Dpp-document-submission-complete

.pdf
School
Grand Canyon University **We aren't endorsed by this school
Course
ART MISC
Subject
Management
Date
Nov 6, 2023
Pages
1
Uploaded by ptodd4 on coursehero.com
DIVISION OF PROFESSIONAL PRACTICES PROFESSIONAL FITNESS QUESTIONS DOCUMENT SUBMISSION FORM Date: To: Commission on Teacher Credentialing Division of Professional Practices 1900 Capitol Avenue Sacramento, CA 95811 [email protected] From: Name: Address: Phone: Email: Re: Document Submission Form SSN (last four): DOB: Maiden Name/AKA: Application Submission Date: Payment Conf. #: Employing Agency/District (at time of discipline action): Current Employing Agency/District: I am submitting the following documents that pertain to my "yes" answers regarding the Professional Fitness Questions (please check the following documents that apply): Notice of Intent to Dismiss/Suspend Statement of Charges/Accusation Request for Hearing Final Decision Board Acceptance CPS Report (other agencies) Social Services Report Case Number(s) Other: District Investigation Report Copy of Signed Contract Letter of Resignation/Retirement Settlement Agreement Explanation of Incident Police, Sheriff's Report/Case # Court Records/Case # Licensing Agency Report: PFQ - CL
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