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Suitability Request Form
Fingerprint-based checks are conducted as authorized by 603 CMR 51.06 which also permits transferring of suitability determinations between public school districts. If you were employed with the Burlington Public Schools and would like your suitability determination to be shared with another MA public school district, please complete the information below.
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Former Name
If you had a different name while working in Burlington, your fingerprint results will be listed under that name
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Your email address
*
Your answer
School District(s) Receiving Suitability Determination
*
Your answer
Name(s) of Individual(s) Receiving Determination
*
Your answer
Email Address(es) of Individual(s) Receiving Determination
*
For mulitiple email addresses, please separate with a comma
Your answer
Notes / Additional Information
Your answer
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