Request for in-service information from previous employing district
If you receive this form it is because a transportation employee at another Oklahoma school district
has named you as a previous employer. This form is to enable the transmission of in-
service documentation from one district to another. This is important because,
Oklahoma Administrative Code 210:30-5-1 states “(i) Every five years, each driver shall have
successfully completed 4 hours per year of in-service training approved by the State
Department of Education.” In order to comply with this rule the school district
listed below is requesting any and all in-service records you have for the
applicant named below from the previous 5 years. This information may be
mailed or faxed to the district currently employing the applicant.
TO: FROM:
___________________ _____________________
SCHOOL DISTRICT SCHOOL DISTRICT
(previous employer) (requesting district)
___________________ _____________________
NAME Title NAME Title
___________________ _____________________
ADDRESS ADDRESS
_____________ ______ _____________________
PHONE # FAX # PHONE # FAX #
(Mr., Mrs., Ms.) ________________________DL# _____________________has made an application to
our district for a school bus driver position. We are requesting a copy of their in-service records for the
previous 5 years or from the beginning date of their employment with you.
What were the dates of the applicant’s employment with you? ____________________
RELEASE AUTHORIZATION
With my signature below, I am authorizing you to release information in regards to school bus
training in-service I was a party to while in your employ, acting as your agent, under contract
with you, or acting as your representative in any capacity during the preceding five years from
the date listed below. This request is specific and to be released only to the district whose name
appears below. Authorization of this release will expire once the requested information has been
sent to the company named below. This authorization may not be used to provide information to
any other persons.
Name of District _________________________________________
Date _____________________________________________________
Name of Applicant _________________________________________
Signature of Applicant _______________________________________
Witness Signature __________________________________________
