"Non-citizen Oath of Allegiance" - New Jersey

Non-citizen Oath of Allegiance is a legal document that was released by the New Jersey Department of Education - a government authority operating within New Jersey.

Form Details:

  • Released on July 14, 2016;
  • The latest edition currently provided by the New Jersey Department of Education;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the New Jersey Department of Education.

ADVERTISEMENT
ADVERTISEMENT

Download "Non-citizen Oath of Allegiance" - New Jersey

Download PDF

Fill PDF online

Rate (4.3 / 5) 37 votes
New Jersey State Department of Education -- Office of Certification and Induction
NON-CITIZEN OATH OF ALLEGIANCE
IMPORTANT: This form is to be completed by only those individuals who are NOT U.S. citizens.
A. Please print your name as it appears on any documentation that you are required to submit.
Last Name
First Name
Middle Name/Initial
Street Address
City
State
Zip
Social Security Number
Date
Month
Day
Year
Of Birth
E-mail Address
Phone
Area Code
Number
Are you applying for the New Charter School Certificates?
Circle whichever applies
YES
NO
Are you a military veteran?
Circle whichever applies
YES
NO
Endorsement Information. Please enter below the code and print the name of the each endorsement for which you
are applying.
Endorsement Code
Endorsement Name
B. Oath of Allegiance – choose one of the options below. (To be subscribed to by non-citizens pursuant to
N.J.S.A. 18A: 26-9.)
Option I
I, ______________________________________________________do solemnly swear, (or affirm) that, during
the period of my employment, I will support the Constitution of the United States and the Constitution of the State
of New Jersey, so help me God.
Option II
I, ______________________________________________________ do solemnly swear, (or affirm) that, during
the period of my employment, I will support the Constitution of the United States and the Constitution of the State
of New Jersey.
C. Certification Failure to complete these items will result in rejection of the candidate’s application for
certification.
Circle whichever applies
1.Have you ever been convicted of, pled guilty, no contest or nolo contendere to, or had adjudication withheld to a
crime or offense, including DUI, in New Jersey or any other state or jurisdiction? If yes, complete and submit a
Criminal/Offense Information Form.
Yes
No
2.Have you ever had an education or other professional certificate, license or credential revoked, suspended,
invalidated or denied for cause in New Jersey or any other state or jurisdiction?*
Yes
No
3. Have you ever surrendered or relinquished an education or other professional certificate, license or credential in
New Jersey or any other state or jurisdiction? *
Yes
No
4.Are you the subject of any pending action or proceedings against your education or other professional
certificate(s), license(s) or credential(s) in New Jersey or any other state or jurisdiction? *
Yes
No
New Jersey State Department of Education -- Office of Certification and Induction
NON-CITIZEN OATH OF ALLEGIANCE
IMPORTANT: This form is to be completed by only those individuals who are NOT U.S. citizens.
A. Please print your name as it appears on any documentation that you are required to submit.
Last Name
First Name
Middle Name/Initial
Street Address
City
State
Zip
Social Security Number
Date
Month
Day
Year
Of Birth
E-mail Address
Phone
Area Code
Number
Are you applying for the New Charter School Certificates?
Circle whichever applies
YES
NO
Are you a military veteran?
Circle whichever applies
YES
NO
Endorsement Information. Please enter below the code and print the name of the each endorsement for which you
are applying.
Endorsement Code
Endorsement Name
B. Oath of Allegiance – choose one of the options below. (To be subscribed to by non-citizens pursuant to
N.J.S.A. 18A: 26-9.)
Option I
I, ______________________________________________________do solemnly swear, (or affirm) that, during
the period of my employment, I will support the Constitution of the United States and the Constitution of the State
of New Jersey, so help me God.
Option II
I, ______________________________________________________ do solemnly swear, (or affirm) that, during
the period of my employment, I will support the Constitution of the United States and the Constitution of the State
of New Jersey.
C. Certification Failure to complete these items will result in rejection of the candidate’s application for
certification.
Circle whichever applies
1.Have you ever been convicted of, pled guilty, no contest or nolo contendere to, or had adjudication withheld to a
crime or offense, including DUI, in New Jersey or any other state or jurisdiction? If yes, complete and submit a
Criminal/Offense Information Form.
Yes
No
2.Have you ever had an education or other professional certificate, license or credential revoked, suspended,
invalidated or denied for cause in New Jersey or any other state or jurisdiction?*
Yes
No
3. Have you ever surrendered or relinquished an education or other professional certificate, license or credential in
New Jersey or any other state or jurisdiction? *
Yes
No
4.Are you the subject of any pending action or proceedings against your education or other professional
certificate(s), license(s) or credential(s) in New Jersey or any other state or jurisdiction? *
Yes
No
5.Have you ever resigned, retired or been dismissed or suspended from an education-related position in New Jersey
or any other state or jurisdiction following allegations of misconduct? *
Yes
No
6. Are you the subject of any civil, criminal or administrative investigation in New Jersey or any other state or
jurisdiction? *
Yes
No
* If any answer to Questions 2 through 6 is “yes,” complete and submit an Additional Information For the Oath of
Allegiance Form.
D. Verification of Accuracy
I certify that all statements and information provided herein are true and accurate.
Applicant’s Signature (in ink)
Date
Sworn and subscribed to before me this _________ day of _______________________________, 20______
Notary Seal
Notary Signature
Once completed, mail the form to:
New Jersey State Department of Education
Office of Certification and Induction
P.O. Box 500
Trenton, New Jersey 08625-0500
Attention: Non-Citizen Oath of Allegiance
Revised 07/14/2016
Page of 2