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DISCLOSURE STATEMENT APPLICATION FOR PROVISIONAL ...

DISCLOSURE STATEMENT APPLICATION FOR PROVISIONAL employment IN A child -CARE SERVICE Required by the child Protective Service Law 23 Pa. section 6344 (relating to information relating to prospective child -care personnel) I swear/affirm that I have mailed the requests for clearance to ChildLine and the Federal Bureau of Investigation. I swear/affirm that I have not been named as a perpetrator of a founded report of child abuse or as an individual responsible for a founded report for a school employee as defined by the child Protective Services Law.

DISCLOSURE STATEMENT . APPLICATION FOR PROVISIONAL EMPLOYMENT IN A CHILD-CARE SERVICE . Required by the Child Protective Service Law . 23 Pa. C.S. Section 6344 (relating to information relating

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