• Section 7.35.F.1 Professional Staff Hiring

    Consent to Conduct Background Investigation & Release


  • I,

  • Have applied for employment with the Dysart Unified School District to work as

  • I understand that in order for the School District to determine my eligibility, qualifications, and suitability for employment, the School District will conduct a background investigation to determine if I am to be considered for an offer of employment. This investigation may include asking my current employer, any former employer, and any educational institution I have attended about my education, training, experience, qualifications, job performance, professional conduct, and evaluations, as well as confirming my dates of employment or enrollment, position(s) held, reason(s) for leaving employment, whether I could be rehired, reasons for not rehiring (if applicable), and similar information.

    I hereby give my consent for any employer or educational institution to release any information requested in connection with this background investigation.

    According to the Family Educational Rights and Privacy Act, I understand that I have a right to see most education records that are maintained by any educational institution.

  • In light of the preceding paragraph, I waive/do not waive (choose one) my right to see any written reference or other information provided to the School District by any education institution.


  • According to Arizona Revised Statutes Section 23-1361, any employer that provides a written communication to the School District regarding my current or past employment must send me a copy at my last known address. I acknowledge that some employers are unwilling to provide factual written references concerning a current or past employee unless they may do so confidentially, without revealing the references to the employee, and that the School District will not further consider my application if it cannot complete its background investigation.

  • In light of the preceding paragraph, I waive /do not waive (choose one) my right to receive a copy of any written communication furnished to the School District by any employer.

  • Whether or not I have waived my right to see or to receive copies of written references furnished to the School District by employers or educational institutions, I release, hold harmless, and agree not to sue or file any claim of any kind against any current or former employer or educational institution, and any officer or employee of either, that in good faith furnishes written or oral references requested by this School District to complete its background investigation.

  • A photocopy, electronic signature or facsimile ("fax") copy of this form that demonstrates my signature shall be as valid as an original.

  • Witness ___________________________________________

    You may want to remove this from this form if applicant accesses form from Dysart website. Just a thought.

  • Reference: Section 7.35, Form 7.35.F.1