Fillable Isabelle Farrington College of Education Applicant Statement of (Sacred Heart University)

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Isabelle Farrington College of Education Applicant Statement of (Sacred Heart University)

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Isabelle Farrington College of Education Applicant
Statement of Understanding Regarding Background Checks
and Professional Conduct
In accord with Section 10-221d of the Connecticut General Statutes (C.G.S), admitted applicants
are required to undergo a local and regional background check. The process is specific to each
school district. Admitted applicants must contact the district of the field experience, internship,
or student teaching and follow that district’s process for completing a background check.
The applicant is hereby advised that, based on information disclosed in this background check, a
school district may deny an individual’s request for authorization to conduct field experiences, an
internship, practicum activities, and student teaching. Such denial may prevent progress through
and/or completion of the intended certification program of study. The applicant (or, if admitted,
the certification or degree candidate) is solely responsible for this consequence of his/her record.
Furthermore, the CT State Department of Education (CSDE) may -- based on information
disclosed by this background check -- deny issuance of a certificate to a candidate, regardless of
the institutional recommendation for certification from Sacred Heart University. The program
applicant (or-- if admitted -- the certification or degree candidate) is solely responsible for
contacting the Bureau of Educator Standards and Certification of the CSDE to determine if the
content of the background check will preclude the issuance of the teaching certificate.
The Isabelle Farrington College of Education expects that candidates for certification will be
familiar with, and conduct themselves in accordance with, the Connecticut Common Core of
Teaching (CCCT) and the current Connecticut Code of Professional Responsibility for Teachers.
Substantial violation of the CCCT or the Code of Professional Responsibility will be a basis for
dismissal from programs within the Isabelle Farrington College of Education. Sacred Heart
University, Incorporated, is hereby authorized to obtain through its own internal means and/or
through external means, including but not limited to: investigating agencies, federal and state
agencies, credit reporting agencies, a background check, education check, and all information,
permitted by law, pertaining to the undersigned’s qualifications to engage in professional
preparation (including but not limited to field and clinical placements in public or private
institutions, that provide education related services for children) leading to recommendation for
certification oran advanced degree in Education. This information includes, but is not limited to
an applicant’s or candidate’s personnel files, information on drug use, driving records, education
verification and criminal conduct reports, and any other documents that establish an
undersigned’s violation of the University’s Mission Statement, theIsabelle Farrington College of
Education’s Conceptual Framework, the Connecticut Common Core of Teaching and the
Connecticut Code of Professional Responsibility for Teachers and Administrators; the
1
undersigned’s ineligibility for admission to professional preparation programs at Sacred Heart
University and/or recommendation, by Sacred HeartUniversity, for certification to the
Connecticut State Department of Education. This consent includes, but is not limited to, the
lawful use of drug use testing and screening procedures, and information regarding sexual
harassment issues, discrimination, criminal or anti- social behavior, both prior to and, if admitted,
during the course of study at Sacred Heart University.
This authorization is also consent, to Sacred Heart University, for conducting investigations
regarding and pertaining to any claims of sexual harassment or other alleged unlawful conduct,
if the applicant is pursuing a degree or certification through the Isabelle Farrington College of
Education of Sacred Heart University.
If an outside agency is used to collect information and adverse action is taken against the
undersigned as a result of the investigation, the undersigned will be notified and instructed to
obtain a copy of the report. THE UNDERSIGNED ACKNOWLEDGES AND UNDERSTANDS THAT THE
CONSUMER REPORT SEEKING AND CONTAINING THE ABOVE INFORMATION MAY BE RETAINED
FOR THE PURPOSES related to professional certification and or advanced degree.
Respond to each of the following questions. If you answer “yes” to any of the following
questions, you will need to meet with the dean (or the dean’s appointee) of the Farrington
College of Education to discuss the issue(s) prior to an admission decision.
1. Have you ever been convicted of any crime, excluding minor traffic violations?
Yes No
2. Have you ever been dismissed for cause from any previous position?
Yes
No
3. Have you ever surrendered a professional certificate, license, permit or other credential
(including, but not limited to, an education credential); had one revoked, suspended,
annulled, invalidated, rejected or denied for cause; or been the subject of any other
adverse or disciplinary credential activity?
Yes
No
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Date:
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Isabelle Farrington College of Education Applicant Statement of (Sacred Heart University)

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Completed 24 July 2020

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