ATTESTATION OF ELIGIBILITY
The Kansas State Board of Education requires that individuals who have been convicted of, or
pleaded guilty to, any act punishable as a felony may not be certified to teach. Wichita State
University is responsible for recommending individuals who have completed the teacher
education program for certification as a teacher. Given this responsibility, it is asked that you read
and sign the statement below.
If you are confident that you understand the standard, please answer the questions below and
complete the "Attestation of Eligibility."
1. Have you ever been convicted of a felony? Yes No
2. Have you ever been convicted on ANY crime involving theft, drugs, or a child?
Yes No
3. Have you entered into a criminal diversion agreement after being charged with any offense
described in Question 1 or 2?
Yes No
4. Are criminal charges pending against you in any state involving any of the offenses described
in question 1 or 2?
Yes No
5. Have you had a teacher’s or school administrator’s certificate or license denied, suspended or
revoked in any state?
Yes No
6. Is disciplinary action pending against you in any state regarding a teacher’s or administrator’s
certificate or license?
Yes No
7. Have you ever been terminated, suspended, or otherwise disciplined by a local Board of
Education for falsifying or altering student tests or student test scores?
Yes No
8. Have you ever falsified or altered assessment data documents, or test score reports required
for licensure?
Yes No
(Continue to Next Page)
