Competence notification - s78

Email address for copy of form response *

Employing authority details

Name of employing authority *

Address *

Full name of contact person *

Phone number *

Email address *

School details

Name of the prescribed school *

Address *

Full name of contact person *

Phone number *

Email address *

Teacher details

Name of the relevant teacher *

Address *

Teacher registration number (QCT) *

Phone number *

Email address *

Dismissal information

Please provide the date notice of dismissal was given to the relevant teacher *

Please provide the date the dismissal has taken or will take effect *

Attachments

Copy of documentation outlining reasons given by the employing authority for the dismissal *

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