ࡱ > d bjbjnn ;r f_gf_g : ( $ $ 42 42 2 2 2 2 2 2 8 2 | p3 2 4 4 4 4 4 j7 7 7 $ : ? 2 7 *7 @ j7 7 7 ? 42 42 4 4 T z; z; z; 7 R 42 R 4 2 4 z; 7 z; z; ^ 2 " 4 @G[ 7 R Ϭ h j 0 7 t B8 2 ] 7 7 z; 7 7 7 7 7 ? ? 9 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 7 $ X 0 : Personal DetailsName & AddressDOBPPS Dates of EmploymentFrom:To:Employed by ___ETB on 5th December 2011Yes ( No (Type of contract on date of leaving Pay details at date of leaving Salary scalePre-2011 ( New Post- January-2011 ( CL 83/2017 AppliedPoint on scaleDegree allowance H. Dip allowance Masters Allowance Last increment paid onHours to be carried forward towards next increment Casual Date first received or was entitled to receive the qualified rate of payHours to be carried forward towards next increment Non casual Note: Superannuation detailsPension Scheme:Education Sector Scheme ( ETB Teachers Scheme ( Single Public Service Pension Scheme (Member of Survivors and Childrens Scheme (appointed after 1986)Yes ( No ( New Entrant (employed in Public Sector after 01/04/2004)Yes ( No (Uncoordinated Scheme (D1)/Coordinated Scheme (A1) please confirmPRSI ClassIs this staff member currently availing of the Notional Purchase Scheme? Yes ( No ( Absence RecordNo. of daysFromToTotal sick leave (in past 4 years)Parental Leave/Sick leave on full payForce Majeure/Sick leave on half pay Career break/TRR Carers Leave /Critical illness Unpaid leave/ Other (please specify) Signed: __________________________________ HR Department Telephone: ___________________ Print Name: _____________________________ email: ________________________________________________________ Date: _____________________ All queries to: xxxxx@xxetb.ie XX Education and Training Board,
Statement of Service Official Stamp $ % & ' + , - 0 1 2 ϾwfYH7HHH7 h b h{ CJ OJ QJ ^J aJ h b h{ CJ OJ QJ ^J aJ h b h~ OJ QJ ^J h b h~ CJ OJ QJ ^J aJ h b h\! CJ OJ QJ ^J aJ h b h~ CJ OJ QJ ^J aJ h b h b OJ QJ ^J /hK hw 5B*CJ OJ QJ \^J aJ ph h b h b CJ OJ QJ ^J aJ h b h# OJ QJ ^J h b h OJ QJ ^J ,j h b h OJ QJ U^J mH nH u % & x l c _ $If gd[^ _ $$If a$gdH | kd $$If l K '* @ t f\ 0 *6 4 4 l a5p f\ yt b _ $If gdw & ' + , - 1 2 t h _ S S J _ $If gdi _ $$If a$gdMG _ $If gdFm _ $$If a$gdH kd $$If l 0 ' O! t 0 *6 4 4 l a5p yt{ 2 3 4 5 6 7 8 9 M S T X Y Z f i q s ijn]L8 & j rh b h~ CJ OJ QJ ^J aJ h b h~ CJ OJ QJ ^J aJ h b h~ CJ OJ QJ ^J aJ #h b h~ CJ H*OJ QJ ^J aJ h b h~ CJ OJ QJ ^J aJ h b hD CJ OJ QJ ^J aJ h b hD CJ OJ QJ ^J aJ h b h\! CJ OJ QJ ^J aJ h b h{ OJ QJ ^J h b h{ CJ OJ QJ ^J aJ h b h{ CJ OJ QJ ^J aJ h b h{ OJ QJ ^J 2 3 4 , _ $$If a$gdH kd $$If l r |' O t 0 *6 4 4 l a5p2 yt{ 4 5 6 7 8 &