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TO: District 205 Applicants FROM: Human Resources Office RE

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TO: District 205 Applicants FROM: Human Resources Office RE THORNTON TOWNSHIP HIGH SCHOOL DISTRICT 205 465 EAST 170 TH STREET SOUTH HOLLAND , ILLINOIS 60473-3481 708.225.4000 FAX : 708.225.4004 TO: District 205 Applicants FROM: Human Resources Office RE: Fingerprint Procedures for New Employees Effective immediately, House Bill 3977 requires that applicants for employment at a school district must undergo a fingerprint-based criminal background check. Applicants in District 205 should call 708-225-4001 to schedule an appointment to be fingerprinted. It is mandatory that this process is completed before employment begins. Each applicant must arrive with the attached form completed and a valid Driver’s License or State ID. Thank you for your cooperation. Hr/employmentforms THORNRIDGE HIGH SCHOOL THORNTON HIGH SCHOOL THORNWOOD HIGH SCHOOL 15000 Cottage Grove Ave. 15001 Broadway Ave. 17101 South Park Ave. Dolton, Illinois 60419 Harvey, Illinois 60426 South Holland, Illinois 60473 708.841.5180 708.596.1000 708.339.7800 THORNTON TOWNSHIP HIGH SCHOOLS DISTRICT 205 465 East 170 th Street, South Holland, Illinois 60473 Tel: (708) 225-4000 Fax: (708) 225-4137 Internet: http:www.district205.net REGULAR TEACHER ______ ARBOR ___________ SUBSTITUTE ______ RJB ___________ NON-CERTIFIED EMPLOYEE ______ CRIMINAL BACKGROUND CHECK AUTHORIZATION & RELEASE Section 10-21.9 of the Illinois School Code requires all applicants for employment with a school district, including persons or firms holding contracts with the district, who have direct daily contact with the pupils of any district school, to authorize a fingerprint-based criminal background check to determine if the applicant has been convicted of certain enumerated offenses. A school board shall not knowingly employ a person for whom a criminal background investigation has not been initiated. By completing and signing this form I authorize Thornton Township High School District 205 to submit fingerprints and other necessary information electronically to the Illinois State Police and FBI. TO BE COMPLETED BY THE APPLICANT – PLEASE BRING A PHOTO ID Last Name First Name Middle Name U.S. Citizen Yes No Address City State Zip Code Home Telephone Cell Phone Number PLEASE USE THE FOLLOWING CODES WHEN COMPLETING THIS FORM : SEX RACE HAIR EYES M Male W Caucasian/Latino BAL Bald GRN Green RED Red BLK Black MAR Maroon F Female B Black BLK Black GRY Gray SDY Sandy BLU Blue MUL Multi U Unknown A Asian/PI BLN Blonde ONG Orange WHI White BRO Brown PNK Pink I Native Indian BLU Blue PLE Purple XXX Unknown GRN Green XXX Unknown U Unknown BRO Brown PNK Pink HAZ Hazel Date of Birth Place of Birth Sex Race Eyes Hair Height Weight Year Mo. Day Social Security Number Drivers License Number DL State I authorize Thornton Township High Schools District 205 to submit the above information, that I acknowledge being true and accurate, to the best of my knowledge, to the Illinois State Police (ISP). The ISP shall conduct a fingerprint-based criminal history records check and shall furnish to the president of the school board of the receiving school district the applicant’s records of convictions, until expunged. The president of the school board shall keep a conviction record confidential and share it only with the Superintendent, Human Resources Director, Business Manager, Principals, or any other person necessary to the hiring decision. _______________________________________________________________ ___________________________________ Signature of Applicant Date DO NOT WRITE BELOW THIS LINE – FOR OFFICE USE ONLY Fingerprint Technician Date of Fingerprint Submitting Agency ORI IL 0 1 6 2 0 5 S .
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