Employee Yearly Updates
These forms are to be completed at time of hire, and must be resubmitted yearly, by ALL employees.
ACT 24 ARREST/CONVICTION REPORT AND CERTIFICATION FORM
Background check update
Act 24 - PDE-6004 03/01/2016
As required by subsection (c.4) and (j)(2) of 24 P.S. §1-111, this form shall be completed and submitted by all current and prospective employees of said institutions to provide written reporting of any arrest or conviction for an offense enumerated under 24 P.S. §§1-111(e) and (f.1) and to provide notification of having been named as a perpetrator of a founded report of child abuse within the past five (5) years as defined by the Child Protective Services Law.
Act 24 - PDE-6004 03/01/2016
As required by subsection (c.4) and (j)(2) of 24 P.S. §1-111, this form shall be completed and submitted by all current and prospective employees of said institutions to provide written reporting of any arrest or conviction for an offense enumerated under 24 P.S. §§1-111(e) and (f.1) and to provide notification of having been named as a perpetrator of a founded report of child abuse within the past five (5) years as defined by the Child Protective Services Law.
As required by subsection (j)(4) of 24 P.S. §1-111, this form also shall be utilized by current and prospective employees to provide written notice within seventy-two (72) hours after a subsequent arrest or conviction for an offense enumerated under 24 P.S. §§1-111(e) or (f.1).
In accordance with 24 P.S. §1-111, employees completing this form are required to submit the form to the administrator or other person responsible for employment decisions in a school entity. Please contact a supervisor or the school entity administration office with any questions regarding the PDE 6004, including to whom the form should be sent.
To Submit Forms
Click here to download the Form PDE-6004. Please print the completed forms and submit directly to the building secretary. Electronic copies will not be accepted. Thank you in advance for your cooperation.
Act 24 of 2011
Frequently Asked Questions
Who must submit the PDE 6004 form?
All current employees of a public school, private school, intermediate unit, or vocational technical school. This includes substitutes, volunteers, senior tax volunteers, extracurricular staff, and PIAA game officials.
What happens if I do not want to submit one?
Your administrator will contact staff members who fail to submit a form and may request submission of updated clearances. Ignoring the request will result in further investigation.
Do I have to report an arrest or conviction for a Reportable Offense?
Yes. Any arrest or conviction for an offense set forth in Section 111(e) must be reported within 72 hours of the arrest or conviction. The intent of the PDE 6004 is for future reporting purposes.
Do I have to submit the form if I do not have a record?
Yes. Again, all district employees must complete the form.
Frequently Asked Questions
Who must submit the PDE 6004 form?
All current employees of a public school, private school, intermediate unit, or vocational technical school. This includes substitutes, volunteers, senior tax volunteers, extracurricular staff, and PIAA game officials.
What happens if I do not want to submit one?
Your administrator will contact staff members who fail to submit a form and may request submission of updated clearances. Ignoring the request will result in further investigation.
Do I have to report an arrest or conviction for a Reportable Offense?
Yes. Any arrest or conviction for an offense set forth in Section 111(e) must be reported within 72 hours of the arrest or conviction. The intent of the PDE 6004 is for future reporting purposes.
Do I have to submit the form if I do not have a record?
Yes. Again, all district employees must complete the form.
POLICY 815 - ACCEPTABLE USE OF INTERNET, COMPUTERS
AND NETWORK RESOURCES (TECHNOLOGY RESOURCES)
AND NETWORK RESOURCES (TECHNOLOGY RESOURCES)