COMMONWEALTH OF PENNSYLVANIA SEXUAL MISCONDUCT/ABUSE DISCLOSURE RELEASE (Pursuant to Act 168 of 2014) Instructions This standardized form has been developed by the Pennsylvania Department of Education,.

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How to fill out the Act 168 online

This guide provides clear and comprehensive instructions on completing the Act 168 form online, essential for individuals seeking employment with school entities in Pennsylvania. It ensures that applicants provide necessary information regarding abuse and sexual misconduct history.

Follow the steps to complete the Act 168 form accurately.

  1. Press the ‘Get Form’ button to access the Act 168 form and open it in your preferred online editor.
  2. Fill in the employer's information at the top of the form. This includes the name of your current or former employer, their address, telephone number, fax number, email, contact person, and title.
  3. Complete SECTION 1, where you certify and release your employment history. Provide your name, any former names, date of birth, and the last four digits of your Social Security number. Include your Pennsylvania professional identification number if applicable.
  4. Indicate the dates of your employment and the position(s) you held with that employer. Be accurate and thorough in your responses.
  5. Answer the questions regarding any past abuse or sexual misconduct investigations. Select 'Yes' or 'No' accordingly, ensuring you are truthful to avoid legal issues.
  6. Sign and date the form at the designated space. Your signature verifies that the information is correct and that you authorize the release of this information to your prospective employer.
  7. Once you complete SECTION 1, submit the form to your current or former employers for them to fill out SECTION 2 regarding your employment history and any relevant misconduct inquiries.
  8. Upon receiving the completed forms back from your employers, review them to ensure accuracy. You can then save your changes, download, print, or share the document as needed.

Complete your Act 168 form online today to ensure a smooth application process for employment in Pennsylvania schools.

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What is the Act 168?

Before the Act's effective date, Act 168 requires PDE to develop and make available a standard form to be completed by applicants for use by schools that requires applicants to disclose the name and contact information of former employers and/or to state whether he or she has been the subject of an investigation, has ...

Act 168 requires the applicant to disclose all former employers that were school entities and/or where the prospective employee had direct contact with children, and the employment history review conducted by the hiring entity must include all such employers listed by the applicant.

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