTATION D’UNE DEMANDE, LES
EXIGENCES SUPPLÉMENTAIRES ET LA DATE LIMITE DE PRÉSENTATION DE LA DEMANDE DE
PARTICIPATION AU PROJET OUTRE-MER (PO).
Nous vous prions de lire les notes qui suivent avant de poser votre candidature :
1.
Les exigences suivantes s’appliquent à toute personne qui fait une demande au PO :
 Adhérer à une organisation provinciale ou territoriale de la profession enseignante qui appuie le
PO;
 être titulaire d’un certificat d’aptitude pédagogique reconnu;
 posséder au moins cinq années d’expérience de l’enseignement au Canada avant le début de
l’affectation outre-mer;
 être de citoyenneté canadienne;
 jouir d’une excellente santé et pouvoir travailler dans les conditions propres aux pays en
développement;
 faire preuve de souplesse, d’un bon jugement et d’une forte volonté de faire passer les besoins
de l’équipe et du programme avant ses besoins personnels;
 avoir, au moment de la présentation de la demande, un passeport canadien qui sera valide
pendant au moins six mois après la fin de l’affectation outre-mer (une preuve qu’une demande
de passeport a été faite sera acceptée).
2.
Les frais de déplacement et de séjour des bénévoles sont couverts par les contributions de la
Fédération canadienne des enseignantes et des enseignants et de ses organisations Membres (les
organisations provinciales et territoriales de l’enseignement).
3.
La FCE prendra les arrangements de voyage à destination du pays partenaire conformément aux
lignes directrices établies par les fidéicommissaires du Fonds en fiducie de la FCE, qui prévoient ce
qui suit : « QUE des efforts soient faits pour choisir les tarifs aériens les moins chers possible pour les
voyages qui sont effectués dans le cadre du PO et qui sont conformes aux objectifs de ce
programme. » Par conséquent, la FCE choisira l’itinéraire le plus direct et le plus économique, et
achètera, autant que possible, des billets à tarif excursion aux conditions qui s’appliquent à ces billets.
.../2
2490 Don Reid • Ottawa • ON • K1H 1E1 • Tel./Tél. 613-232-1505 • Fax 613-232-1886 • [email protected] • www.ctf-fce.ca
President/Présidente Dianne Woloschuk • Secretary General/Secrétaire général Dr. Calvin Fraser
Past President/Président sortant Paul Taillefer
Vice-Presidents/Vice-président(e)s Katherine Mackwood, Mark Ramsankar, Heather Smith, Maureen Weinberger
4.
L’engagement envers le PO est considérable, tant à l’intérieur qu’à l’extérieur de la classe, tout au
long du séjour dans le pays partenaire. Outre de longues journées d’enseignement, vous devrez
participer à des activités arrangées par l’organisation partenaire, notamment des activités sociales
ainsi que des réunions avec des personnes représentant le ministère de l’Éducation et avec le
Comité exécutif de l’organisation partenaire.
5.
Vu la nature du PO, les bénévoles n’ont pas le droit d’être accompagnés de membres de leur famille
ou d’amis ni au cours du stage d’orientation ni pendant l’affectation outre-mer.
6.
Les bénévoles doivent accepter qu’un projet puisse être annulé à la dernière minute en raison de
circonstances imprévues. En cas d’annulation, la FCE ne peut pas garantir le placement au sein
d’une autre équipe.
7.
Pour des raisons de budget et de sécurité, les bénévoles du PO partagent normalement un
logement avec un ou plusieurs collègues.
8.
Il est défendu aux bénévoles de conduire des véhicules automobiles pendant leur séjour à
l’étranger. Il appartient d’ordinaire à l’organisation d’accueil de fournir le transport se rattachant au
programme. Votre chef d’équipe arrangera tout autre transport nécessaire.
9.
Il est très profitable de communiquer les expériences vécues dans le cadre du PO une fois de retour
au Canada. Nous encourageons les bénévoles à parler de leurs expériences à des réunions de leur
organisation de l’enseignement, à des groupes communautaires et à l’école, et à participer à des
consultations et à d’autres activités pertinentes. Nous les prions également de rédiger des articles
au sujet de leurs expériences et de les faire paraitre dans des publications chaque fois qu’ils le
peuvent.
10. Le PO envoie des équipes en Afrique, en Asie, aux Caraïbes et, occasionnellement, ailleurs. Les
bénévoles doivent être disposés à accepter une affectation à n’importe quel endroit où un
programme de la FCE est offert.
11. La FCE n’est habituellement pas en mesure de confirmer les dates des programmes avant la
formation des équipes. Les programmes se déroulent normalement en juillet et en aout; toutefois,
les tâches relatives au PO débutent en février. Dès ce mois, les membres des équipes travaillent
ensemble à préparer les documents des ateliers (au moyen d’Internet et de téléconférences),
communiquent et collaborent avec la coïnstructrice ou le coïnstructeur qui leur a été assigné,
effectuent des recherches sur le pays d’affectation, et ainsi de suite.
12. Dès le mois de mai, les bénévoles devront faire parvenir leur passeport valide à l’agence de voyage
désignée afin qu’elle puisse se procurer les visas requis. Les passeports seront retournés aux
bénévoles pendant le stage d’orientation, avant le départ à destination du pays d’affectation.
Organisations Membres de parrainage
Association des enseignantes et des enseignants
du Yukon (AEY)
Téléphone : 867-668-6777
www.yta.yk.ca
Association des enseignantes et des enseignants
franco-ontariens (AEFO)
Téléphone : 613-244-2336
www.aefo.on.ca
Association provinciale des enseignantes et
enseignants du Québec (APEQ)
Téléphone : 514-694-9777
www.qpat-apeq.qc.ca
Fédération des enseignantes et des enseignants de la
Saskatchewan (FES)
Téléphone : 306-373-1660
www.stf.sk.ca
Fédération des enseignantes et des enseignants de
l’élémentaire de l’Ontario (FEEO)
Téléphone : 416-962-3836
www.etfo.ca
New Brunswick Teachers’ Association (NBTA)
Téléphone : 506-452-8921
www.nbta.ca
Newfoundland and Labrador Teachers’ Association (NLTA)
Téléphone : 709-726-3223
www.nlta.nl.ca
Northwest Territories Teachers’ Association (NWTTA)
Téléphone : 867-873-8502
www.nwtta.nt.ca
Nova Scotia Teachers Union (NSTU)
Téléphone : 902-477-5621
www.nstu.ca
Nunavut Teachers’ Association (NTA)
Téléphone : 867-979-0750
www.ntanu.ca
Ontario English Catholic Teachers’ Association (OECTA)
Téléphone : 416-925-2493
www.oecta.on.ca
Prince Edward Island Teachers’ Federation (PEITF)
Téléphone : 902-569-4157
www.peitf.com
The Alberta Teachers’ Association (ATA)
Téléphone : 780-447-9400
www.teachers.ab.ca
The Manitoba Teachers’ Society (MTS)
Téléphone : 204-888-7961
www.mbteach.org
Project Overseas 2015
“Teachers Teaching Teachers”
APPLICATION FORM FOR ALBERTA TEACHERS’ ASSOCIATION
Information on this form is collected on behalf of the CTF
• Please provide all information requested in the space assigned for each response. Incomplete
applications will not be processed.
• French applicants are asked to complete their initial application in English and in French in a final
selection of the national level.
• Date and sign each page of your application. Mail the original to the Alberta Teachers’ Association,
11010 142 Street NW, Edmonton AB T5N 2R1. Do not fax or e-mail your application.
• Ensure that your application is received by November 3, 2014, at the latest.
• Please contact Brenda Dobie at 780-447-9400 ext 657 for further information.
• All applications MUST be original copies. Photocopied/faxed applications will not be accepted.
SECTION A
PLEASE PRINT CLEARLY OR TYPE
❒ Male
Name (underline the name that you go by)
(First)
(Middle)
(Last)
Level of Membership:
Name as it appears on your Canadian passport:
Passport expiration date:
Active Member of ATA
Associate Member of ATA
Life Member of ATA
PLEASE ATTACH A PHOTOCOPY OF PAGE 2-3 OF YOUR CANADIAN
PASSPORT TO THIS FORM OR PROVIDE PROOF OF YOUR PASSPORT APPLICATION
Year of birth:
Home address:
Age:
❒
❒
❒
If retired, state month & year:
City:
Telephone: ( )
Postal Code:
Cell: ( )
Current workplace name:
Address:
❒ Female
Present Position:
City:
Postal Code:
Telephone: ( )
Fax: ( )
Preferred e-mail:
Alternate e-mail:
Your last work day in June 2015 will be:
Date on which your school will reopen after summer break:
Latest date by which you must arrive home after the assignment:
Signature of Applicant: ____________________________________________ Date ____________________________ Page 5
Please complete this page. Do
not send a résumé or curriculum vitae.
ACADEMIC BACKGROUND (List most recent studies first.)
Name and location of teacher training institution or
university and recent summer courses.
Dates
Degree/Certificate
received
Major area of study
TEACHING BACKGOUND (List most recent assignment first, and indicate if you worked full-time, part-time or
as a substitute.)
School and location
Position
(teacher, principal, etc.)
Grades
taught
Subjects taught
From
Years
To
OTHER WORK EXPERIENCE (Do not list short-term or summer positions.)
Job title
Dates
Certificate or Qualifications required
Location
Signature of Applicant: ____________________________________________ Date ____________________________ Page 6
LINGUISTIC ABILITY
Rate your ability by circling the appropriate level on each category for each language:
English
Poor/Fair/Good/Excellent
Poor/Fair/Good/Excellent
Poor/Fair/Good/Excellent
Poor/Fair/Good/Excellent
French
Oral Comprehension
➜
➜
➜
➜
Written Comprehension
Oral Expression
Written Expression
➜
➜
➜
➜
Poor/Fair/Good/Excellent
Poor/Fair/Good/Excellent
Poor/Fair/Good/Excellent
Poor/Fair/Good/Excellent
In what language did you complete your studies?
Secondary level:
❒ English
❒ French
❒ Other (specify)______________________
University:
❒ English
❒ French
❒ Other (specify)______________________
What is your first language?
❒ English ❒ French ❒ Other (specify)______________________
In what language can you competently teach?
❒ English ❒ French ❒ Other (specify)______________________
SUBJECT PREFERENCES
Bearing in mind that you will likely be teaching both content and methodology to under-qualified teachers, what
subjects and levels would you feel confident teaching and in which language(s)? (We typically receive many
requests for teachers interested in teaching mathematics, English language arts, English as a foreign language,
science, social studies, assistive technologies and school administration. Other topics in demand are classroom
management, action research, teacher mentorship, special education, assessment, physical education, health,
leadership, gender equity, and trade unionism.)
Subject
Primary
Elementary Secondary
English
French
Other
Signature of Applicant: ____________________________________________ Date ____________________________ Page 7
EXPERIENCE IN ORGANIZATIONS
Outline your involvement in the Alberta Teachers’ Association: (eg Specialist Council conference director,
presented a session at teachers’ convention, president of Economic Policy Committee)
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
Outline your involvement in other educational organizations:
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
INTERNATIONAL COOPERATION PROGRAMS
a.
Have you ever participated in CTF’s Project Overseas?
❒ Yes
❒ No
❒ Yes
❒ No
If yes, in what year(s)? ______________________________________________________
In what country(ies)? _______________________________________________________
Are you interested in being a team leader?
NOTE: Whenever possible, we select Team Leaders with prior Project Overseas experience. Team Leaders must be available to initiate
and facilitate correspondence with and between the Team Members, the Host Organization and CTF from February to July. We do not
recommend you volunteer to be a Team Leader if you will be unavailable for much of that period. Team Leaders are also required to
attend a training session in Ottawa in late February and a debriefing in October.
b.
Have you ever participated in intercultural cooperation programs designed to assist people? ❒ Yes
❒ No
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Overseas (specify countries, dates and nature of program):
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
In Canada (dates and nature of programs):
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
List any other international and/or intercultural experience that you have had, including location(s), dates and
duration of the experience(s):
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Signature of Applicant: ____________________________________________ Date ____________________________ Page 8
SECTION B
PLEASE RESPOND BRIEFLY. DO NOT ATTACH ADDITIONAL PAGES.
a. Why do you wish to participate in Project Overseas?
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
b. Why do you think you are well suited to such an assignment?
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
c. What do you see as the responsibilities of Project Overseas team members?
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Signature of Applicant: ____________________________________________ Date ____________________________ Page 9
d. In your opinion, what are some of the challenges of participating in Project Overseas? How would you cope with
these challenges?
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
e. What do you think the general aims and objectives of a Project Overseas in-service program should be?
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
f. On Project Overseas, it is important to put what is best for Project Overseas and your team before your own
needs and wants. Please provide at least one example of when you have done so in the past?
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
g. Please describe any experience you have had facilitating workshops/teaching courses to adults:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Signature of Applicant: ____________________________________________ Date ___________________________ Page 10
h. Please describe how you would share what you learn through Project Overseas upon return to Canada.
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
i. How do you feel your experience will change your professional practice? Your engagement within the
Association?
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
EXTRA-CURRICULAR ACTIVITIES
j. Do you possess other training, experience or skills which will contribute to the success of the program
Yes
No
(ie in a specific, sport, performing arts, etc)
❒
❒
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Signature of Applicant: ____________________________________________ Date ___________________________ Page 11
HEALTH
k. How would you grade your current level of health?
(Poor) 1
2
3
4
5
(Excellent)
Project Overseas participants are often exposed to extreme weather conditions, less-than-perfect housing and
sanitary conditions, unfamiliar diet and long work hours. Access to medical facilities and care may not be available
in some locations. Given these circumstances, do you believe that your present level of health would allow you to
be a fully active participant in a Project Overseas team?
❒ Yes
❒ No
List any technical aids (cane, wheelchair, hearing aids, etc.), or accessibility requirements (ramps, grab bars in
washrooms, etc.) you need, as well as food allergies or dietary restrictions you may have. Also indicate allergies
or factors that we should be aware of prior to an overseas placement, such as sensitivity to malaria prevention or
other medications, aversion to particular modes of travel, insects, etc. Note: If you are selected at the national level
you will be required to send a written confirmation of good health by your doctor.
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Signature of Applicant: ____________________________________________ Date ___________________________ Page 12
REFERENCES
I authorize the Alberta Teachers’ Association and the Canadian Teachers’ Federation to contact the two
persons listed below in order to determine my suitability to participate in Project Overseas.
1. Current principal, assistant principal or superintendent:* ___________________________________________________
Name and Position: _____________________________________________________
Work
Phone: ( ) ______________
Address: _______________________________________________________________
Cell
Phone: ( ) ______________
_______________________________________________________________________
City: ___________________________________________________________________
Postal Code: ________________
2. Either
(1) an Alberta Teachers’ Association official at the provincial or local level or
(2) someone in the field of education (such as a university professor or an official with Alberta
Education) who can attest to your involvement in education and your suitability as an ambassador
of Alberta teachers:
Name and Position: _____________________________________________________
_______________________________________________________________________
Address: _______________________________________________________________
City: ___________________________________________________________________
Work
Phone: ( ) ______________
Cell
Phone: ( ) ______________
Postal Code: ________________
*If retired, submit most recent Principal or Superintendent and, if appropriate, add the name and address of a reference
with current information about your educational involvement.
SCHOOL BOARD
Name of present school board or employer:
Address:
City:
Telephone: ( )
Postal Code:
Fax: ( )
Signature of Applicant: ____________________________________________ Date ___________________________ Page 13
ACKNOWLEDGMENT
As a Project Overseas applicant, I understand and accept the following conditions:
1. I understand that every effort will be made to assign successful applicants in accordance with their
skills and experience, but I am also aware that the nature of the requests from host countries may
make this impossible.
❒ Yes
2. I am willing to accept an assignment in any country in which CTF organizes a cooperative project.
❒ Yes
❒ Yes
3. I understand that Project Overseas is a collaborative team effort and participants are expected to
share accommodation, both in Canada and while on assignment overseas.
4. I understand that because of the nature of the Project, I am not allowed to be accompanied by
friends or family during the Orientation program or during the placement overseas.
❒ Yes
5. I attest that I am a Canadian citizen.
❒ Yes
❒ Yes
❒ Yes
6. I attest that I have taught fulltime in Canada for five full years.
7. I attest that I am currently a member of the Alberta Teachers’ Association.
If yes, indicate the category of membership:
❒ Regular
❒ Associate
❒ Life
8. Be in excellent health and able to work in developing country conditions.
9. Show evidence of flexibility, mature judgment, and a strong willingness to put the team and project
needs above personal needs.
10. At the time of application, hold a Canadian passport valid for at least 6 months after the PO
assignment concludes; note - proof that a passport application has been made will be accepted.
❒ Yes
❒ Yes
❒ Yes
11. I consent to the collection, use and disclosure of my personal information provided here by the
Alberta Teachers’ Association on behalf of the Canadian Teachers’ Federation.
I consent to and understand that the Alberta Teachers’ Association will use my personal information
for the purpose of selecting Alberta Project Overseas nominees to be forwarded to the Canadian
Teachers’ Federation for further consideration.
I consent to and understand that, if I am selected as an Alberta nominee by the Canadian Teachers’
Federation, my personal information will be collected, used, and disclosed by the Canadian
Teachers’ Federation for the purpose of:
a.Communicating with me respecting my involvement in Project Overseas.
b.Administering all aspects of my Project Overseas assignment, travel, and return to Canada.
c.Ensuring all regulatory and eligibility requirements related to my involvement in Project Overseas are met.
I consent to the Canadian Teachers’ Federation’s further collection, use and disclosure of additional
personal information required to grant final approval to my application to participate in Project
Overseas.
I understand that the privacy officer of the Alberta Teachers’ Association is available to answer my
questions regarding that organization’s collection, use or disclosure of my personal information
(780-447-9400 or 1-800-232-7208).
I understand that the privacy officer of the Canadian Teachers’ Federation is available to answer my
questions regarding CTF’s collection, use or disclosure of my personal information (1-866-283-1505).
Date:
❒ Yes
Signature:
Signature of Applicant: ____________________________________________ Date ___________________________ Page 14
INTERNATIONAL COOPERATION PROJECTS OTHER
THAN PROJECT OVERSEAS
The ATA is involved in a number of International Cooperation projects other than Project
Overseas. From time to time teachers are needed to assist with these projects in similar
capacities. If you are interested in being considered for such work, please sign below to confirm
your willingness to keep your file active with the Association.
I would like to keep my file active with the Association for a period of one year, commencing
January 1, 2016, in order to be considered for International Cooperation projects other than
Project Overseas within this time period. I understand that my personal information will remain
confidential and will be used for the sole purpose of such intiatives.
SAVE
PRINT
Signature of Applicant: ____________________________________________ Date ___________________________ Page 15
COOR-61 2014 11

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