Form Rcjtc F 02 02 PDF Details

The Form Rcjtc F 02 02 is a document used to report information about a Canadian criminal record. The form is completed by the person who has the criminal record and submitted to the Royal Canadian Mounted Police (RCMP). The information on the form can be used to determine if someone is eligible for a pardon or not. Anyone with a criminal record should complete and submit this form to the RCMP.

Before you fill in form rcjtc f 02 02, you will need to know more in regards to the type of form you'll use.

QuestionAnswer
Form NameForm Rcjtc F 02 02
Form Length1 pages
Fillable?Yes
Fillable fields32
Avg. time to fill out6 min 43 sec
Other namestsp, diabetes emergency action plan template, Renfrew, Cecelia

Form Preview Example

Renfrew County Joint Transportation Consortium

999 Cecelia Street, Pembroke, ON K8B 1A4

Telephone: 613.732.8419 Fax: 613.732.2874

Website: www.rcjtc.on.ca Email: trans@rcjtc.on.ca

F.02.02

Student’s Name:

 

 

 

 

 

 

Place Student’s

 

Classroom Teacher:

 

 

 

 

 

 

Picture Here

 

 

 

 

 

 

 

 

 

 

Parent/Guardian/Emergency Contacts:

 

 

 

 

 

 

 

 

 

(Prioritize calls, i.e. 1, 2, 3)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Names, please print)

 

 

 

 

 

 

 

 

 

Signs and Symptoms:

Sweating

Hunger

Other, please specify:

Trembling Headaches

Dizziness Blurred vision

Mood changes

Extreme tiredness/paleness

Optimum Level (Range) of Blood Sugar is

Location of Sugar Treatment

With Student

Other, please specify:

Select one treatment, provided by parent, from the following: 6 oz. (125 ml) of fruit juice/drink (junior juice box) OR

3

– 4 tsp. (10

– 15 ml) of sugar (3 – 4 packets) OR

 

6 oz. (125 ml) of regular pop (not diet type) OR

 

 

3

– 4 tsp. (10

– 15 ml) of honey OR

 

 

4

– 5 glucose tablets

Other

 

Wait 10 – 15 minutes. If there is no improvement, repeat the above treatment.

If the student is unconscious,

*Roll the student on his/her side

 

having a seizure or unable to swallow

*Call 9-1-1

 

 

DO NOT give food or drink

*Inform parents/guardians

 

 

 

 

 

 

 

 

Rte #

AM

PM

 

 

Rte #

AM

PM

Original – School; Copy – Renfrew County Joint Transportation Consortium

The personal information you have provided on this form and any other correspondence relating to transportation is collected by the Renfrew County Joint Transportation Consortium (RCJTC) under the authority of the Education Act (R.S.O. 1990 c.E.2) ss. 58.5, 265 and 266 as amended. The information will be used to arrange appropriate transportation, and to give information to employees and transportation providers to carry out their job duties. In addition, the information may be used to deal with matters of health and safety or discipline and is required to be disclosed in compelling circumstances or for law enforcement matters or in accordance with any other Act. The information will be used in accordance with the Education Act, the regulations, and guidelines issued by the Minister of Education governing the establishment, maintenance, use, retention, transfer and disposal of pupil records. For questions about this collection, speak to the General Manager of the RCJTC, 999 Cecelia St., Pembroke, 613-732-8419.

Form RCJTC.F.02.02

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