**Email this completed form to New York City DOE Division of 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out Section 1. Enter your name (last, first, middle), sex, home address, social security number, city/state/zip, telephone number, email address, and date of birth. Ensure all information is accurate to avoid processing delays.
3. Proceed to Section 2. Select one option that best describes your employment status with NYCBOE: whether you are leaving or have left, remaining for certification clearance, or seeking additional employment.
4. In Section 3, read and authorize the statement regarding the forwarding of your criminal history record. Sign and date the form at the bottom of this section.
5. Finally, navigate to Section 4 where you will find the email address for submission. Ensure that you send the completed form to HRCServiceCenter@schools.nyc.gov.

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