Fillable Online (Please print your completed form and submit to 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your FULL NAME, including your middle name, in the designated field.
3. If applicable, provide any AKA and/or MAIDEN NAMES in the next section.
4. Fill in your DATE OF BIRTH (DOB) accurately to ensure proper identification.
5. Enter your SOCIAL SECURITY NUMBER (SSN) as required for governmental processing. Remember, this is optional for private entities.
6. For CHARITABLE ORGANIZATIONS AND SCHOOL DISTRICTS, input the NAME OF ORGANIZATION and VERIFICATION NUMBER provided by SLED.
7. If you are applying through a SCHOOL DISTRICT, specify the POSITION APPLIED FOR in the relevant field.
8. For INTERDEPARTMENTAL TRANSFER requests, fill out the NAME OF STATE AGENCY and STATE AGENCY CODE as instructed.
9. Complete the NAME AND NUMBER OF REQUESTOR section and ensure that the CHIEF FINANCIAL OFFICER SIGNATURE is included where necessary.
10. Review all entries for accuracy before printing your completed form for submission.

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