Jt. Jerome School District No. 261

PERSONNEL 5100F1

Jerome Jt. School District No. 261

District Office

125 4th Avenue West

Jerome, Idaho 83338

Telephone (208) 324-2392 • FAX (208) 324-7609

Dale Layne, Superintendent of Schools ____________________________________________________________________

AUTHORIZATION FOR RELEASE OF INFORMATION ON PAST

EMPLOYMENT WITH SCHOOL EMPLOYERS

IDAHO CODE 33-1210

Idaho Law requires Applicants for any position at any Idaho Public School to allow the hiring School

District Employer to obtain a copy of past public school employer personnel file materials and other

documentation relating to the performance of the Applicant when such Applicant was employed by any

other public school, whether in Idaho or any other state.

Before hiring an Applicant for any position, the District must request the Applicant sign this form. Should

the Applicant refuse or fail to sign this form, the District is not permitted to hire the Applicant for any

position. This authorization does not limit any employer from seeking additional information or

disclosures from any Applicant.

This form:

1. Authorizes current and past public school employer of the Applicant/undersigned on this

form, including Applicants outside of the State of Idaho, to release to the hiring School

District all information relating to the job performance and/or job related conduct of the

Applicant and make available to the hiring School District copies of all documents in the

previous employer’s personnel file, investigative file (regardless of outcome or finding, if

any), or other files relating to the job performance of the Applicant; and

2. Releases the Applicant’s/undersigned’s current and past employers, and employees acting

on behalf of the employer, from any liability for providing the above-mentioned information.

Pursuant to state law, “documentation related to the job performance or job related conduct of any

employee/applicant is defined as, and may be limited by the producing district to include,: all annual

evaluations, letters of reprimand, letters of direction, letters of commendation or award, disciplinary

actions and documentation of disciplinary investigations, recommendations for probation, notices of

probation, notices of removal from probation, recommendations for termination or nonrenewal, notices

of termination or nonrenewal, notices from the professional standards commission of Idaho or any other such similar state agency of action taken against an individual's certificate and any rebuttal

documentation filed by the employee relative to any of the above documents.” I.C. § 33-1210(2)(b).

§ 33-1210 RELEASE:

I understand that the above requirements are a condition of my obtaining employment with the District

and I consent to my current and former employers, both inside and outside the State of Idaho, upon

receipt of this signed authorization, to comply with Idaho law. I further consent that such authorization

may be provided to the hiring District via electronic means.

_____________________________________________ ________________________

Signature of Applicant Date

_____________________________________________

Printed Name of Applicant

____________________________________________________________

Identifying Employee Number/Name of Applicant or other Identifying

Information for Past Employer

*Information obtained through the use of this Release will be used only for the purpose of evaluating the

qualifications of the Applicant for employment. This information will not be disclosed in any manner other

than as provided by Statute.

*A copy of this Release and all information obtained through use of this Release will be placed into the

Applicant’s Personnel File with the District upon employment of the Applicant, if any.

*An Applicant’s failure to disclose any former School District employer, whether within or outside of the

State of Idaho, will serve as the basis for immediate termination and, for certificated personnel, may also

result in the District’s reporting of the individual to the Idaho Professional Standards Commission for a

potential violation of the Code of Ethics for Professional Educators.

*By accepting an executed copy of this form, the hiring School District makes no guaranty or promise of

employment to the Applicant. Further, the hiring School District may employ the Applicant on a

conditional basis pending review of information gathered pursuant to this Release. Such conditional

employment is not a guarantee or promise of continued employment with the hiring School District for

any length of time or pursuant to any additional conditions.

Policy History:

Adopted on: 07/26/11

Revised on: 10/23/12