Criminal History
Answer the following question: Have you ever been convicted of a felony
(including a conviction plea), are you addicted to the use of intoxicants or
narcotics or have you ever falsified or altered documentation required for
licensure? _______YES _______NO
I AFFIRM:
- I recognize that, if I am employed, the Board of
Education may assign or reassign me to a specific position as the need
requires.
- I have not been convicted of a felony in any
state of the United States.
- I have not been dismissed from any previous
employment for improper or unprofessional conduct, inefficient service,
neglect of duty, incompetence, or insubordination.
- If my most recent employer was another Tennessee public school system and if my termination was
voluntary; I certify that my resignation was, or will be submitted in
writing at least thirty (30) days prior to the date stated, or, if within
thirty days, the previous board has waived its right to such notice. A copy of my letter of resignation or
the said board action is attached or will be provided.
- I am a citizen of the United States.
- I do not have any contagious or communicable
disease which may endanger the health of school children.
- I shall support the constitution of Tennessee and the United States.
- I understand that misrepresentation of any of the
above statements may subject me to a fine, loss of an opportunity for
employment, and loss of position if employed.
_________________ ___________________________________
Date Signed
Tennessee
Bureau of Investigation Background Check
Required by Law
$48.00 FEE
(Reimbursed after 6-months of positive employment)
School Systems Name & Address of Initial Background
Check (if applicable):
____________________________________
____________________________________
____________________________________
Stewart County Schools has implemented a Drug
Free Workplace Policy in compliance with federal regulations.
It is the policy of the Stewart County Board of Education
not to discriminate on the basis of sex, race, national origin, creed, age,
marital status or disability in its educational programs, activities or
employment policies.