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Calhoun Christian School 20 S. Woodrow Avenue, Battle Creek, MI 49015 Phone 269.965.5560 Fax 269.965.8038 www.calhounchristian.org AFFIRMATION OF PRIOR DISCIPLINE RECORD A willful false statement
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How to fill out affirmation of prior discipline:

01
Start by reading the instructions carefully. Familiarize yourself with the purpose of the affirmation of prior discipline and the information required to complete it.
02
Identify the disciplinary action or actions that you need to disclose. This may include any previous professional licenses that have been disciplined, any criminal convictions or pleas, or any other disciplinary actions taken against you in the past.
03
Gather the necessary documents. Depending on the requirements, you may need to provide copies of any disciplinary orders, court records, or other relevant documents.
04
Begin filling out the form by providing your personal information, such as your full name, address, contact details, and any professional licenses or certifications you currently hold.
05
Clearly and accurately disclose the details of any prior disciplinary actions. Be sure to include the dates, locations, and reasons for the disciplinary actions, as well as any penalties or restrictions imposed.
06
If required, provide additional information or explanations for the disciplinary actions. This can help provide context and clarity to the circumstances surrounding the actions.
07
Review the completed form for any errors or omissions. Make sure all information is accurate and up-to-date before submitting it.
08
Sign and date the affirmation, certifying that all information provided is true and accurate to the best of your knowledge.
09
Submit the form as instructed, whether it is through mail, email, or an online submission portal.

Who needs affirmation of prior discipline:

01
Professionals applying for a new license or certification may be required to submit an affirmation of prior discipline. This is often done to ensure that any disciplinary actions in the past are properly considered before granting a new professional license.
02
Individuals seeking employment in certain fields may also be asked to provide an affirmation of prior discipline. Employers may want to assess any potential risks or liabilities associated with hiring someone who has a history of disciplinary actions.
03
Individuals who are currently under investigation or facing disciplinary actions may also be required to complete an affirmation of prior discipline as part of the disciplinary process. This allows the governing body or organization to fully evaluate and consider any previous disciplinary actions in their decision-making process.
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Affirmation of prior discipline is a form that requires individuals to disclose any previous disciplinary actions or sanctions taken against them.
Professionals in certain fields such as law, medicine, and finance are typically required to file affirmation of prior discipline.
The form usually requires the individual to provide details about the disciplinary action, including dates, reasons, and outcomes.
The purpose of affirmation of prior discipline is to ensure transparency and accountability in professions where ethical conduct is crucial.
Information such as the date of disciplinary action, reasons for the action, and any sanctions imposed must be reported on affirmation of prior discipline.
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