Background Check-Information
I, , understand that the state
of
Texas requires all applicants for a teaching certificate to
be
fingerprinted and to give pennission for a nationwide criminal background check. I further understand that the State
Board for Educator Certification (SBEC) can deny a teaching certificate to an applicant who has a criminal record. I am
al
so
aware
that even
if
SBEC agrees to grant a teaching certificate to a per
so
n with a criminal record, a school district will
conduct
its own criminal background check and can decline to hire the applicant because
of
his
or
her
record.
I understand that
if
I do have a criminal history record and continue in the
Au
stin Teacher Program, I
am
doing
so
at
my
own
risk. I will hold Austin College and the Austin College Education Department hannless
if
I
am
denied a teaching
certificate
or
am unable to find a teaching
job
because I have a criminal record.
Signature Date
Educators Code
of
Ethics Statement
I, , have read the
"co
de
of
Ethics and Standards Practices for Texas Educators" as established
by the State Board
of
Educator Certification and agree to abide by this co
de
as a pre-professional educator and/
or
st
udent
observer in classrooms.
Signature Date
FERP A - Consent
to
Release Educational Records & Information
I give my consent to the Austin Teacher Program to disclose my student records infonnation relating to any
of
my
field
based experiences as
it
is
appr
opriate for conversing and reviewing performance, acquiring feedback, or procuring
required signature
s.
This infonnation
may
be shared with
(I)
School districts or other agencies associated with field-
based experiences; (2) School-bas
ed
/ Agency-based administrators
or
co
operating teachers/mentors; (3) ATP program
faculty.
I understand that under the Family Educational
Ri
ghts and Privacy
Act
of 1974 no disclosure
of
my records can be made
without my written consent unless otherwise provided for in the legal statutes and judicial decisions. I also understand
that I may revoke this consent at any time (via written request to the Austin Teacher Program) except to the extent that
action has already been taken upon this release. Further, without such a release, I
am
unable to participate
in
any field-
ba
sed experiences including clinical teaching, student teaching,
or
internship.
Signature
of
Candidate
Date
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
