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Texas State Law Public School Employment

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Texas State Law Public School Employment Powered By Docstoc
					                                                        SUBSTITUTE
                                              FINGERPRINTING CERTIFICATION FORM

The information requested below is necessary to obtain criminal history. This confidential information will NOT be
included as part of your application but it must be completed in order to be considered for employment by Plano
Independent School District. All Texas public schools are required by state law to obtain criminal history record
information on all applicants for employment with the District (Texas Education Code Section 22.083).

To be able to attend the substitute orientation, this form must be completed AFTER the fingerprinting appointment
and immediately submitted to the Human Resources Substitute Office at Plano ISD Administration Building, 2700 W.
15th St., Plano, TX 75075 via mail, e-mail (substitute@pisd.edu), or fax no. (469-752-8009).


 FIRST NAME:                                                                      LAST NAME:

 SOCIAL SEC. NO:                                                                  DATE OF BIRTH:

 DO YOU HAVE A VALID U.S. DRIVER'S LICENSE?                                       YES       NO

 DRIVERS LICENSE NUMBER:

 DRIVERS LICENSE STATE:

 DATE COMPLETED FINGERPRINTING:

 TCN #:
                Identification no. located on bottom page of FAST fingerprint receipt


 Complete the following section only If your finger prints are rejected
 Reprint
 DATE COMPLETED FINGERPRINTING:

 TCN #:
                Identification no. located on bottom page of FAST fingerprint receipt


 I certify the above information is true and correct.


 APPLICANT SIGNATURE:                                                                              DATE:




FOR OFFICE USE ONLY:

TEAMS ID NO.:

COMPLETED BY:                                                                            DATE:

APPROVED BY:                                                                             DATE:

STATUS:                   No Show                                                        DATE:

                          Sent to Sec.                                                   DATE:

                          Other                                                          DATE:
 Rev. 9/22/09

				
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