School Director And/or Program Director Application Form Page 2
Download a blank fillable School Director And/or Program Director Application Form in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete School Director And/or Program Director Application Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2DISCLOSURE:
Indicate any prior involvement as a director with a private occupational school in Connecticut or any
other state which school had its certificate of authorization revoked or privilege to carry on vocational
instruction cancelled by the state:
Name of State__________________________________________________
Initial the correct answer below:
No Prior Involvement
Yes, Prior Involvement, complete the following information:
Name of School
Full Address
Position(s) Held at School
Period Employed
Date of Revocation or Cancellation of Privilege to Operate
Reason for revocation:________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
I do swear or affirm that the statements made on the School Director Form are complete and
correct to the best of my knowledge and belief.
Signature of Director
Date
_______________
It is the responsibility of the school to ensure that it hires an appropriately qualified individual. The
Executive Director of the Office of Higher Education may waive the educational and other
requirements for a director where there is other evidence of qualification. If applicable, attach
documentation showing the grant of a waiver.
I do swear or affirm that the statements made on the Director Form are complete and correct to the best
of my knowledge and belief.
Chief Fiscal Officer Signature:
___________ Date: ____________
Name of Chief Fiscal Officer:
____________
(8/2012)
HPOSA AP Page 9
ADVERTISEMENT
0 votes
Related Articles
Related forms
Application For Permit To Mix, Blend And/or Distributealcohol-gasoline Blends Form - Mississippi Department Of Agriculture And Commerce
Legal
![Application For Review Of Civil Assessment [penal Code 1214.1] And/or Delinquent Fine Payments Form](https://data.formsbank.com/pdf_docs_html/179/1794/179410/page_1_thumb.png "Application For Review Of Civil Assessment [penal Code 1214.1] And/or Delinquent Fine Payments Form")
Application For Review Of Civil Assessment [penal Code 1214.1] And/or Delinquent Fine Payments Form
Legal
Related Categories
Parent category: Education