Preliminary Branch Registration

Preliminary Branch Registration
September 2011 - June 2012

Preliminary branch registration forms are to be filled out by the last day of school in June. Even partially completed forms should be submitted before the deadline. If you have any questions please contact Geralyn Costello, Executive Assistant, Governance at 726-3223 or 1-800-563-3599, ext. 222.

Branch: *

Fax number: *

Location of fax: *

BRANCH EXECUTIVE

President

Name: *

Street Address / P O Box : *

City / Town: *

E-mail: *

Postal Code: *

School Phone Number: *

Home Phone Number: *

Vice-President

Name: *

Street Address / P O Box : *

City / Town: *

E-mail: *

Postal Code: *

School Phone Number: *

Home Phone Number: *

Past President

Name: *

Street Address / P O Box : *

City / Town: *

E-mail: *

Postal Code: *

School Phone Number: *

Home Phone Number: *

Secretary

Name: *

Street Address / P O Box : *

City / Town: *

E-mail: *

Postal Code: *

School Phone Number: *

Home Phone Number: *

Treasurer

Name: *

Street Address / P O Box : *

City / Town: *

E-mail: *

Postal Code: *

School Phone Number: *

Home Phone Number: *

Political Action Officer

Name: *

Street Address / P O Box : *

City / Town: *

E-mail: *

Postal Code: *

School Phone Number: *

Home Phone Number: *

Professional

Name: *

City / Town: *

E-mail: *

Street Address / P O Box : *

Postal Code: *

School Phone Number: *

Home Phone Number: *

Communications Officer

Name: *

Street Address / P O Box : *

City / Town: *

E-mail: *

Postal Code: *

School Phone Number: *

Home Phone Number: *

Equality Rights Officer

Name: *

City / Town: *

E-mail: *

Street Address / P O Box : *

Postal Code: *

School Phone Number: *

Home Phone Number: *

Substitute Teacher Representative

Name: *

City / Town: *

E-mail: *

Street Address / P O Box : *

Postal Code: *

School Phone Number: *

Home Phone Number: *

New Teacher Representative

Name: *

City / Town: *

E-mail: *

Street Address / P O Box : *

Postal Code: *

School Phone Number: *

Home Phone Number: *

1. Members At Large

Name: *

City / Town: *

E-mail: *

Street Address / P O Box : *

Postal Code: *

School Phone Number: *

Home Phone Number: *

2. Members At Large

Name: *

City / Town: *

E-mail: *

Street Address / P O Box : *

Postal Code: *

School Phone Number: *

Home Phone Number: *

May 2012

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6	7	8	9	10	11	12
13	14	15	16	17	18	19
20	21	22	23	24	25	26
27	28	29	30	31

2012
Jan  Feb  Mar  Apr  May  Jun
Jul  Aug  Sep  Oct  Nov  Dec

2013
Jan  Feb  Mar  Apr  May  Jun
Jul  Aug  Sep  Oct  Nov  Dec