This verification form is to certify an individual's teaching or administrative experience, including their social security number, name(s) used, employer details, position(s) held with dates and hours worked. The authorized signatory must validate the experience claimed under penalty of perjury, and provide contact information and an official stamp or seal if certifying experience from outside the United States.
This verification form is to certify an individual's teaching or administrative experience, including their social security number, name(s) used, employer details, position(s) held with dates and hours worked. The authorized signatory must validate the experience claimed under penalty of perjury, and provide contact information and an official stamp or seal if certifying experience from outside the United States.
Original Title
Verification of TeachingAdministrative Experience.doc
This verification form is to certify an individual's teaching or administrative experience, including their social security number, name(s) used, employer details, position(s) held with dates and hours worked. The authorized signatory must validate the experience claimed under penalty of perjury, and provide contact information and an official stamp or seal if certifying experience from outside the United States.
This verification form is to certify an individual's teaching or administrative experience, including their social security number, name(s) used, employer details, position(s) held with dates and hours worked. The authorized signatory must validate the experience claimed under penalty of perjury, and provide contact information and an official stamp or seal if certifying experience from outside the United States.
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(to be reproduced on official district or school letterhead)
VERIFICATION OF TEACHING/ADMINISTRATIVE EXPERIENCE FORM
SOCIAL SECURITY NUMBER: ________________________________
This is to certify that ____________________________________________________________________
(Last Name) (First Name) (Middle Name)
Any other name(s) Used_________________________________________________________________
Was employed by: _____________________________________________________________________
City of: __________________________________________State of/Country of: _____________________________
*NUMBER *BEGINNING *ENDING OF DAYS *HOURS PER *FULL-TIME MONTH-DAY-YEAR MONTH-DAY-YEAR *POSITION WORKED DAY PART-TIME
*Must be completed
Authorized Signature, Title & Organizational Stamp (Official stamp or seal is required if verification is from a country outside the United States). I attest, under penalty of perjury, that to the best of my knowledge, this employee was authorized and worked as an educator within the school district and the above verification is genuine and relates to the individual.
_____________________________________ _____________________________________ SIGNATURE DATE
_____________________________________ _____________________________________ TITLE E-MAIL
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