Form FIN-115: Teacher Service Record

Fill in LAST, FIRST, MI and ID NUMBER.

School Year corresponds to the scholastic school year (e.g., 1997-98, etc.) employment is claimed. No more than one year of experience can be shown on one line.

State or Country: enter state or territory of USA. Enter name of foreign nation if applicable.

County or Equivalent: enter county or parish in USA.

School District or Institution: enter name of public school district or institution and name of private school or institution. Give sufficient information in this column to identify the school for accreditation purposes. (e.g. Public or Private).

Position Held: enter position held (e.g., teacher, substitute, bus driver, etc.)

Years of Experience: enter the number of year(s) of actual experience as of September 1 of the school year indicated in column 1.

Common mistake: Do not include the additional year(s) for career ladder, career and technology education work experience, or qualified teacher aide experience. Career and technology education work experience or qualified teacher aide experience must be recorded as a footnote on the service record.

% of Day Employed: enter percentage of the school day employee was employed. Full day is reported as 100%, one-half day is reported as 50%, three-quarters of the day is reported as 75%, etc.

No. of Days Employed: enter the number of days employed during the contractual year (July 1 thru June 30).

Common mistake: The days entered must not include the number of days a person was docked a full day's pay.

Dates of Service: enter the actual beginning and ending dates of employment during the contractual year (July 1 thru June 30).

For (a) State Sick Leave Program and (b) State Personal Leave Program, fill in Prior Year Balance, Earned, Used and End-of-Year Balance.

(a) State Sick Leave Program: enter state sick leave information in this row, not required for private schools, colleges, and out-of-state schools.

(b) State Personal Leave Program: enter state personal leave information in this row (Required for Charter schools if state days are offered), not required for private schools, colleges, and out-of-state schools. Note: This program was initiated in the 1995-96 school year.

An authorized official of the school system must sign the record.

The record must be verified by either signing each line of the record separately (in ink) or by drawing a diagonal line and placing the signature diagonally across from the years of experience.

A rubber stamp signature may be used, in lieu of the original signature, provided the name of the person appearing on the stamp is the same name designated by the school district to sign the service record.

The authorized official, if not the superintendent of the school, must have been authorized to sign personnel records of the institution by the governing board of that institution. In the case of public schools, the board of trustees is the governing body.

The organization's official stamp must be included on the service record if service from overseas is reported. For public schools, colleges and universities, the country's Department of Education is the organization official stamp. Service reported from the US: official stamp may be included depending on availability.

Service records and any supporting documents must be complete in ink.

Common mistake: White out may not be used. Any white out used on any document submitted will nullify the document.

For Department of Defense Dependents' Schools (DODDS) enter the names of subterritories of foreign nations.

DODDS Service records must be completed by an official from the National Archives and Records Administration (NARA) in St. Louis, MO. (A blank service record must be sent to: NARA,CPR 111 Winnebago Street, St. Louis, MO 63118-4199).