ࡱ> bea]  bjbjZ!Z! 7H8K4\8K4\""<:!.OOO#!%!%!%!%!%!%!$"%I!O-"OOOI!?^!O8#!O#!PT0ae!t!0!N&{N&N&xOOOOOOOI!I!OOO!OOOON&OOOOOOOOO"> `: Polk County Public Schools, Human Resource Services P.O. Box 391 1915 S Floral Ave Bartow, Florida 33831 Telephone (863) 534-0781 SECTION I COMPLETED BY APPLICANT Date Name Prior Name Applicant Ref. # Dates of EmploymentI authorize you to provide Polk County Public Schools with the following information: Signature of Applicant _______________________________________________ VERIFICATION OF NON-INSTRUCTIONAL EXPERIENCE SECTION II COMPLETED BY FORMER EMPLOYER  (FORMER EMPLOYER PLEASE USE A SEPARATE LINE FOR EACH YEAR) SCHOOL YEAR Year to Year NAME OF SCHOOL/BUSINESSDATES OF SERVICE FROM: M/D/Y TO: M/D/YACTUAL NO. OF DAYS EMPLOYEDNO. OF HOURS WORKED PER DAY SPECIFIC ASSIGNMENTFULL TIME or PART TIME I Certify that according to our records  Namewas employed atSworn to and subscribed before me thisOrganizationDay ofYear EMPLOYER ADDRESSSeal and Signature of Notary Public EMPLOYER WEB ADDRESS  SIGN NAMEMy Commission Expires PRINT NAME(MUST BE NOTARIZED OR AFFIX SCHOOL BOARD SEAL) TITLE  PHONE ( ) - Ext. OFFICE USE ONLY SAP # __________ _______yrs = ________steps _______yrs/2 = ________steps Approved by ________________ Date ______  +35ABSTijúïvj_T_T_T_LTh|iCJaJh(#h+CJaJh(#hnVCJaJhnVh+5CJaJ *h|h+5CJaJhnVhd5hXqCJaJh(#CJaJhnVh(#CJaJh2CJaJhnVh2CJaJh4dt5CJ aJ h2h(#5CJ aJ h `h `5CJ aJ h `h(#5CJ aJ /jh `h25CJ UaJ mHnHtHu5BTj $Ifgd|i$If$a$gd|i$a$gd(#64...$Ifkd$$Iflִ0 ~",F209 + t96    44 layt. -  " B Z ^ ø߭}ujYjK= *h(#hnV5CJaJ *h(#h|5CJ aJ *h(#h|B*CJaJphh(#h|CJaJhnVh{95 h{95hnVh|5 h|5h(#h2CJaJh(#hFCJaJh CJaJh(#h(#CJaJh `h `CJaJh `hnVCJaJ *h(#hnVB*CJaJphh(#hnVCJaJh$z\h+CJaJh(#h. -CJaJC pd[ $Ifgd{9 $$Ifa$gd|kd$$Ifl4\092`` t9644 layt $Ifgd$If $Ifmkdq$$Ifl4F09   t96    44 layt z  + , 2 3 7 @ E J M S T b k   ܵ~s~s~skscsksksk[h2CJaJh CJaJhBECJaJh(#hnVCJaJh(#h|CJaJh(#h(#CJaJh|h+5CJaJh{95CJaJh|hnV5CJaJh(#h2CJaJh(#hnVCJ aJ *h(#h+B*CJaJphh(#h+CJaJ *h|h|5CJ aJ  *h+5CJaJ , 8 S T l } mk_Y__M $$Ifa$gd(#$If $$Ifa$gd2kd$$Iflr$09*9o t9644 layt }  $$Ifa$gd2 $IfgdBE$If $IfgdnV   $Ifkdh$$Ifl֞On":)309G  TP  t09644 layt                     ! FfFf$$If     " # , - 6 7 @ A J K T U ^ _ h i ɾɶɣ}rgh(#hCJaJhH hCJaJhCJaJh(#h2CJaJhCJaJh(#hR8CJaJhH CJaJhBEhBECJaJhBECJaJh(#hBECJaJh(#hBECJaJhBEhBECJaJh(#hFCJaJh(#h2CJaJh(#hnVCJaJ$! " # $ % & ' ( ) * + , - . / 0 1 2 3 4 5 6 7 8 9 : ; < FfFf Ff $If< = > ? @ A B C D E F G H I J K L M N O P Q R S T U V W FfFfFf$IfW X Y Z [ \ ] ^ _ ` a b c d e f g h i j FfFf$If nh\h $$Ifa$gdBE$Ifkd $$IflF $8v t096t    44 layt nhhhh$Ifkdp!$$IflF **8v  t096t    44 layt [UIUUUUU $$Ifa$gdH $Ifkd"$$Ifl\x8nf4 t09644 layt    4 5 6 7 L M N O P Q R [ \ ^ ɾti^V^Kh(#h4NCJaJhCJaJh]ih4NCJaJh(#h. -CJaJh]ih. -CJaJh(#h|iCJaJh|iCJaJh(#h|iCJaJh]ih|iCJaJh(#h2CJaJh(#hR8CJaJh(#hR8CJaJh]ihR8CJaJh]ihH CJaJh(#hCJaJh(#hCJaJhH hCJaJ   Pkd&$$Ifl\jx8f4 t09644 laytEwrFf$$If    5 6 7 L M N RII $Ifgd|ikd'$$Ifl48\jx8`f4 t09644 laytEwr$IfN O P Q R \ ] ^ I@ $Ifgdjkd($$Ifl4\jx8 f4 t09644 laytEwr $Ifgd$If^ s t u       ޞޞ}ujbWLjLE h h h(#h zCJaJh(#h. -CJaJh zCJaJh(#h zCJaJh. -CJaJh]ih zCJaJh]ih4NCJaJh]ih|iCJaJh]ih. -CJaJh5h4NCJaJhH hEwr5CJaJh(#h4NCJaJh]ihCJaJhCJaJh(#h4NCJaJh(#h4N5CJaJh5hEwrCJaJ^ t u v C:1 $Ifgd $Ifgdjkd)$$IflA\x8T*f4 t09644 lapytEwr$If C:: $Ifgd4Nkd+$$IflF\x8T*f4 t09644 lapyt$If 5kd.,$$Ifl\x8T*f4 t09644 lap(yt$If $Ifgdj     lff$IfkdG-$$Ifl40`T`* t09644 layt $Ifgd. - $Ifgd]i   ) : U r ~ytttttrrygdgd. -kd .$$Ifl40 T * t09644 layt  ) . / 2 4 7 8 9 : = H K U X f i ~ ÿ h h h4dth(#hh5CJaJhX\CJaJh|CJaJhhCJaJh CJaJhh2CJaJ51h0:p z= /!"#$% $$If!vh#v#v#v#v#v#v #v+#v:V l t96555555 5+5/ / / / yt. -$$If!vh#v2#v#v#v:V l4 t96++52555/ yt r$$If!vh#v#v#v:V l4 t96++555yt z$$If!vh#v*#v#v#v9#vo:V l t965*55595oyt $$If!vh#v#vG #v #vT#v#vP #v:V l t09655G 5 5T55P 5yt$$If!v h#v:#v#vG #v#v#vT#v#vP #v :V l t0965:55G 555T55P 5 ytkd:$$Ifl O.n":)309:G TP  t096$$$$44 layt$$If!v h#v:#v#vG #v#v#vT#v#vP #v :V l t0965:55G 555T55P 5 ytkd($$Ifl O.n":)309:G TP  t096$$$$44 layt$$If!v h#v:#v#vG #v#v#vT#v#vP #v :V l t0965:55G 555T55P 5 ytkd $$Ifl O.n":)309:G TP  t096$$$$44 layt$$If!v h#v:#v#vG #v#v#vT#v#vP #v :V l t0965:55G 555T55P 5 ytkd $$Ifl O.n":)309:G TP  t096$$$$44 layt$$If!v h#v:#v#vG #v#v#vT#v#vP #v :V l t0965:55G 555T55P 5 ytkd$$Ifl O.n":)309:G TP  t096$$$$44 layt$$If!v h#v:#v#vG #v#v#vT#v#vP #v :V l t0965:55G 555T55P 5 ytkd$$Ifl O.n":)309:G TP  t096$$$$44 layt$$If!v h#v:#v#vG #v#v#vT#v#vP #v :V l t0965:55G 555T55P 5 ytkd$$Ifl O.n":)309:G TP  t096$$$$44 layt$$If!v h#v:#v#vG #v#v#vT#v#vP #v :V l t0965:55G 555T55P 5 ytkd$$Ifl O.n":)309:G TP  t096$$$$44 layt$$If!v h#v:#v#vG #v#v#vT#v#vP #v :V l t0965:55G 555T55P 5 ytkd$$Ifl O.n":)309:G TP  t096$$$$44 layt$$If!v h#v:#v#vG #v#v#vT#v#vP #v :V l t0965:55G 555T55P 5 ytkd$$Ifl O.n":)309:G TP  t096$$$$44 layt$$If!vh#vv#v#v:V l t096t5v55/ / / / / / yt$$If!vh#vv#v #v:V l t096t5v5 5/ yt$$If!vh#vn#v#vf#v4:V l t0965n55f54/ / / / / / yt$$If!vh#vn#v#vf#v#v#vx #v<#v:V l t0965n55f555x 5<5/ / / / / / / / / / / /  / p2ytkd #$$IflִxB!$b.18nfx < t096    44 lap2yt$$If!vh#v#v#vf#v4:V l t096555f54/ / / / / / ytEwr$$If!vh#v#v#vf#v4:V l48 t096+555f54/ / / / / ytEwr$$If!vh#v#v#vf#v4:V l4 t096+555f54/ / / / / /  / ytEwr7$$If!vh#vT#v*#vf#v4:V lA t0965T5*5f54/ / / / / / / / pytEwr $$If!vh#vT#v*#vf#v4:V lF t0965T5*5f54/ / / / / pyt$$If!vh#vT#v*#vf#v4:V l t0965T5*5f54/ / / / / p(yt$$If!vh#vT#v*:V l4 t096++5T5*/ / /  yt$$If!vh#vT#v*:V l4 t096++5T5*/ /  / yts2 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@_HmH nH sH tH @`@ NormalCJ_HaJmH sH tH DA D Default Paragraph FontRi@R  Table Normal4 l4a (k (No List jj + Table Grid7:V0HH (# Balloon TextCJOJQJ^JaJN/N (#Balloon Text CharCJOJQJ^JaJPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭VvnB`2ǃ,!"E3p#9GQd; H xuv 0F[,F᚜K sO'3w #vfSVbsؠyX p5veuw 1z@ l,i!b I jZ2|9L$Z15xl.(zm${d:\@'23œln$^-@^i?D&|#td!6lġB"&63yy@t!HjpU*yeXry3~{s:FXI O5Y[Y!}S˪.7bd|n]671. tn/w/+[t6}PsںsL. J;̊iN $AI)t2 Lmx:(}\-i*xQCJuWl'QyI@ھ m2DBAR4 w¢naQ`ԲɁ W=0#xBdT/.3-F>bYL%׭˓KK 6HhfPQ=h)GBms]_Ԡ'CZѨys v@c])h7Jهic?FS.NP$ e&\Ӏ+I "'%QÕ@c![paAV.9Hd<ӮHVX*%A{Yr Aբ pxSL9":3U5U NC(p%u@;[d`4)]t#9M4W=P5*f̰lk<_X-C wT%Ժ}B% Y,] A̠&oʰŨ; \lc`|,bUvPK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!R%theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] H  ^   # }   ! < W  N ^    !"8@(  \   3"? B S  ?@)3N9Ot +355",,SSbklliilst   45QR[\\^st +355",,SSbklliilst   45QR[\\^stG+j-1fkj; n zB||  t \ 'uBE-wtJO[ |w4By AYKK*M+K]it1`M I ZY" >#e$ ')/*d*4u+ w+. -Zl.-3/NP0!A3qY4_5Y(5B5H5!r5R6EK7:8R8x9{95 :(:{;@<0;>D>qj>k>t?OEGtGH]HxHI7IJWKM2NkN3PS9)Ti=TiTnV W=W:Y_[r[$z\E]d]L!^!_ `#`uE`-bcd&d:mdgfg%h^h^h|is5inSilgmM2nA_oqXqEwrT t4dt+vGv[My z}~7"5x(#'*+G\8.v\b]i ;iw&} H  VF S}O8d&p;yl {OyL[2p Yftd_n)2?LJ^t"F !0w MLe.kj0?JSNO A42$Ub)F\A']*<WXofT^ /-VP~v, BFc 8U u +|3q[f:MVR%X\@@UnknownG*Ax Times New Roman5Symbol3. *Cx Arial5. .[`)TahomaA$BCambria Math"hȦVGsVg ?W W !r43HP ?+2!xx 0VERIFICATION OF SATISFACTORY TEACHING EXPERIENCEjoanne.vickersCoe, Christie M.Oh+'0 ( DP p |  4VERIFICATION OF SATISFACTORY TEACHING EXPERIENCEjoanne.vickersNormalCoe, Christie M.12Microsoft Office Word@:@ _UD@/ @2aW՜.+,0( hp  Polk County Schools  1VERIFICATION OF SATISFACTORY TEACHING EXPERIENCE Title  !"#$&'()*+,-./0123456789:;<>?@ABCDEFGHIJKLMNOPRSTUVWXZ[\]^_`cdgRoot Entry F0X0afData %.1Table=N&WordDocument 7HSummaryInformation(QDocumentSummaryInformation8YMsoDataStoreA0aPT0a4WOYETD3SJA==2A0aPT0aItem  PropertiesUCompObj r   F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q