EMPLOYEE’S SECTION. I hereby authorize my physician to release the foregoing information (including any explanation arising from the information provided) concerning my current illness or injury to my Employer, the Chignecto-Central Regional School Board. It is understood that this information be only of the same nature and extent as is provided under Part A of this form and does not authorize the release of information which is different in nature or greater in extent. I understand that I will receive a copy of any medical information received by the Board from my physician. Teacher’s Signature Date APPENDIX “B” CHIGNECTO-CENTRAL REGIONAL SCHOOL BOARD DEADLINE: April 1st JOB-SHARING • An Interview Team consisting of at least the school principal, the permanent contract teacher who has requested the job-share, and one other teacher or administrator to interview the other contract teacher. • Description of a new job-sharing proposal must be attached to this form. • Continuation of a Job-Sharing Team must receive approval of the Principal and Family of Schools Supervisor. • Applications must be received by April 1st of the school year the job-sharing is to commence, continue or discontinue. • Permanent contract teachers through application commit to filling the position for one (1) year. • Please refer to Article 16 for further information. Please check: New Job-sharing Proposal Continuation of Job-Sharing School: School Year: 20 - Name (Permanent Contract Teacher) Prof. # Name (Other Contract Teacher) Prof. # Proposed Schedule (including percentage of time for each teacher, grade level, etc.): Signature of Permanent Teacher: Date: Signature of Other Contract Teacher: Date: Approval of the Principal: Approval of the Family of Schools Supervisor: Approval of the Human Resources Division: RETURN TO THE HUMAN RESOURCES DEPARTMENT BY APRIL 1ST APPENDIX “C” Summary of Staffing Rounds – Article 19 The following represents a summary only. Although it is being provided in the collective agreement, it is provided for informational purposes only. Nothing within this Appendix is intended to be considered to be an Article and, as such, not be the basis for a grievance as defined in 5.02. To the extent there may be any discrepancies between this summary and the actual provisions of the collective agreement, the actual provisions of the collective agreement are paramount. Any disputes regarding the application, operation, or any alleged violation of the Collective Agreement must be reference...
EMPLOYEE’S SECTION. This evaluation has been discussed with me and I have been offered the opportunity to comment on it. Employee’s signature: _ Date: I concur with the evaluation I do not concur with the evaluation Employee Comments:
EMPLOYEE’S SECTION. I hereby authorize my physician to release the foregoing information (including any explanation arising from the information provided) concerning my current illness or injury to my Employer, the Chignecto-Central Regional School Board. It is understood that this information be only of the same nature and extent as is provided under Part A of this form and does not authorize the release of informa- tion which is different in nature or greater in extent. I understand that I will receive a copy of any medical information received by the Board from my physi- cian. Teacher’s Signature Date APPENDIX “B” TERM SERVICE FORM AS PER ARTICLE 14 OF THE REGIONAL CONTRACT Name: Prof. # According to the Local Agreement we will be generating a Seniority List for all 100% and part-time term teachers. We have calculated your seniority to be: Aug 1, 20 - July 31, 20 (previous school year) Aug. 1, 20 - July 31, 20 (current school year) Service - Aug. 1, 20 - July 31, 20 Recognized Service Prior to August 1, 20 Total Service - July 31, 20 The following is the criteria and the staffing rounds that apply to term teachers:
EMPLOYEE’S SECTION. I hereby authorize my physician to release the foregoing information (including any explanation arising from the information provided) concerning my current illness or injury to the Tri-County Regional School Board. I understand that I will receive a copy of any medical information received by the Board from my physician. Teacher’s Signature Date cc: Superintendent of Schools, Tri-County Regional School Board APPENDIX B Request for Functional Information of Presenting Illness/Injury Tri-County Regional School Board 00 Xxxxx Xx., Xxxxxxxx, XX X0X 0X0 Phone: 000-0000 Fax: 000-0000 The Tri-County Regional School Board has developed a return to work program to assist employees in their rehabilitation and return to full health and employment. Part of the process is to get information about your current abilities from your physician as it relates to your illness/injury. To do this we ask that you have your physician complete this form.
EMPLOYEE’S SECTION. I hereby authorize my physician to release the foregoing information (including any explanation arising from the information provided) concerning my current illness or injury to my Employer, the Atlantic Provinces Special Education Authority. I understand that I will receive a copy of any medical information received by the Board from my physician. Teacher’s Signature Date APPENDIX D
