All applicants for certification shall submit the
following:
(1) An affidavit from the
applicant indicating that he or she has not been convicted of any crime or a
complete disclosure of all arrests and subsequent dispositions of such arrests.
In the event of a conviction for any arrest, the applicant shall state reasons
why such conviction does not reflect adversely on the requirement to possess
good moral character and be personally fit.
(2) An affidavit from the applicant that he
or she has no history of serious behavioral problems or a complete disclosure
of the nature and status of all such problems, including the names and
addresses of health practitioners who have treated the applicant within the
past ten years and an executed consent form permitting the superintendent of
public instruction to contact and consult with such health practitioners and
for such health practitioners to fully disclose medical information related to
such behavioral problems.
(3) An
affidavit from the dean of the college or school of education or one or more
officials designated by such dean, or, if none, by the college or university
president, where the applicant completed his or her approved preparation
program, that indicates that a designated college or university official has
contacted several faculty members who personally know or knew the applicant and
has no knowledge of any relevant information related to the applicant's
character or fitness that would adversely affect the applicant's ability to
serve in a certificated role or a statement from such affiant of the reasons
why it is not possible to make such an affidavit.
(4) If the affidavit described in subsection
(3) of this section is impossible or impractical to obtain, the applicant shall
submit to the superintendent of public instruction the following:
(a) A complete employment history, including
the names, addresses, and phone numbers of the immediate supervisor of such
applicant when an employee; and
(b)
The names, addresses, and phone numbers of three character references who are
not related to the applicant.
(5) If the applicant holds or has held a
certificate in any other state, such applicant shall prepare one of the
following affidavits for each such state:
(a)
An affidavit that such certificate has not been suspended, surrendered, or
revoked. The superintendent of public instruction shall determine the status of
certificates held by applicants in any other state to find if such certificates
have been suspended, surrendered or revoked.
(b) An affidavit which shall fully disclose
the reasons for the suspension, surrender, or revocation of the certificate.
Such affidavit shall be submitted directly to the superintendent of public
instruction.
