County-Paid & NDSU-Paid Staff Rescreening Instructions

County-Paid and NDSU-Paid Extension Staff Rescreening Instructions

 Thank you for responding to the email reminder to be rescreened. Please follow the instructions below, noting that the left column is for those paid by NDSU, and the right column is for those paid by the county.

If you are paid by NDSU, please do what’s in this column.

If you are paid by your county, please do what’s in this column.

Please complete the forms below within two weeks and hand deliver, campus mail or USPS mail the forms (do not email) to the Extension Director’s Office, Morrill Hall 311, NDSU Dept 7000, PO Box 6050, Fargo, ND 58108-6050.  Do not include your social security number on the SFN 433 form.

The Director’s Office will conduct the rescreening with the Department of Human Services (DHS), enter the date that DHS signed the form in the Ag Info Center’s People database, then file all forms in the employee’s secure personnel file in the Ag Budget Office.  

Please complete the forms below within two weeks and give them to the Extension county coordinator in your office. Do not include your social security number on the SFN 433.

The county coordinator will place Forms A and H in a secure office file, i.e. locked cabinet or cabinet in locked room.

Next the county coordinator will complete Part I of the SFN 433 form with his/her contact information then submit the form to the address at the bottom of the form using fax or USPS mail (donot email) for screening on the North Dakota Child Abuse Information Index. Department of Human Services (DHS) will do the screening, sign the form, then return it to the county coordinator.

The county coordinator will relay to the Extension Director’s Office the date that DHS signed the form, then file the form with Forms A and H in the secure office file. The Director’s Office will enter the date that DHS signed the form in the Ag Info Center’s People database.

1.      Adult Behavioral Expectations (Form A)

1.      Adult Behavioral Expectations (Form A)

2.      Child Abuse and Neglect Background Inquiry for NDSU-Paid Staff (DHS SFN433)

2.      Child Abuse and Neglect Background Inquiryfor County-Paid Staff (DHS SFN433)

3.      Confidentiality Agreement (Form H)

Complete Form H if you handle confidential records of volunteers, paid staff or 4-H members.

3.      Confidentiality Agreement (Form H)

Complete Form H if you handle confidential records of volunteers, paid staff or 4-H members.

 

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