Form SNB12555 "Qifs Change Form" - New Brunswick, Canada

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Download Form SNB12555 "Qifs Change Form" - New Brunswick, Canada

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QIFS Change Form
Department of Education and Early Childhood Development
Changes received by the 10
of each month will be reflected in the next monthly payment.
th
Facility Name:
Licence #:
Operator/Administrator:
Telephone:
Date:
REASON FOR CHANGE:
Change to an educator’s hours
Status Type:
Name of educator:
New # of hours per week:
(if eligibility type or training has changed a new Eligible Employee Form is
needed)
Educator no longer works at this facility
Name of educator:
Departure effective date:
Reason (maternity leave, termination, etc).
Payment inquiry or other (please attach any supporting documents):
CHANGE FORMS must be submitted by regular mail:
or email:
Department of Education and Early Childhood Development,
QIFS-SFAQ@gnb.ca
Quality Improvement Funding Support
Place 2000, P.O. Box 6000
Faxes are no longer accepted.
250 King Street
Fredericton NB E3B 9M9
Internal use only
Action
Signature
Date
©2020 EECD NB
SNB 12555
Reset form
QIFS Change Form
Department of Education and Early Childhood Development
Changes received by the 10
of each month will be reflected in the next monthly payment.
th
Facility Name:
Licence #:
Operator/Administrator:
Telephone:
Date:
REASON FOR CHANGE:
Change to an educator’s hours
Status Type:
Name of educator:
New # of hours per week:
(if eligibility type or training has changed a new Eligible Employee Form is
needed)
Educator no longer works at this facility
Name of educator:
Departure effective date:
Reason (maternity leave, termination, etc).
Payment inquiry or other (please attach any supporting documents):
CHANGE FORMS must be submitted by regular mail:
or email:
Department of Education and Early Childhood Development,
QIFS-SFAQ@gnb.ca
Quality Improvement Funding Support
Place 2000, P.O. Box 6000
Faxes are no longer accepted.
250 King Street
Fredericton NB E3B 9M9
Internal use only
Action
Signature
Date
©2020 EECD NB
SNB 12555