Pc Form Ta 5192 - Teacher Assistant/instructional Aide Processing Form - Los Angeles Unified School District

TEACHER ASSISTANT/INSTRUCTIONAL AIDE PROCESSING FORM

TO:

CLASSIFIED EMPLOYMENT OFFICE

DATE:

FROM:

SCHOOL

TELEPHONE NUMBER

CONTACT PERSON

Please process _______________________________ as a Teacher Assistant/

Instructional Aide.

The applicant will present you with the following completed forms:

____ Application for Issuance of Teacher Assistant Certificate (Form 503-103)

____ Proficiency test results or evidence of meeting the proficiency standards

____ Tuberculosis clearance (Mantoux Skin Test)

____ Request for Greenie (Budget Services Branch Form 52.8, Rev. 8/87)

____ Documents to demonstrate eligibility to legally work in the United States

Has this applicant ever worked for LAUSD? £ £ NO

£ £ YES

If YES, please state _______________

__________________

EMPLOYEE NUMBER

DATE LAST WORKED

Name (while working) if different from above: ____________________________________.

PC Form TA 5192 (Rev. 6/01)

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Parent category: Education