Cal. Code Regs. Tit. 5, div. 4, ch. 1, art. 14, att. C.5
Current through Register 2025 Notice Reg. No. 2, January 10, 2025
FORM IS OPTIONAL - INFORMATION IS STILL REQUIRED FOR APPLICATION PROCESS
APLE for District Interns 2xxx-xx Selected Applicants
School Name:__________
NAME | *SOCIAL SECURITY # | TEACHING SERVICE AREA | |
1. | ___________________________ | ___________________________ | ___________________________ |
2. | ___________________________ | ___________________________ | ___________________________ |
3. | ___________________________ | ___________________________ | ___________________________ |
4. | ___________________________ | ___________________________ | ___________________________ |
5. | ___________________________ | ___________________________ | ___________________________ |
6. | ___________________________ | ___________________________ | ___________________________ |
7. | ___________________________ | ___________________________ | ___________________________ |
8. | ___________________________ | ___________________________ | ___________________________ |
9. | ___________________________ | ___________________________ | ___________________________ |
10. | ___________________________ | ___________________________ | ___________________________ |
11. | ___________________________ | ___________________________ | ___________________________ |
12. | ___________________________ | ___________________________ | ___________________________ |
13. | ___________________________ | ___________________________ | ___________________________ |
14. | ___________________________ | ___________________________ | ___________________________ |
15. | ___________________________ | ___________________________ | ___________________________ |
16. | ___________________________ | ___________________________ | ___________________________ |
17. | ___________________________ | ___________________________ | ___________________________ |
18. | ___________________________ | ___________________________ | ___________________________ |
19. | ___________________________ | ___________________________ | ___________________________ |
20. | ___________________________ | ___________________________ | ___________________________ |
21. | ___________________________ | ___________________________ | ___________________________ |
22. | ___________________________ | ___________________________ | ___________________________ |
23. | ___________________________ | ___________________________ | ___________________________ |
24. | ___________________________ | ___________________________ | ___________________________ |
25. | ___________________________ | ___________________________ | ___________________________ |
* Please see attached State of California Information Practices Act (IPA) of 1977 & Use of Your Social Security Number
Cal. Code Regs. Tit. 5, div. 4, ch. 1, art. 14, att. C.5