North Carolina Administrative Code › Title 12 - JUSTICE › Chapter 09 - CRIMINAL JUSTICE EDUCATION AND TRAINING STANDARDS › Subchapter G - MINIMUM STANDARDS FOR CRIMINAL JUSTICE SCHOOL DIRECTORS › Section .0700 - FORMS › Section 09G .0701 - REPORT: APPLICATION: AND CERTIFICATION FORMS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The
				  following are Commission approved forms to be used by the North Carolina
				  Department of Public Safety, Division of Adult Correction and Juvenile Justice
				  in making reports, applications, or requests for certification to the
				  Commission:
(1) The Medical History
				  Statement. The Medical History Statement is a questionnaire to be completed by
				  an applicant. The form includes information pertinent to the applicant's
				  present and past physical condition, injuries, diseases, or
				  operations.
(2) The Medical
				  Examination Report. The Medical Examination Report is a form provided to the
				  examining physician to record the results of the applicant's medical
				  examination. The Medical Examination Report is form that includes the following
				  information regarding the applicant:
(A)
				  contact information;
(B) date of
				  birth; and
(C) medical
				  information.
(3) The
				  Request for School Accreditation Form. The Request for School Accreditation
				  Form provides the means for an agency or institution to become certified to
				  conduct corrections training and to affiliate with the Criminal Justice
				  Education and Training System. It seeks information on the physical, financial,
				  and staff support provided to the school by the agency or
				  institution.
(4) The Request for
				  Training Course Accreditation Form. The Request for Training Course
				  Accreditation Form is used to obtain accreditation for a school's particular
				  offering of a corrections training course. It requests information regarding
				  the administration of the course, the particular facilities to be used, and the
				  proposed curriculum of the course.
(5) The Report of Appointment/Application for
				  Certification. The Report of Appointment/Application for Certification is used
				  for reporting the appointment of correctional officers and probation/parole
				  officers, and indicating the applicant's progress toward completing the
				  requirements for certification. The Report of Appointment/Application for
				  Certification form includes the following information:
(A) type of certification;
(B) applicant contact information;
(C) criminal history;
(D) military history;
(E) applicant appointment date and position
				  title; and
(F) medical
				  information.
(6) Notice
				  of Transfer. The Notice of Transfer form is used to notify the Standards
				  Division of an officer's change in the type of corrections officer
				  certification. The Notice of Transfer form includes the following information:
(A) applicant information;
(B) transfer information;
(C) employment date and title; and
(D) education completed.
(7) Report of Separation. The North Carolina
				  Department of Public Safety, Division of Adult Correction and Juvenile Justice,
				  when separating a person from employment as a correctional officer or
				  probation/parole officer shall forward to the Commission a completed Report of
				  Separation or Department of Public Safety Personnel Action Form within 30 days
				  of separation. The Report of Separation form includes the following
				  information:
(A) type of
				  certification;
(B) applicant
				  contact information;
(C) criminal
				  history; and
(D) applicant
				  appointment date and position title.
(8) The Request for Instructional
				  Certification Form. The Request for Instructional Certification Form is used by
				  persons seeking certification as general instructors. It seeks information
				  regarding personal and professional background as well as documentation of the
				  specific criteria for certification. The Request for Instructional
				  Certification form includes:
(A) applicant
				  contact information;
(B)
				  certification type;
(C) employment
				  date and title;
(D) education
				  completed;
(E) practical
				  experience; and
(F)
				  recommendation
(9) The
				  Recommendation for General Instructor Certification Form. The Recommendation
				  for General Instructor Certification Form is completed by a School Director or
				  agency head after an instructor has finished the required probationary period.
				  In the form the official recommends that the instructor receive General
				  Instructor Certification and certifies that the official has observed and
				  evaluated the instructor to be a teaching professional. The Recommendation for
				  General Instructional Certification form includes:
(A) applicant contact information;
(B) certification type;
(C) employment date and title;
(D) education completed;
(E) practical experience; and
(F) recommendation
(10) The Application for Award of State
				  Corrections Certificate. The Application For Award of State Corrections
				  Certificate requests information regarding the education, training, and
				  experience qualifying the applicant for various levels of certification under
				  the State Corrections Officers' Professional Certificate Program. The
				  Application for Award of State Corrections Certificate form includes:
(A) applicant contact information;
(B) certificate type;
(C) employment date and title;
(D) education completed;
(E) practical experience; and
(F) recommendation