Teacher's Name _______________________ Present School ________________________________

Grade/Subjects _____________________________________________________________________

Total experience in this Division as of June 30, 2010__________________________________________

Each Teacher is requested to complete the following brief questionnaire regarding his/her intentions for next year. Your response to these questions will assist the Superintendents' Department in planning staffing details for the fall, including consideration for internal transfers. For those planning retirement, please inform your Supervisor/Principal as soon as possible. It would be extremely helpful to know this as early as possible to assist the division in its budget and staffing preparations. Internal transfers will generally not be considered after July 31. Thank you.

                                                                                                                            10/11 11/12

            1. It is my wish to continue teaching in the Division.

            2. I have definite plans to leave the Portage la Prairie School Division.

            3. I am considering retirement