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The Fingerprint Referral Form serves as an essential component in the hiring process for individuals looking to work within the New York City Department of Education. To start, the form requires careful completion, ensuring that all sections are filled out with accuracy. Section I is designated for the Certification Referring Official and must be filled out by the appropriate office. The applicant must then provide personal details in Section II, which includes answering critical background questions designed to assess employment eligibility. Important background checks are conducted, addressing any past convictions or employment-related issues. Lastly, Section III focuses on Employment Eligibility Verification, completed by the Office of Personnel Investigation. This multifaceted form plays a crucial role in safeguarding schools and ensuring that all employees meet the necessary standards for employment, thus emphasizing the importance of honesty and transparency throughout the application process.

Form Sample

The New York City Department of Education

Division of Human Resources & Talent

65 Court Street, Brooklyn, New York 11201

FINGERPRINT REFERRAL FORM

GENERAL INSTRUCTIONS: Please print all information clearly on the form. Section I (Certification Referring Official) must be completed by the appropriate office. Section II (Background Questions) must be completed by the applicant. Section III (Employment Eligibility Verification) will be completed by the Office of Personnel Investigation.

 

 

 

OFFICE USE ONLY

 

 

 

 

 

I-9 CODE

 

 

 

 

ORG.

 

 

 

 

 

 

CODE

 

 

 

 

 

 

Y

REXP. DATE _______/_______/_______

A EXP. DATE _______/_______/_______

PLACE OF BIRTH

HEIGHT/

FEET INCHES

WEIGHT

HAIR COLOR

EYE COLOR

SECTION I: BACKGROUND INVESTIGATION IN THE TITLE OF

Signature of Referring OfficialOffice/DistrictTelephone Number

SECTION II: BACKGROUND QUESTIONS

TODAY’S DATE

SOCIAL SECURITY NUMBER

Month Day Year

LAST NAME

-

FIRST NAME

Month Day Year

-

M.I.

Male Female

OTHER OR MAIDEN NAME

DATE OF BIRTH

CHECK THE BOX BELOW WHICH BEST DESCRIBES YOU:

PLEASE () ONE

1.

2.

AMERICAN INDIAN/ALASKAN NATIVES

3.

ASIAN: INCLUDES ASIAN INDIANS, CHINESE,

4.

JAPANESE, KOREANS, FILIPINOS, INDONESIANS,

 

AND POLYNESIANS

5.

BLACK (Not of Hispanic Origin)

HISPANIC

WHITE (Not of Hispanic Origin)

STREET ADDRESS

 

 

 

 

APT. NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

STATE

 

ZIP CODE

-

-

(AREA)

TELEPHONE NUMBER

FILE NUMBER (IF ANY)

E-MAIL ADDRESS

 

FORM 551 (1096)

Answer “YES” or “NO” to the following questions. If your answer to any of these questions is “YES”, explain, giving details, in the space provided below. You must answer these questions truthfully even though you may have disclosed the same information to the Department of Education or another agency on a previous occasion. Please be advised that if you answer “NO” to question #1 and your fingerprint results disclose a conviction record, your application will be denied. Please sign your name at the end of this section.

YES NO

Have you ever been convicted of or pled "GUILTY" or pled "NO CONTEST" to any offense in this state or

1.elsewhere? [This includes Felonies, Misdemeanors and Violations. For Felonies or Misdemeanors, you must answer "Yes" if you were convicted or pled guilty or no contest even if your records have been sealed.]

2.Are any criminal charges currently pending against you anywhere?

3.Have you ever been placed on a state registry as a sex offender in New York State or elsewhere?

4.Have you ever forfeited bail or bond following your appearance as a defendant in a criminal court action?

5.Has a warrant been issued by a court requiring that you appear in court?

6a.

Has a Family Court ever found that you abused or neglected a child? If so, explain below which court issued

the finding, the nature of the finding, and when it happened.

 

 

6b.

Are you currently in arrears [4 months or more] for child support payments?

 

 

7.

Have you ever been discharged [fired] or required to resign from any position for reasons other than a layoff

due to reduction in the work force?

 

 

8.

Have you ever been denied employment as a result of information obtained following a background check or

 

investigation? If so, explain the reasons for denial of employment below.

9.

Have you ever resigned or left a job rather than face charges or dismissal?

 

 

10a.

Has an employer ever brought or filed charges against you?

 

 

10b.

If yes, were you found guilty of the charges?

11.Have you ever had any professional certificate or license denied, revoked or suspended?

Have you ever applied for a civil service position, such as police officer or worker for a federal, state, city or

12.local agency, and been notified you do not qualify?

Have you ever had a teaching license or certificate denied, revoked or suspended by any Education

13.Department: New York City, New York State or elsewhere?

14.Have you ever received an unsatisfactory rating or unsatisfactory evaluation for your work in a school?

15.Have you ever lost your job as a teacher, or as another pedagogue, before achieving tenure?

16.Did you ever receive a discharge from military service for reasons other than an honorable discharge?

Are you now, or were you ever employed by the NYC Department of Education? If yes, indicate dates

17a. ________________________.

17b.

Were you ever fingerprinted by the NYC Department of Education?

Explanation:

Falsifying an employment application is a punishable offense under the Penal Law of New York State.

Signature of person being fingerprinted

Today’s Date

SECTION III: EMPLOYMENT ELIGIBILITY VERIFICATION

COMPLETE

EXEMPT

Signature of Examiner

Signature of Fingerprint Technician

Document Specifications

Fact Name Description
Purpose of the Fingerprint Referral Form The form is used to collect information for background checks on individuals applying for positions within the New York City Department of Education.
Applicable Governing Law New York State Education Law, Article 35, requires all prospective employees to undergo a criminal history background check.
Completion Requirements The form must be completed in three sections: Certification by the Referring Official, responses by the applicant to background questions, and verification by the Office of Personnel Investigation.
Consequences of Falsification Providing false information on the form can lead to denial of application and possible legal consequences, as noted in New York State Penal Law.

Steps to Filling Out Fingerprint Referral

After completing the Fingerprint Referral form, you will submit it to the appropriate office for processing. Ensure all sections are filled out accurately to avoid delays in your application. Follow the steps below to fill out the form correctly.

  1. Begin by writing your details clearly in the designated sections of the form.
  2. In Section I, have the referring official complete their part, including signature, office, district, and telephone number.
  3. Go to Section II and fill out your personal information. Use your full name, date of birth, and address.
  4. Answer all the background questions truthfully. Mark YES or NO accordingly. If you answer YES to any questions, provide detailed explanations in the space given.
  5. Sign and date the form at the end of Section II to certify your answers.
  6. For Section III, only the Office of Personnel Investigation will complete this section after your application is reviewed.
  7. Review the entire form to ensure all information is accurate and complete before submitting.

More About Fingerprint Referral

What is the purpose of the Fingerprint Referral Form?

The Fingerprint Referral Form is used by the New York City Department of Education to gather necessary information about individuals who are applying for employment or other positions within the department. This form helps facilitate a background investigation, ensuring that all applicants meet the required eligibility standards for employment, particularly in roles that involve working with children or youth.

Who needs to complete this form?

All individuals applying for certain positions within the NYC Department of Education must complete the Fingerprint Referral Form. This includes teachers, administrative staff, and any other personnel who will have direct interaction with students. The information collected helps ensure the safety and integrity of the educational environment.

What information is required on the form?

The form requires various personal details, including your name, date of birth, social security number, and contact information. Additionally, you'll need to answer background questions related to any criminal history, employment background, and other pertinent details. It's important to answer truthfully, as discrepancies could affect your application.

What happens if I answer "yes" to any of the background questions?

If you answer "yes" to any of the background questions, you are required to provide further explanation in the space provided. This could include details about convictions, pending charges, or any previous employment issues. The Department of Education will review this information as part of your background check and determine how it may impact your application.

How do I submit the completed Fingerprint Referral Form?

Once you have completed the Fingerprint Referral Form, you need to submit it to the designated office along with any required additional documents. This is typically the office that is responsible for human resources or personnel investigations within the NYC Department of Education. Make sure to keep a copy for your own records before submission.

Common mistakes

  1. Illegible Writing: Writing should be clear and easy to read. If the form is filled out in messy handwriting, it can lead to confusion.

  2. Incomplete Sections: Ensure every section is fully completed. Leaving out answers can delay processing or cause rejection of the application.

  3. Incorrect Personal Information: Double-check names, addresses, and dates. Misstated information can cause complications during background checks.

  4. False Answers: Always answer truthfully. Providing false answers can result in a denial of your application or other legal repercussions.

  5. Missing Signature: Don’t forget to sign the form. Without a signature, the submission could be considered invalid.

  6. Ignoring Background Questions: All background questions must be answered even if the answers are difficult to disclose. Omitting an answer can raise red flags.

  7. Using Wrong Dates: Entering incorrect dates for employment or personal history can lead to inconsistencies in your application.

  8. Failure to Explain "Yes" Answers: If any question is answered "Yes," you must provide an explanation. Failure to do so may lead the reviewing officials to assume the worst.

  9. Overlooking Section II: Section II must be completed by the applicant. It's crucial not to skip this section as it contains essential background questions.

  10. Not Keeping a Copy: Make a copy of your completed form for your records. This can help in case of future inquiries or discrepancies.

Documents used along the form

When completing the Fingerprint Referral form, several other forms and documents may often be required to ensure a comprehensive background check. Each document serves a specific purpose in the verification process, facilitating the swift evaluation of an applicant’s eligibility for employment within the New York City Department of Education.

  • I-9 Form: This form is used to verify the identity and employment authorization of individuals to ensure they are legally allowed to work in the United States.
  • Employment Application: An employment application collects detailed information regarding the applicant's work history, education, and qualifications relevant to the position they are seeking.
  • Employment Eligibility Verification Form (E-Verify): This document helps confirm that the information provided on the I-9 form is valid by cross-referencing it with federal databases.
  • Child Abuse Clearance Form: This form is necessary to establish whether an applicant has any history of child abuse, aiming to protect children in educational environments.
  • Reference Check Form: This form gathers information from previous employers or others who can vouch for an applicant’s character and work history, providing additional context to their application.
  • Criminal Background Check Authorization Form: Here, the individual gives consent for a detailed review of their criminal history, which is crucial for assessing their suitability for employment.
  • Certification of Professional Credentials: A certification form verifies that an applicant’s professional licenses and qualifications are current and valid, ensuring compliance with educational requirements.

Being prepared with all necessary documents when submitting a Fingerprint Referral form is essential. This preparation leads to a smoother application process and can expedite the hiring timeline significantly.

Similar forms

The Employment Application form serves a similar purpose to the Fingerprint Referral form as both documents collect essential personal information and qualifications from an applicant. The Employment Application asks about the applicant's work history, education, and skills, while the Fingerprint Referral form additionally addresses specific background questions related to criminal history. Each document requires clarity and honesty in responses, emphasizing the importance of background verification in the hiring process.

The Background Check Authorization form is akin to the Fingerprint Referral form in the sense that both require the applicant's consent to conduct a background investigation. While the Fingerprint Referral form focuses on collecting fingerprints and certain demographic data, the Background Check Authorization form typically details the specific checks to be performed, such as criminal history, credit reports, and education verification. Both documents aim to ensure a safe and qualified hire.

The I-9 Employment Eligibility Verification form overlaps with the Fingerprint Referral form in that they both verify certain information necessary for employment. The I-9 form requires documentation proving an individual’s right to work in the United States, whereas the Fingerprint Referral form assesses an applicant's background for potential issues that might affect employability. The thoroughness of both forms serves to comply with legal employment standards and to safeguard the workplace.

The Authorization for Release of Information form is similar to the Fingerprint Referral form because both necessitate the applicant's permission to obtain sensitive information. Just as the Fingerprint Referral form includes sections for answering background questions, the Authorization for Release of Information allows employers to check references and other personal details. The shared goal is to help employers make informed decisions based on the applicant's complete background.

The Medical History Questionnaire can also be compared to the Fingerprint Referral form, as both seek detailed personal information about the applicant. While the Fingerprint Referral form emphasizes criminal history and background checks, the Medical History Questionnaire collects health-related data that may affect an applicant's ability to perform job functions. Both documents require openness and thoroughness to achieve the intended employment outcomes.

The Driver's License Application form has similarities with the Fingerprint Referral form through the collection of identifying information and verification processes. The Driver's License Application requires identification, residency, and a clean driving record, much like how the Fingerprint Referral form seeks to verify the individual’s background and personal data for employment. Both forms assess the applicant’s likelihood of engaging in responsible behavior.

The Vendor Registration form can reflect characteristics of the Fingerprint Referral form as it collects information from individuals or businesses seeking to establish a working relationship with an organization. Both documents gather necessary data such as names, addresses, and identification numbers. They also may include questions about criminal background with the aim of ensuring compliance and responsibility in business partnerships.

The Social Security Application form resembles the Fingerprint Referral form, as both require accurate personal information to receive a government-issued document. The Social Security Application necessitates proof of identity, age, and citizenship, similar to the fingerprinting process that verifies identity and background history. Each form's meticulous nature illustrates the importance of maintaining clear and verifiable records.

The Professional License Application is comparable to the Fingerprint Referral form in the way both involve extensive personal and professional background checks. While the Professional License Application assesses qualifications for a specific profession, the Fingerprint Referral form evaluates an applicant’s suitability for employment, particularly in sensitive positions. Both applications are crucial steps to ensure that licensed professionals meet the necessary standards.

The Child Abuse Registry Clearance form shares a connection with the Fingerprint Referral form, as both are geared toward protecting vulnerable populations by screening individuals for potentially harmful histories. The Child Abuse Registry Clearance focuses specifically on any allegations or convictions related to child abuse, while the Fingerprint Referral form covers a broader range of background checks. Both forms underscore the need for safety and accountability in various roles.

Dos and Don'ts

When filling out the Fingerprint Referral form, there are some important do's and don'ts to keep in mind to ensure a smooth and successful submission.

  • Do print clearly. Legibility is key. Take your time to fill out each section neatly.
  • Do answer all questions truthfully. Providing false information can lead to serious consequences and may affect your application.
  • Don't leave sections blank. Ensure you fill out every part of the form as instructed to avoid delays.
  • Don't forget to sign the form. Your signature is essential to validate your application, so make sure it's included before submission.

Misconceptions

Misconceptions about the Fingerprint Referral Form can create confusion for applicants. Here are ten common myths along with clarifications:

  1. Misconception 1: The form can be filled out casually.

    In reality, it is crucial to print all information clearly. The accuracy of details is essential for processing.

  2. Misconception 2: Anyone can refer an applicant.

    Only an authorized official from the appropriate office can complete Section I of the form.

  3. Misconception 3: Background questions don’t need serious attention.

    Applicants must answer truthfully. Misleading answers can lead to the denial of their application.

  4. Misconception 4: The form is only for new applicants.

    Returning employees must also complete the form if their previous fingerprinting is not current.

  5. Misconception 5: All fingerprints are processed immediately.

    Processing times vary, and delays may occur based on the volume of applications and background checks.

  6. Misconception 6: The fingerprint results are not shared.

    Results are evaluated by the Office of Personnel Investigation and relevant parties may be notified as needed.

  7. Misconception 7: Only criminal records affect employment eligibility.

    Other factors, such as child support arrears and negative evaluations, are also considered.

  8. Misconception 8: Applicants can skip any questions they find uncomfortable.

    All questions on the form must be answered, and any “YES” responses need explanations.

  9. Misconception 9: Employment history is irrelevant.

    Your past employment details can influence the outcome, especially if there were dismissals or charges.

  10. Misconception 10: Once submitted, the form cannot be amended.

    It is important to review the information before submission. Corrections may be challenging but should be addressed promptly.

Understanding these misunderstandings can help applicants navigate the Fingerprint Referral Form process more effectively.

Key takeaways

  • Clear Information: It is essential to print all information clearly on the Fingerprint Referral Form to avoid any processing delays.

  • Complete Required Sections: Section I must be filled out by the appropriate office, while Section II is designated for the applicant. Ensure both sections are completed correctly.

  • Assess Background Questions: In Section II, applicants should answer the background questions honestly. A simple 'Yes' or 'No' is needed, but details are required for any 'Yes' responses.

  • Understand the Importance: Answering “No” to the first question when there is a conviction record can lead to application denial. Be truthful.

  • Personal Information: Applicants must provide their personal details, including social security number, date of birth, and complete address.

  • Emergency Contacts: Include a reliable phone number and email address to facilitate communication regarding your application.

  • Falsifying Information: Be aware that providing false information can lead to serious legal consequences under New York State law.

  • Process Timing: Completion of the fingerprinting and background check can take time. Patience is advised following submission.

  • Office Use Only: Ensure any sections that are marked "OFFICE USE ONLY" are left blank, as they will be completed by the Office of Personnel Investigation.

  • Check Your Work: Before submitting, double-check all information for accuracy and completeness to prevent any issues during processing.