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Name must match EXACTLY as shown on Social Security card.
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If assigned multiple locations, select "Multiple Locations" and specify locations in comments below.
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Are you a final intern? *
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Indicate the duration of the contracted services to be provided by this employee.
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Number must match EXACTLY as shown on Social Security card.
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In order to comply with government reporting requirements, the District School Board of Pasco County invites employees to voluntarily and confidentially self-identify their race and ethnicity. Submission of the following information is voluntary and the refusal to provide it will not subject you to any adverse treatment. The information will be kept confidential and will only be used in accordance with the provisions of applicable laws. When reported, data will not identify any specific individual.
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RACE (check all that apply):
In order to comply with government reporting requirements, the District School Board of Pasco County invites employees to voluntarily and confidentially self-identify their race and ethnicity. If the employee volunteers this information, please include below. Refusal to provide will not result in any adverse treatment. The information will be kept confidential and will only be used in accordance with the provisions of applicable laws. When reported, data will not identify any specific individual.
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Final Intern Badge Request
To process your request for your intern badge, please upload a picture of yourself using the below requirements.
• Photos must be in color (no black and white photos or photos with filters).
• Plain background (not in a vehicle).
• Close-up of face (similar to a driver's license or passport photo – bottom of photo should not be below shoulder level).
• Photo must have been taken within the last 6 months.
• Head facing directly into camera (no profile/side view poses). Face cannot be partially cut off.
• No sunglasses, hats, or items covering the face, except for prescription glasses that are worn regularly.
• Photos may be taken with a smartphone, digital camera, or webcam.
If you have difficulty uploading a photo, email Kelly Smith at kelsmith@pasco.k12.fl.us for assistance.
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To be completed by Pasco County Schools
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