Attention: Human Resources/ Personnel Office

Date:

Attention: Human Resources/ Personnel Office

Moses Lake School District has just hired______, a former employee of yours.

The state auditor allows districts to transfer official transcripts and other original documents between school districts. Districts transferring such documents are to retain copies of all the documents sent for audit purposes. Also, you should retain this request in the file for verification that this transfer was requested and approved by the former employee.

The above named individual has authorized (signature below) that you send Moses Lake School District the following original documents.

Ø  All official transcripts for college credits, clock hours/ in-service hours;

Ø  All course approval forms;

Ø  All verification of years of acceptable educational experience earned prior to your district;

Ø  The attached Moses Lake School District verification of experience form to document acceptable experience earned in your district and transferable sick leave;

Ø  The enclosed Washington State Sexual Misconduct Disclosure Release form;

Ø  All Washington State Sexual Misconduct Disclosures on file from former employers;

Ø  Documentation of Highly Qualified status, if applicable;

Ø  Documentation of vaccinations or immunization history;

Thank you for helping make this transition to Moses Lake Schools as smooth as possible. If you have any questions, please do not hesitate to contact me at (509) 766-2650, ext. 2725.

Thank you,

Patty Laughery

Human Resources Manager

I request release of all documents listed above to the Moses Lake School District.

Signature Date

Printed Name Certificate Number

TRANSFER OF RECORDS AUTHORIZATION FORM

(from another district to Moses Lake School District)

I, ______, hereby give my permission to

______School District to forward all of the following original documents from my personnel file; official transcripts, clock hour registration forms, credit and clock hour approval forms, verifications of

employment and highly qualified documentation, to the Moses Lake School District. I understand that photo copies of these documents will be kept in my personnel file at the ______School District. I will hold harmless the above named transferring school district for this transfer of records.

______

Signature of requesting employee Date

The ______School District hereby certifies that the attached documents are original documents from the above named former employee’s personnel file, transferred with that individual’s written permission.

______

Signature/Title (transferring school) Date

Please forward a copy of this release with the original documents to Moses Lake School District.

Thank you!