Lock Haven University of Pennsylvania
Clearance Information
Child Abuse Clearance (ACT33/151)
Criminal Record Check (ACT34)
Federal Criminal History (ACT114)
Tuberculin Test (TB)
Patricia Cozzi
Office of Student Teaching and Clearances
613 Robinson Learning Center
Lock Haven University of Pennsylvania
401 North Fairview Street
Lock Haven, PA 17745
Phone: 570-484-2024
Fax: 570-484-2773
E-mail: pcozzi@lhup.edu
Office Hours: Monday – Friday 8:00 a.m. – 4:00 p.m.
(Lunch 12-1)
*Please note hours are subject to change
If you are using the electronic version of this document and have issues clicking on the links try holding the
control button and clicking at the same time. Thank you!
CLEARANCES AND TB TESTS
REQUIRED FOR STUDENTS
LOCK HAVEN UNIVERSITY OF PENNSYLVANIA
Students going out into the schools (public and private) K-12 or to any public agencies are required to have the
clearances and TB Test listed below. Links to clearance applications are on page 4 of this packet. The
clearances are obtained solely by the student and the results are only shared with the student.
Directions for Recording Data
Students should wait until they have all four pieces of documentation and then personally bring them into the
Clearance Office to be recorded. There is a cover sheet that needs to be completed and attached to the
clearances and TB test result (Page3 of this packet). The Clearance Coordinator checks these documents for
authenticity, records the dates and then returns the original forms to the student in person or by mail.
NO COPIES OF CLEARANCES ARE KEPT ON FILE IN THE CLEARANCE OFFICE OR THE TEACHER
EDUCATION OFFICE. IT IS THE RESPONSIBILITY OF THE STUDENT TO KEEP THESE DOCUMENTS
IN A SAFE PLACE.
Students are permitted to mail documents to the Clearance Coordinator for recording. If you choose to mail
them you print off the cover sheet and mail with the document(s) or attach a note indicating:
1. Major
2. ID number
3. Semester/year of entrance to LHU.
**********The information will be recorded and returned to you at the address you provide***********
Office Use Only
Child Abuse Clearance (ACT33): _______________
Criminal Record Check (ACT34): _______________
FBI: _______________
TB: _______________
Date Processed: _______________
Processed by: _______________
Clearance Cover Sheet
Please Note: This Office does NOT make copies of clearances.
It is your responsibility to keep them secure place once they are returned to you.
Please Print Clearly or Type
Today’s Date:
Name:
ID#:
Major:
Date You Enrolled at LHU:
Semester Year
When will you student teach?
Semester
Year
☐
Don’t Know
If I am out of the office and you wish to leave your clearances and TB test results, please address and envelope
to yourself (DO NOT SEAL).
If you wish to mail your information please see address below:
Tonja Davis-Allen
Clearance Office
607 Robinson Learning Center
Lock Haven University
Lock Haven, PA 17745
******************Originals of clearances will be recorded and returned to you *********************
Criminal Record Check (Act 34 Background Clearance)
Only document with State Seal Watermark Accepted






The Criminal Background Check can also be obtained on-line using a debit or credit card at https://epatch.state.pa.us .
Is good for one year from the date the clearance has been granted.
Students must check “Education” under Purpose of Clearance
Must say “no record”.
May take two to four weeks to be processed.
Applicants must make sure that they print the “official” Certification Form with the state seal watermark in the background.
Pennsylvania Child Abuse History Clearance (Act 33/151)
Only originals Accepted






Is good for one year from the date the clearance has been granted.
Students must check “School Employee” under Purpose of Clearance
Will only take $10.00 money orders
Must say “no record”.
May take three weeks or more to be processed
Child Abuse History can only be obtained by mail but the form can be printed off at
http://www.dpw.state.pa.us/ucmprd/groups/webcontent/documents/form/s_001762.pdf
FBI Clearance (Act 114)
Only originals Accepted







All student teachers, students participating in the classrooms, and anyone employed in private or public schools must have
a current FBI Federal Criminal History Record done.
This clearance is good for the entire time you are enrolled at LHU; unless you lose the original or if you have a break in
your enrollment.
Must say “no record”
This clearance requires fingerprinting done at specific sites in Pennsylvania.
You must be registered with Cogent Systems at http://www.pa.cogentid.com prior to having your fingerprinting done.
You must click on the PDE link. Use only the Pennsylvania Department of Education Site. This website will walk you
through the process and list fingerprinting sites.
It may take up to 8 weeks to receive your clearance results back and you will not be able to enter schools without it so plan
ahead.
Tuberculin (TB) Test
Only Physicians Report Accepted



Is good for two years from the date of the test. If a student has a valid TB test on record at the LHU Glennon Infirmary, the
student may go there to request a TB Test Verification Form. (New students must have the TB test as part of their Medical
Record for entrance to the University, so it will be part of their physical examination form and we recommend that you
keep a copy of that TB Test Verification information to submit to our office.)
If a student needs a TB test, the Infirmary will do the test free of charge everyday but Thursday
The TB Test verification from the infirmary or from a private physician must include the student’s name, date of test,
and the test results (which should be negative), and the physician’s name on the report. No hand written notes accepted.
Note: Non-U.S. citizens must apply for clearances and a TB test as well.
This link will allow you to click on a county for Fingerprint Service Sites in your area
Pennsylvania Department of Education
Company
City
State
County
PA Career Link of Clinton County
Lock Haven
PA
Clinton
The UPS Store 0069
State College
PA
Centre
Central Intermediate Unit 10
West Decatur
PA
Clearfield
Penn State University
University Park
PA
Centre
Behavioral Advancements of DuBois
DuBois
PA
Clearfield
Futures Community Support Services, Inc.
Towanda
PA
Bradford
Intermediate Unit 17
Canton
PA
Bradford
The UPS Store 1927
Williamsport
PA
Lycoming
Tioga County Courthouse
Wellsboro
PA
Tioga