Act 24

Below you will find a link to PDE Form 6004 - Arrest/Conviction Report and Certification Form. This form has been developed by the Pennsylvania Department of Education. The law imposes an ongoing requirement for school employees to report any arrest or conviction for an offense listed on page two of this form to a school administrator within 72 hours. The reportable offenses are from Section 111 of the Public School Code and are found on page two of the form. Copies of the form will be available in your building office and may be downloaded from the link below.

To Submit Forms
Click below to download Form PDE-6004. The completed forms should be submitted directly to Louise Woods-Rzepka, Human Resources Coordinator in the District Administration Office. Electronic copies will not be accepted. Thank you in advance for your cooperation, if you have any questions regarding the Form PDE-6004, please contact Louise at 724-941-6251 or WoodsL@PT-SD.org.