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Canadian Institute of Sathya Sai Education (CISSE)

www.cisse.ca

Excellence through Education in Human Values

APPLICATION FOR REGISTRATION

COURSE 1 –STANDARD DIPLOMA COURSE IN SSEHV

VENUE: SRI SATHYA SAI BABA COMMUNITY CENTRE OF VANCOUVER, 2215 East Pender Street, Vancouver, BC

DATE: August 16-23, 2013 inclusive .

Note: This session is open to Sathya Sai School teachers and members of the Sri Sathya Sai Baba Organization in Canada NATIONALLY.

1) Before completing this form, applicants are strongly advised to read the program information, course requirements and FAQ’s on our web site www.cisse.ca

(2) Registration is limited to 25 candidates based on appropriate qualifications.

(3) To expedite the selection process, applicants are urged to submit (a) this application form (b) a resume and (c) a short essay of about three paragraphs in length on why they wish to do this course. (Use page 3 of this form for the essay)

DEADLINE FOR APPLICATION: JUNE 15TH, 2013. SUBMIT BY EMAIL TO: director@cisse.ca WITH A COPY TO trpillay@gmail.com

A.PERSONAL INFORMATION

FIRST NAME:________________________________________________

LAST NAME: ________________________(as in passport/birth certificate as certificates will be issued in this name)

ADDRESS: _______________________________________________________________________

City: ______________________PROVINCE: ________________P. CODE: __________________

PHONE: RES: ________________________________MOBILE: ____________________________

EMAIL ADDRESS: _________________________________________________________________

B. OCCUPATION: ________________________________________________________________

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C. EDUCATIONAL BACKGROUND (NOTE: For the Standard Diploma, a Bachelor’s Degree is preferred.

Equivalent post-secondary education/experience may be considered. The prerequisite for the Advanced Diploma is

completion of the Standard Diploma. For both courses, interest/experience in teaching children would be an asset.

____________________________________________________________________________________________________

D. ADDITIONAL QUALIFICATIONS IN TEACHING VALUES/CHARACTER EDUCATION, IF ANY. PLEASE Specify CERTIFICATE/DIPLOMA RECEIVED/YEAR/LENGTH OF COURSE/NAME OF INSTITUTION)

E. VOLUNTEER ACTIVITIES:

F. INTEREST AND EXPERIENCE IN WORKING WITH CHILDREN, IF ANY. PLEASE SPECIFY

E. FOR TEACHERS: IF YOU ARE A QUALIFIED TEACHER, PLEASE DESCRIBE YEARS OF EXPERIENCE,

GRADES TAUGHT & CURRENT EMPLOYER, if applicable

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F. FOR MEMBERS OF THE SATHYA SAI ORGANIZATION: PLEASE PROVIDE NAME OF CURRENT CENTRE, NAME OF PRESIDENT AND HIS/HER EMAIL ADDRESS, PHONE NUMBER

SIGNATURE OF APPLICANT:

DATE: (KINDLY COMPLETE PAGES 3/4)

FOR OFFICIAL USE:

PLEASE US THIS SPACE TO TYPE A SHORT ESSAY (MIN. THREE PARAGRAPHS) ABOUT WHY YOU

WISH TO DO THIS COURSE. (Optional for current Sathya Sai School teachers)

NAME OF APPLICANT: ________________________________________________________

TITLE OF ESSAY: ______________________________________________________________

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