1. THE BUCK STOPS WITH YOU

2. I CAN ONLY TELL YOU WHAT IS TRUE FOR TODAY

3. SOCIAL SECURITY NUMBERS WATCH FOR OUT- OF-STATE NUMBERS

4. CHALLENGES POSED BY OUT- OF- STATE APPLICANTS

5. NON-TRADITIONAL STUDENTS -vs- TRADITIONAL STUDENTS

6. REVIEW MILITARY DISCHARGE PAPERS (DD214)

7. GAPS IN EMPLOYMENT

8. CONTACT LAST KNOWN PLACES OF EMPLOYMENT

9. RICH MAN POOR MAN DOCTOR LAWYER INDIAN CHIEF

10. CONSENT AGREEMENTS SHOULD ALLOW FOR INFORMATION TO BE RETRIEVED FROM BOTH STATE AND FEDERAL DATA BASES

11. Georgia Bureau of Investigation Georgia Crime Information Center Consent Form I hereby authorize Georgia Professional Standards Commission to receive any Georgia criminal history record information pertaining to me which may be in the files of any state or local criminal justice agency in Georgia. ________________________________________________________________________ Full Name (print) ________________________________________________________________________ Address ______ ______ ________ __________ ______________________ Sex Race Date of Birth Social Security Number ________________________________________________ Signature __________________ Date ------------------------------------------------------------------------------------------------------------------------------- Special employment provisions (check if applicable):  Employment with mentally disabled (Purpose code ‘M’)  Employment with elder care (Purpose code ‘N’)  Employment with children (Purpose code ‘W’) One of the following must be checked: This authorization is valid for 90/180 (circle one) days from date of signature. I, ____________________________________________ give consent to the above named to perform periodic criminal history background checks for the duration of my employment with this company.

12. PURPOSE CODE W vs. PURPOSE CODE E

13. CRIMES OF MORAL TURPITUDE

14. CAN FELONS TEACH IN GEORGIA?

17. UNITED STATES DEPARTMENT OF JUSTICE FEDERAL BUREAU OF INVESTIGATION CRIMINAL JUSTICE INFORMATION SERVICES DIVISION CLARKSBURG, WV 26306 GA930090Z TCN 00000000000000000-0000000000 THE FBI IDENTIFIED YOUR TEN- PRINT SUBMISSION WHICH CONTAINED THE FOLLOWING DESCRIPTORS: NAME DATE ARRESTED/FINGERPRINTED 2007/01/19 SEX RACE BIRTH DATE HEIGHT WEIGHT EYES HAIR STATE ID BIRTH PLACE GA0000000L OTHER BIRTH SOCIAL DATESSCARS-MARKS-TATTOOS SECURITY MISC NUMBERS ALIAS NAMES(S) NONE

18. UNITED STATES DEPARTMENT OF JUSTICE FEDERAL BUREAU OF INVESTIGATION CRIMINAL JUSTICE INFORMATION SERVICES DIVISION CLARKSBURG, WV 26306 GA000000Z ICN IFCS0000000000000000 BECAUSE ADDITIONS OR DELETIONS MAY BE MADE AT ANY TIME, A NEW COPY SHOULD BE REQUESTED WHEN NEEDED FOR SUBSEQUENT USE. THIS RECORD IS SUBJECT TO THE FOLLOWING USE AND DISSEMINATION RESTRICTIONS UNDER PROVISIONS SET FORTH IN TITLE 28, CODE OF FEDERAL REGULATIONS (CFR), SECTION 50.12, BOTH GOVERNMENTAL AND NONGOVERNMENTAL ENTITIES AUTHORIZED TO SUBMIT FINGERPRINTS AND RECEIVE FBI IDENTIFICATION RECORDS MUST NOTIFY THE INDIVIDUALS FINGERPRINTED THAT THE FINGERPRINTS WILL BE USED TO CHECK THE CRIMINAL HISTORY RECORDS OF THE FBI. IDENTIFICATION RECORDS OBTAINED FROM THE FBI MAY USED SOLELY FOR THE PURPOSE REQUESTED AND MAY NOT BE DISSEMINATED OUTSIDE THE RECEIVING DEPARTMENT, RELAATED AGENCY OR OTHER AUTHORIZED ENTITY. IF THE INFORMATION ON THE RECORD IS USED TO DISQUALIFY AN APPLICANT, THE OFFICIAL MAKING THE DETERMINATION OF SUITABILITY FOR LICENSING OR EMPLOYMENT SHALL PROVIDE THE APPLICANT THE OPPORTUNITY TO COMPLETE, OR CHALLENGE THE ACCURACY OF, THE INFORMATION CONTAINED IN THE FBI IDENTIFICATION RECORD. THE DECIDING OFFICIAL SHOULD NOT DENY THE LICENSE OR EMPLOYMENT BASED ON THE INFORMATION IN THE RECORD UNTIL THE APPLICANT HAS BEEN AFFORDED A RESONABLE TIME TO CORRECT OR COMPLETE THE INFORMATION, OR HAS DECLINED TO DO SO. AN INDIVIDUAL SHOULD BE PRESUMED NOT GUILTY OF ANY CHARGE/ARREST FOR WHICH THERE IS NO FINAL DISPOSITION STATE ON THE RECORD OR OTHERWISE DETERMINED. IF THE APPLICANT WISHES TO CORRECT THE RECORD AS IT APPEARS IN THE FBI’S CJIS DIVISION RECORDS SYSTEM, THE APPLICANT SHOULD BE ADVISED THE PROCEDURES TO CHANGE, CORRECT OR UPDATE THE RECORD ARE SET FORTH IN TITLE 28, CFR, SECTION 16.34.

19. - FBI IDENTIFICATION RECORD - WHEN EXPLANTION OF A CHARGE OF DISPOSITION IS NEEDED, COMMUNICATE DIRECTLY WITH THE AGENCY THAT FURNISHED THE DATA TO THE FBI. NAME FBI NO. DATE REQUESTED DOE, JANE 000000HB32007/01/26 SEX RACE BIRTH DATE HEIGHT WEIGHT EYES HAIR BIRTH PLACE FINGERPRINT CLASS PATTERN CLASS CITIZENSHIP END OF PART 1 - PART 2 TO FOLLOW

20. UNITED STATES DEPARTMENT OF JUSTICE FEDERAL BUREAU OF INVESTIGATION CRIMINAL JUSTICE INFORMATION SERVICES DIVISION CLARKSBURG, WV 26306 GA930090ZICN IFCS0000000000000000 - FBI IDENTIFICATION RECORD - FBI NO-000000HB3 1.-ARRESTED OR RECEIVED 1997/12/04 SID- SC00000000 AGENCY-SHERIFF’S OFFICE GREENVILLE (SC0000000) AGENCY CASE - 000000 CHARGE 1- FRAUDULENT CHECK Ff000000 COURT-SHERIFF’S OFFICE GREENVILLE (SC0230000) CHARGE- FRAUDULENT CHECK SENTENCE- VERDICT - CONVICTED ADDITIONAL DATE - PAID $45. ALL ARREST ENTIRES CONTAINED IN THIS FBI RECORD ARE BASED ON FINGERPRINT COMPARISONS AND PERTAIN TO THE SAME INDIVIDUAL. THE USE OF THIS RECORD IS REGULATED BY LAW. IT IS PROVIDED FOR OFFICIAL USE ONLY AND MAYBE USED ONLY FOR THE PURPOSE REQUESTED.

21. FIRST OFFENDER TREATMENT

22. PRE-TRIAL DIVERSION PROGRAMS

23. DUI

24. DRIVING WITH A SUSPENDED LICENSE

25. MARIJUANA LESS THAN AN OUNCE

26. DISORDERLY CONDUCT

27. PROSTITUTION (BUYER BEWARE)

28. DISMISSAL OF CHARGES

29. SEALED AND EXPUNGED RECORDS

30. HOW OFTEN SHOULD BACKGROUND CHECKS BE RUN?

31. SCHOOL SYSTEM’S RESPONSE TO APPLICANTS OR EDUCATORS ANSWERING “YES” TO PERSONAL AFFIRMATION QUESTIONS PSC

32. REPORTING Reporting to a school system does not fulfill the requirement of reporting to a licensing agency.