CLB Assessors’ Registry Form

If you are a new assessor, have changed your mailing address, or made any changes not yet reported to the CCLB, please print and fill in the questionnaire and return it to the CCLB:

By fax: (613) 230-9305

or mail:
Centre for Canadian Language Benchmarks,
200 Elgin Street, Suite 803,
Ottawa, Ontario, K2P 1L5

Name

Organization

Address

City / Province & Postal Code

Business Telephone

Business Fax

Business e-mail

Home address

City / Province & Postal Code

Home Telephone

Home e-mail

Province Assessing

Province Trained

Date of Certification

Date of last Evaluation

Active or Inactive

Part time (PT) or Full Time (FT)

Supervisor

A-LINC Experience

Other