Section 4:

4. The following persons maybe referred to as to my character— (a) Name ....................... Address ............................................................ (b) Name ....................... Address ............................................................ E2 – 25 [Issue 9] Education Act FORM 4—continued .......................................................... Signature of applicant • We declare that the applicant is a person of good character and that the contents of this application are true to the best of our knowledge, information and belief. Signed ................................................ Signed ................................................ FORM 5 [Section 16] CERTIFICATE OF REGISTRATION AS QUALIFIED TEACHER This is to certify that ............................. whose photograph is affixed hereto has been registered as a qualified teacher under the Education Act. Photograph of holder .......................................................... Permanent Secretary Port Louis ............. 20 ...... [Sch. amended by s. 14 (u) of Act 18 of 2016 w.e.f. 1 January 2017.] [Issue 9] E2 – 26