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Employment Verification

Verify Prior Teaching Experience for Salary Step Placement

Collect signed release authorizations and verified service records from former employers to confirm teaching experience and assign the correct salary step.

Use This Template Free Preview

Neo theme

formbuilder.ai/f/school-district-teacher-prior-teaching-experience-salary-step-placement-verification-form

School District Teacher Prior Teaching Experience & Salary Step Placement Verification Form

Teacher Full Name

· · ·

Name Used During Prior Employmen

· · ·

Employee ID at Previous Employer

· · ·

Submit

This prior teaching experience and salary step placement verification form helps school districts confirm a newly hired teacher's previous teaching service before assigning a step on the salary schedule. It has three sections. The teacher provides identifying details, including any prior name used, and signs a release authorization. The previous employer completes a detailed employment record. An authorized official then certifies the information with their name, title, email, and phone number.

The template is built for human resources teams, payroll and business offices, and hiring administrators in public school districts, charter schools, private schools, and other educational institutions. Former employers can record the institution type, primary position held, teaching certificate or license status, dates of employment, and a year-by-year service record for each school year worked. The total years of full-time equivalent service verified gives your district a clear, documented figure to use for step placement decisions.

Moving this process online replaces mailed paper requests, faxes, and repeated follow-up calls with a faster, more reliable workflow. Collect electronic signatures, keep every completed verification organized in one secure place, and maintain a clear record for audits and future salary reviews. Customize the fields to match your district's salary schedule policies, add your branding, and start verifying prior experience sooner so new teachers are placed accurately and paid correctly from their first paycheck.

3 Pages

20 Questions

~7min To complete

Free Included on every plan

Field types Short Text ×4 Full Name ×2 termsandconditions ×2 Signature ×2 Dropdown ×2 Address Yes / No daterange Table / Grid number Email Phone File Upload

Questions in this template

Free template

The exact questions included — customize any of them to fit your needs.

Page 1 Teacher Information & Release Authorization 5 questions

Section A: Teacher Information & Release Authorization (Completed by Teacher)

1 Teacher Full Name * Full Name

2 Name Used During Prior Employment (if different) Short Text

3 Employee ID at Previous Employer or Last 4 Digits of SSN * Short Text

4 I authorize the employer named in Section B to release my employment records, including dates of service, position held, full-time equivalency, days employed, and leave history, to the hiring school district. These records will be used to verify my prior teaching experience and determine my salary step placement. * termsandconditions

5 Teacher Signature * Signature

Page 2 Prior Employment & Service Record 8 questions

Section B: Prior Teaching Employment Record (Completed by Previous Employer)

1 School District / Employer Name * Short Text

2 School District / Employer Address * Address

3 Type of School or Institution * Dropdown

4 Primary Position Held * Dropdown

5 Did the employee hold a valid teaching certificate or license for this position? * Yes / No

6 Dates of Employment (First Day to Last Day of Service) * daterange

7 Year-by-Year Teaching Service Record (one row per school year) * Table / Grid

8 Total Years of Full-Time Equivalent Service Verified * number

Page 3 Verifying Official Certification 7 questions

Section C: Certification by Authorized Official (Completed by Previous Employer)

1 Verifying Official Name * Full Name

2 Verifying Official Title * Short Text

3 Verifying Official Email Address * Email

4 Verifying Official Phone Number * Phone

5 Supporting Documentation (Official Service Record or Letter on District Letterhead) File Upload

6 I certify that the information provided in this form is true and accurate according to the official personnel and payroll records of this school district or institution. * termsandconditions

7 Authorized Official Signature * Signature

How to use this template

Click "Use This Template Free" to open it in the FormBuilder editor. From there you can add, remove, or reorder fields with drag-and-drop, switch themes for instant restyling, add your logo, configure email notifications, and set your success message. When ready, publish with a unique link and start collecting responses immediately.