Jt. Jerome School District No. 261

PERSONNEL 5100F3

125 4th Ave. West, Jerome, Idaho 83338

Phone 208‐324‐2392 Fax 208‐324‐7609

www.d261.k12.id.us

REQUEST FOR VERIFICATION OF CERTIFICATE STATUS

Attn: Christina P. Linder

Director of Certification/Professional Standards

Idaho State Department of Education

650 W. State Street

P.O. Box 83720

Boise, ID 83720‐0027

Pursuant to § 33‐1210(5), Idaho Code, the District is seeking information regarding the following

individual:

Name of Applicant ____________________________

D.O.B.: ____________________________

Specifically, pursuant to the above‐referenced statute, the District is seeking the

following information in order to address a hiring decision:

1. Certificate Status.

2. The existence of any past findings or complaints relating to violations of the Code of

Ethics for Professional Educators.

3. The existence of any current complaints or investigations relating to alleged

violations of the Code of Ethics for Professional Educators.

4. Any information relating to job performance as defined by the State Board of

Education, pursuant to Subsection (11) of Idaho Code 33‐1210, for any applicants

for certificated employment.

The District would greatly appreciate it if this information could be advanced to the attention of

_____________________________ on or before the __________ day of

______________________________ in order to allow a timely decision as to employment matters. This

information may be mailed at the above address or sent via electronic format to:

________________________________________.

Sincerely,

District HR Department

Policy History:

Adopted on: 07/26/11

Revised on: