Box 2222, Kemptville, Ontario K0G 1J0
1-800-443-4562   Fax: (613) 258-3610
 

"I, ___________________________________________ authorize the Catholic District School Board of Eastern Ontario (the 'Board') to obtain personal information from my present and/or previous employers and any other persons I have listed as references, to assist in determining my suitability, eligibility or qualifications for employment with the Board."

    Name:                                                                                   Phone Number:

1. _________________________________________________________________________

2. _________________________________________________________________________

3. _________________________________________________________________________