BACKGROUND CHECK CONSENT FORM

READ THESE INSTRUCTIONS

How to determine the appropriate REASON FOR BACKGROUND CHECK on this form:

  • If you are a LICENSED TEACHER you will check one of the following reasons:
    • Licensed Teacher Transfer of Employment
    • Teacher (Licensure, Renewal, Lifetime License)
  • If you are NOT a licensed teacher or if you are a SUBSTITUTE TEACHER, you will check one of the following reasons:
    • Employment (Classified)
    • Employment (Substitute Teacher)
  • If you are a person seeking employment as a FISCAL OFFICER, you will check Employment (Fiscal Officer) for the reason.

STEP 1. REASON FOR BACKGROUND CHECK

Check the CORRECT boxState Statute:Requestor/Agency ID:
Employment (Classified)Ark. Code Ann. § 6-17-414EDN - AR920140Z
Employment (Fiscal Officer)Ark. Code Ann. § 6-17-421EDF - AR920623Z
Employment (Substitute Teacher)Ark. Code Ann. § 6-17-414EDN - AR920140Z
Licensed Teacher Transfer of EmploymentArk. Code Ann. § 6-17-411EDC - AR920080Z
Teacher (Licensure, Renewal, Lifetime License)Ark. Code Ann. § 6-17-410EDC - AR920080Z
Teacher (Pre-Service)Ark. Code Ann. § 6-17-410EDC - AR920080Z
NOTE: IT IS A VIOLATION OF FEDERAL LAW TO REQUEST A DEPARTMENT OF EDUCATION BACKGROUND CHECK FOR ANY PURPOSE NOT LISTED ABOVE
(For Example: Volunteers, Handgun Carry, etc.).