11 NCAC 08 .0604 APPLICATION FORM: CONTENTS
The application form requires the applicant to furnish all of the following pertinent information necessary to determine the qualifications of the applicant for a probationary certificate:
(1) the date;
(2) name, address and telephone number where applicant can be reached;
(3) date of birth;
(5) work experience;
(6) certificates and other professional licenses, if any, held previously or currently;
(7) title of position to which appointed or promoted;
(8) date of appointment or promotion to position;
(9) governmental unit by which employed;
(10) duties in a new position, in sufficient detail to determine appropriate type and level of certification;
(11) name and title, certification, or other qualifications of persons to be responsible for supervision; and
(12) Social Security number.
History Note: Authority G.S. 143‑151.13;
Eff. June 28, 1979;
Amended Eff. July 18, 2002.