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PA Sexual MisconductAbuse Disclosure Release free printable template
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Under Act 168 the wilful failure to respond to or provide the information and records as requested may result in civil penalties and/or professional discipline where applicable. L. 6 No. 3 known as the Right to Know Law. The Department of Education shall have jurisdiction to determine wilful violations of Act 168 and may following a hearing assess a civil penalty not to exceed 10 000. The individual whose name appears below has reported previous employment with your entity. We request you...provide the information requested in SECTION 2 of this form within 20 business days as required by Act 168 of 2014. Return all completed information to School Entity Council Rock School District Address Phone 30 North Chancellor St. State Newtown PA 18940 215-944-1000 Zip Fax Instructions This standardized form has been developed by the Pennsylvania Department of Education pursuant to Act 168 of 2014 to be used by school entities and independent contractors of school entities and by applicants...who would be employed by or in a school entity in a position involving direct contact with children to satisfy the Act s requirement of providing information related to abuse or sexual misconduct. COMMONWEALTH OF PENNSYLVANIA SEXUAL MISCONDUCT/ABUSE DISCLOSURE RELEASE under Act 168 of 2014 Hiring school entity or independent contractor submits this form to ALL current employer s and to former employer s that were school entities and/or where the applicant had direct contact with children To No...applicable employment Name of Current or Former Employer Street Address City State Zip Telephone Number The named applicant is under consideration for a position with our entity. As required by Act 168 in addition to fulfilling the requirements under section 111 of the School Code and the Child Protective Services Law CPSL an applicant who would be employed by 1 of this form and a written authorization that consents to and authorizes the disclosure by the applicant s current and former...employers of the information requested in SECTION 2 of this form. The applicant shall complete one form for the applicant s current employer s and one for each of the applicant s former employers that were school entities or where the applicant was employed in a position having direct contact with children therefore the applicant may have to complete more than one form. Upon completion by the applicant the hiring school entity or independent contractor shall submit the form to the applicant s...current and former employers to complete SECTION 2. Signature of Applicant Date SECTION 2 CURRENT/FORMER EMPLOYER VERIFICATION TO BE COMPLETED BY THE APPLICANT S CURRENT EMPLOYER S AND ALL FORMER EMPLOYERS THAT WERE SCHOOL ENTITIES AND/OR WHERE THE APPLICANT HAD DIRECT CONTACT WITH CHILDREN Employing Entity receipt date Received by Contact telephone Dates of employment of Applicant To the best of your knowledge has Applicant ever Former Employer Representative Signature and Title Pursuant to Act...168 an employer school entity administrator and/or independent contractor that provides information or records about a current or former employee or applicant shall be immune from criminal liability under the CPSL the Educator Discipline Act and from civil liability for the disclosure of the information unless the information or records provided were knowingly false.
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PA Sexual Misconduct-Abuse Disclosure Release Form Guide
How does the PA sexual misconduct-abuse disclosure release form work?
Understanding the PA Sexual Misconduct-Abuse Disclosure Release Form is critical for ensuring the safety and welfare of students across Pennsylvania. The form serves to collect essential information from applicants seeking employment in educational settings, enabling schools to maintain a safe environment by screening for past misconduct. This guide clarifies the purpose and process of this important legal document.
What is included in the disclosure form?
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The form is crucial for conducting thorough background checks on potential employees who will have direct contact with children.
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The form is part of Pennsylvania law aimed at protecting children from abuse and ensuring that educational institutions take significant steps to employ trustworthy individuals.
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Schools have a responsibility to provide a safe learning environment; the disclosure form aids in risk prevention.
How do navigate the form efficiently?
Navigating the PA disclosure form involves understanding its key sections. Ensure that all required details are completed accurately to avoid delays or issues with your application. Key components include applicant information, employment history, and sections related to past investigations.
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This section includes personal information like your name and date of birth. Accuracy here is crucial, as discrepancies can lead to issues in processing your application.
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Listing your previous employers and detailing roles held, including dates of employment, is necessary. This helps to establish your background related to child contact.
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Responses to inquiries about past investigations or disciplinary actions are critical. Be honest; your responses can affect your eligibility for employment.
What are the guidelines for completing the disclosure form?
Filling out the PA sexual misconduct abuse disclosure form requires attention to detail. Following guidelines can help ensure compliance with Pennsylvania law and minimize errors, which may result in processing delays.
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Before filling out the form, collect all necessary documents, including previous employment records and identification. This can streamline the process.
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Familiarize yourself with relevant laws regarding background checks and disclosures, ensuring your responses meet legal expectations.
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Double-check name spellings, important dates, and completeness to prevent inaccuracies that could raise red flags during processing.
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What are the timelines and submission processes?
Understanding the submission timelines for the PA sexual misconduct abuse disclosure form is essential for timely processing. Late submissions could impact your application status.
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Each school district may have its own timeline, so check with your prospective employer to ensure you meet deadlines.
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Forms typically need to be submitted to your hiring district or organization; follow their instructions carefully.
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After submission, expect a timeline for when you can follow up on the status of your application. Be proactive in checking back.
Frequently Asked Questions about act 168 form
What should I do if I have no prior employment to disclose?
If you have no previous employment, indicate this on the form. Some agencies may have alternative checks to confirm your eligibility.
How do I clarify doubts about the investigative process?
If uncertain, consult with legal or employment professionals or contact the agency requiring the form for specific inquiries.
What happens if discrepancies are found in my responses?
Discrepancies can lead to serious implications, including the potential rejection of your application. It's important to answer truthfully.
Are there penalties for not disclosing past misconduct?
Yes, failure to disclose can result in legal consequences, including job loss or issues with your professional license.
Can I appeal a decision made based on this disclosure form?
If denied employment due to the form, it's advisable to review the decision process and seek legal counsel to explore possible appeals.
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People Also Ask about act 168 blank
What are Act 168 forms?
Before the Act's effective date, Act 168 requires PDE to develop and make available a standard form to be completed by applicants for use by schools that requires applicants to disclose the name and contact information of former employers and/or to state whether he or she has been the subject of an investigation, has
What is Act 168 Form 2014?
Under Act 168, the hiring entity is prohibited from hiring an applicant for a position involving direct contact with children unless the applicant provides the required information on the form and consent.
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