Portales Municipal Schools
501 South Abilene
Portales, NM   88130

VERIFICATION OF EMPLOYMENT

Name                                                                              			District/Business____________________________

Social Security Number                                                 			Mailing Address                                                         

Date                                                                               			City-State                                                                   

Signature of employee authorizing release of information:										

The above named individual states that he/she has been employed by you.  In order to determine the salary for this employee in accordance with the Portales Salary Schedule, please provide the information requested below.  If a teacher, do not count substitute teaching, student teaching or contract coaching as teaching.

  Please use a separate line for each year.  This affidavit should be signed by an official who knows the services of the applicant and NOT by the applicant.
School /Calendar Year	        Position/Title	F/T or P/T	Number of hours per day
	Number of days worked per year
	         Dates of Service
   From                      To
Month/Year         Month/Year	Written Signature of Certifying Officer	

							

							

							

____________________________________________________________________________  			RETURN TO:   Lois McAlister
Signature                                                            Printed name                                  Phone number			Personnel Coordinator
													Portales Municipal Schools
___________												501 S. Abilene
___________												Portales, NM   88130