SUBCHAPTER 09I – FORMS FOR CRIMINAL JUSTICE EMPLOYMENT, EDUCATION, AND TRAINING

SECTION .0100‑ FORMS FOR USE IN TRAINING PROGRAMS AND INSTRUCTOR CERTIFICATION

12 NCAC 09I .0101           INSTRUCTOR AND PROFESSIONAL LECTURER CERTIFICATION FORMS

The following Commission-approved forms shall be used by individuals applying for initial or renewal of certification as an instructor or professional lecturer, pursuant to 12 NCAC 09B .0300:

(1)           Form F-12, Application for Instructor or Professional Lecturer Certification, shall contain the following information:

(a)           name of applicant;

(b)           address, phone number, email address, date of birth, age, last four of Social Security Number, and academy ID number;

(c)           current agency or firm, status (Retired, Civilian, Sworn), agency address, and business phone number;

(d)           type of instructor certification applying for;

(e)           supporting documents for specific certification sought;

(f)            highest education level, school attended, school location, and graduation date;

(g)           criminal justice experience;

(h)           signature of applicant;

(i)            Commission-accredited school taught at, course title, hours taught, course dates, and whether the course was a requirement of Mandatory In-Service Training; and

(j)            signature of certifying School Director or In-Service Training Coordinator, school or agency name, phone number, and email address.

(2)           Form F-16, Criminal Justice Instructor Evaluation, shall contain the following information:

(a)           instructor's name, date of birth, and academy ID number;

(b)           evaluator's name and academy ID number;

(c)           block of instruction, date, location, and total hours of instruction;

(d)           scores for Instructional Ability and Strategies; and

(e)           Presentation Evaluation Criteria.

History Note:        Authority G.S. 17C‑6;

Eff. February 1, 2026.