Act 168 Form Instructions

Applicant needs to provide an Act 168 form for:

  • The applicant’s current employer (may have multiple current employers)
  • Any previous employment within a school entity (Ex. Teacher, Aide, Cafeteria Worker, Janitor, etc.)
  • Any position that the applicant had, “The possibility of care, supervision, guidance or control of children or routine interaction with children.” When considering “routine interaction with children,” consider the prospective employee’s role within your entity and whether their contact with children will be regular, ongoing contact that is part of their day-to-day job responsibilities
  • Applicants fills “Current or Former Employer” section, and all of the information in Section 1. Make sure to sign the form on page three and then submit this form back to EMAIL.

Download the Act 168 Form here

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