Request a Statement of Professional Standing

Current Page 1
Page 2
Preview

Pursuant to sections 98 and 100 of the Education Act R.S.P.E.I. 1988, Cap. E-.02 , personal information on this form will be used for the purpose of verifying identity. If you have any questions about this collection of personal information, you may contact Registrar’s Office of the Department, Tel. 902-438-4130

Identification

First Name

Middle Initial

Last Name

Address 1

Address 2

City, Town, or Community

Province

Postal Code

For example C1B 0X1 or 12345

Country

Telephone Number

For example 902-555-5555

Email Address

Previous Name

If you were educated or previously certified in a name other than that used above please state the other name.

Date of Birth