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APPLICATION FOR A TEACHER'S LICENSE
Application Package intended for Applicants who
completed their teacher education program outside of Canada
Send all documentation to:
Office of the RegistrarCertification and Standards Section
Department of Education, Early Learning and CultureSuite 101,
Holman Centre
250 Water StreetSummerside, Prince Edward Island C1N 1B6
Tel:(902) 438-4130Fax:(902) 438-4062
Effective from August 20, 2016 TL-INT -Eng
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GUIDELINES FOR APPLYING FOR A PEI ACADEMIC TEACHERS CERTIFICATE
FOR APPLICANTS WHO COMPLETED THEIR PROFESSIONAL TEACHER EDUCATION
PROGRAM
OUTSIDE OF CANADA Please read the instructions carefully before
completing this application for an Academic Teachers
Certificate
Under Section 67. (1) of the Education Act, an education
authority shall not employ a person as a teacher unless the person
holds a teachers license. A person who applies for a teachers
license must apply in accordance with section 98 of the Education
Act and provide the supporting documents, as outlined below with
the application.
ATTENTION APPLICANTS EDUCATED OUTSIDE OF CANDA! As you completed
your initial pre-service professionalteacher education program in a
jurisdiction outside of Canada, you must provide proof that you
were certified first to teach in the jurisdiction where you
completed your teacher education program, even if you never taught
there.
APPLICATION REQUIREMENTSYou must provide the following documents
for the purpose of
an evaluation to obtain a PEI Teachers License. [Please note:
Some documents should be enclosed with
your completed application form, while others must be sent
directly from the issuing institution. A. Enclose with your
completed application form:T proof of identity such as a copy of
your Birth Certificate
T proof of eligibility to work in Canada such as a copy Social
Insurance Number card, work permit etc.
T $175.00 evaluation fee in the form of a cheque or money
order made out to the Minister of Finance. Payment in cash will
be accepted in personal at the Office of the Registrar. Credit Card
payments may be made of the phone.
T a copy of a Criminal Background Check current to within
three
(3) months of the submission of your application
T a copy of a Vulnerable Sector Screen current to within
three
(3) months of the submission of your application
T proof that you were certified to teach in the jurisdiction
in
which you completed your pre-service teacher education
program (even if you never taught there) such as a copy of
your teachers certificate
T a copy of your teachers certificate from every additional
jurisdiction where you have been certified to teach
T a copy of your degree from each university attended
B. Request the following documents be sent to the Office ofthe
Registrar to support your application:
T proof of completion of all post- secondary education such
as
an original official transcript(s) sent directly from all
post-
secondary institutions where you have attended to the Office
of the Registrar
T proof of completion of a recognized pre-service teacher
education program such as an original official transcript of
marks sent directly to the PEI Office of the Registrar from
the
university where you completed your initial pre-service
profession teacher education program.
T proof that your teachers license from the jurisdiction
where
you completed your initial pre-service professional teacher
education program is valid and in good standing such as a
Statement of Professional Standing. The Statement of
Professional Standing must confirm that your teachers
certificate has never been suspended or revoked and that
your
teaching license is in good standing in that jurisdiction.
This
must be mailed directly from the regulator in the
jurisdiction
where you completed your initial pre-service professional
teacher education program. This applies even if you never
taught there.
T proof of professional status from ALL of the jurisdictions
where you have been certified to teach such as a Statement
of
Professional Standing. The Statement of Professional
Standing from other jurisdictions where you have taught must
confirm that your teachers certificate has never been
suspended or revoked and that your teaching license is in
good
standing in that jurisdiction. This applies even if you
never
taught there.
PERSONAL BACKGROUND INFORMATION: Proof of Identity:Alternatives
to a copy of a Birth Certificate include, a Canadian or Foreign
Passport (must include middle names), a Permanent Resident Card
(front and back required), a Canadian Immigration Record and Visa
Record of Landing (front and back required).
[Please note: Drivers Licenses, Provincial Health Cards and
Canadian Citizenship Cards are not acceptable as proof of
identity.]
Proof of Change of Name (if applicable): If your name was
changed throughout your educational or work experience, please
provide a copy of a legal document which supports this change of
name such as a copy of a Marriage Certificate, a Divorce
Certificate, a Change of Name Certificate, a Court Order that
changed a name.
http://../../../teaching_certificates.aspx?lang=en-CAhttps://www.princeedwardisland.ca/sites/default/files/forms/payment_form.pdf
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Proof of Eligibility to Work In Canada:A Teaching Certificate
will not be issued until proof of eligibility
to work in Canada has been provided to the Registrar. For
out-of-
country applicants, a valid work permit issued by the
federal
government indicating that the applicant is not restricted
from
working in a school environment is required on the front and
back of your Permanent Resident Card or Record of Landing
Form.
Conditional Letter of Eligibility In instances where an
applicant has met all of the requirements
of teacher certification with the exception that they do not
hold
a work permit or proof that they are eligible to work in
Canada,
a Conditional Letter of Eligibility will be issued. This will
indicate
that your credentials have been evaluated and that you will
be
eligible to teach in the public schools of PEI upon providing
proof
of permission to work in Canada.
Criminal Background Check & Vulnerable SectorScreen:All
applicants must submit an original, or a copy of an original,
of a signed, Canadian criminal record check report including
a
Vulnerable Sector Screen. The report must be current to
within
three (3) months of the date of submission of your
application.
The report must include your current and past full names.
These
will have to match your proof-of-identity documents. You can
obtain a criminal record check from a local, regional or
national
police service.
ACADEMIC CREDENTIALSOfficial Post-Secondary Transcripts:
Official transcripts, bearing the institutions name and the
educational institutions Registrars signature, must be mailed
directly from the post-secondary institution to the Office of the
Registrar in a sealed envelope. The official transcript must
contain the title of the degree that you were awarded and the date
when you successfully completed your degree. It must outline the
courses and credit hours completed, the completion date as well as
the length of the program. You should include a transcript for each
university you attended. Only course work completed at an
accredited recognized post-secondary institutions will be
recognized.
Official Teacher Education Program Transcripts: You must provide
proof that you have completed an approved and recognized
pre-service teacher education program. The official transcript must
contain the name of the degree that you were awarded and the date
when you successfully completed your degree.
[Please note: Only initial pre-service professional teacher
education programs that are recognized for licensure in the
jurisdiction in which they are offered will be considered for
certification purposes.]
Your transcript must outline the courses and credit hours
completed as well as the length of the supervised practicum. An
acceptable pre-service teacher education program must include a
minimum of thirty (30) credit hours beyond a minimum of 90 credit
hours of undergraduate study plus a supervised practicum of a
minimum length of twelve (12) weeks or sixty (60) days.
[Please note: Individuals are asked not to apply for a PEI
teachers
certificate until such time as they have successfully completed
their
teacher training program. Only pre-service teacher education
programs that are completed at an approved accredited post-
secondary institution will be recognized.]
Faxed, e-mailed, photocopied, hand-delivered or copies of
transcripts will NOT be accepted in the Office of the
Registrar.
All transcripts m ust be originals sent directly by the
post-
secondary institution to the Office of the Registrar. In the
event
that the university uses only a secure server system to post
transcripts, we will require the login and password access
information.
Countries or Jurisdictions Where Universities do notIssue
Official Transcripts to Third PartiesIn some countries,
post-secondary institutions only issue official
original transcripts to the student. In these cases, the
applicant
must present these original records to the Registrar in person
at the
Office of the Registrar. The Registrar will make a copy and
initial that
the original has been viewed. The Registrar will then mail
the
transcript to the originating university for verification.
PROFESSIONAL CREDENTIALS
Statement of Professional Standing You must request that an
official Statement of Professional
Standing be sent on your behalf from the certification
authorities in
ALL jurisdictions where you held a teachers certificate even if
you
never taught there, including the jurisdiction where you
completed
your teacher education program. The statement (s) must
confirm
that your teachers certificate is valid and is in good standing
in the
jurisdiction (s) and that it has never been suspended, revoked
or
suspended. The Statement of Professional Standing must be
issued
by the Ministry, College or the regulatory body that holds
the
authority to license teachers in that jurisdiction. It must be
mailed
directly to the Office of the Registrar.
[Please note: The Statement of Professional is NOT a copy of
your
teachers certificate nor is it an evaluation of your
teaching.]
Faxed, e-mailed, copied or hand-delivered copies of
Statements
of Professional Standing will NOT be accepted. Statements of
Professional Standing must be sent directly by the
regulatory
body to the Office of the Registrar.
When the Statement of Professional Standing is Available
Online
Exclusively
In the instance where a jurisdiction only provides the Statement
of
Professional Standing online, you will be required to provide
the
Registrar with your registration number and any login
information
so that your Statement of Professional Standing can be
accessed
online by the Registrar.
When there is No Central Authority Responsible for Teacher
Certification
In countries where there are no centralized regulators for
licensing
teachers, applicants may provide alternate documentation.
Instead,
you must arrange for the head of the last school where you
taught
to send a letter of reference directly to the Office of the
Registrar.
The letter must be current. It must list the dates and length of
your
employment and say that you were never suspended for
disciplinary
reason and that your conduct was satisfactory.
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Language Proficiency
To teach in PEI Public School system, teachers must be
thoroughly proficient in either English or in French. Applicants
must demonstrate effective communication skills in either of
English or French. Applicants who have completed a portion of their
education in a language other than English or French may be asked
by the Registrar to provide acceptable results in an approved
language proficiency test. The test results must not be older than
one full year from the date of submission of the application. For
more information on the International Language Tests that are
recognized by the Registrar and for the acceptable scores on these
tests, please contact the Office of the Registrar.
PEI Academic Teachers Certificate Qualification LevelsThe PEI
Registrar evaluates the academic credentials
submitted by each applicant and assigns a qualification level
according to the criteria outlined in the Teacher Certification and
Standards Board regulations under the authority of the Education
Act. Academic credit hours may be weighted differently as well.
Every effort is made to ensure that academic credentials are
treated equitably. The assignment of a level impacts the pay rate
of a contract teacher. Therefore, it is important that you provide
the Office of the Registrar with transcripts for all post-secondary
studies that you wish
to have evaluated for classification and salary placement
purposes. Qualification levels assigned in PEI differ from those in
other jurisdictions.
Academic Teachers Certificate 4
An Academic Teachers Certificate Level 4 may be granted to
an applicant who has successfully completed an approved
pre-service teacher education program and a minimum of
one-hundred and twenty (120) approved credit hours of
post-secondary study. This could include: an approved
ninety (90) credit hour undergraduate degree along with an
approved thirty (30) credit pre-service teacher education program
or an approved one hundred and twenty (120) credit hour bachelor of
education degree.
Academic Teachers Certificate 5
An Academic Teachers Certificate Level 5 may be granted to
an applicant who has successfully completed an approved
pre-service teacher education program and a minimum of
one hundred and fifty (150) approved credit hours of
post-secondary study. This could include an approved one hundred
and twenty (120) credit hour undergraduate degree plus an approved
teacher education program of a minimum of thirty (30) credit hours
or a consecutive bachelor and bachelor of education program of a
minimum of one hundred and fifty (150) credit hours.
Academic Teachers Certificate 5A
An Academic Teachers Certificate Level 5A may be granted to
an applicant who has successfully completed a minimum of an
approved one full academic year of study totalling thirty (30)
credit hours beyond the Certificate 5 totalling a minimum of one
hundred and eighty (180) credit hours where the additional course
work did not result in the granting of a masters degree.
Academic Teachers Certificate 6
An Academic Teachers Certificate Level 6 may be granted to
an
applicant who has successfully completed an approved one full
year
of academic year of study totalling thirty (30) credit hours
beyond
the Academic Teachers Certificate Level 5 totalling a minimum
of
one hundred and eighty (180) credit hours and an approved
academic master's degree. The Masters degree must be in an
area
related to the authorized PEI Public School system
curriculum.
Academic Teachers Certificate 7
Beginning in October 2013 the achievement of an approved
doctoral
degree or an approved additional masters degree resulting in
a
minimum of two hundred and ten (210) credit hours beyond the
Academic Certificate 6 may be recognized for a Academic
Teachers
Certificate 7. The additional degree must be in an area related
to the
authorized PEI Public School system curriculum. There are
currently
no salary implications associated with this level.
Appeal Policy
An applicant may appeal the decision of the Registrar to 1)
either refuse a license or 2) to assign a certain level to an
applicants certificate to the Teacher Certification and Standards
Board.
An appeal must be requested no later than 15 days from the date
when the decision was provided to the applicant. For more
information on the appeal process, contact the Registrar.
Document Policy:
All documents received by the Registrar become the property of
the Department of Education, Early Learning and Culture. Applicants
are advised to make copies of each document before submitting them
to the Registrar. The Office of the Registrar will not provide
third parties with copies of your documents. An application file
that is inactive for one full year will be destroyed.
Translation Policy:
All documents must be received in the official language of the
granting institution. When the Registrar receives official
documents from the granting institution that are in a language
other than English or French, you will be required to provide
official translations. We will provide you with a copy of each
document. You must use these copies to arrange for official
translation. Translations will only be accepted from a document
translation service that has been approved by the Registrar. This
could include the consulate or high commission or embassy in Canada
of the country that issued the documents or a translator that has
been accredited by the federal or provincial government.
Effective Date:
An Academic Teachers Certificate becomes effective from the date
when the Office of the Registrar has received all of the required
documentation and in the event that all documentation has been
approved by the Registrar and meets the requirements outlined in
Teacher Certification and Standards Boards policies. An Academic
Teachers Certificate remains valid from the date of issue unless
suspended, revoked or cancelled.
It is your duty to report within 48 hours to the Registrar any
charges or convictions under the Criminal Code of Canada or the
Controlled Drugs and Substances Act of Canada.
http://www.gov.pe.ca/go/reg
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EMPLOYMENT ISSUES
Island Employers
Teachers seeking employment in Prince Edward Island must apply
to the employers directly. There are two public school K to 12
systems in PEI; the English system and the French system. You may
request in Section 6 of this application form to have your
certification information forwarded to one or both school systems,
the English and/ or the French. You may also indicate in Section 5
if you wish to receive a Verification of your Eligibility to
Substitute Teach.
Seeking Employment Outside of PEI
Should you wish to apply outside of PEI, you may require that
the PEI Registrar issue a Statement of Professional Standing on
your behalf. You may request this using the application form found
on our web site.
Recognition of Teaching Experience
If you have accumulated experience teaching outside of Prince
Edward Island, or in other venues, you may qualify to receive
recognition for this experience under the Registrar's Work
Experience policy. You must apply for service recognition to the
Registrar. Once an evaluation of your teaching experience has been
completed, the Office of the Registrar will inform
the education authoriaties (school board (s)) as requested by
yourself.
To Apply for Recognition for Teaching Experience within a Public
School System Outside of PEI
You may have teaching experience in a public school system
outside of Prince Edward Island that qualifies for service
recognition in this province. Recognition for teaching experience
includes contractual, short-term contractual and substitute outside
of Prince Edward Island not exceeding one hundred and eighty-five
(185) days in each school. This may be granted
by the Registrar upon application.
You may complete the application form for work experience
recognition and submit it with your application for a P.E.I.
Academic Teachers Certificate. Support letters from former
employers will be required.
[Please note: Teaching experience that was a result of a Teacher
Practicum is not eligible for work experience recognition.]
To Apply for Recognition for Allied Work Experience
The Allied Work Experience program provides an opportunity
for certified PEI teachers to apply for and receive recognition
for past work experience that involves teaching in settings outside
of the regular K to 12 public school system or that is similar to
or related to teaching.
You may attach the Work Experience Application form with this
application. Please note letters from employers will be required to
support all applications for Work Experience Recognition.
{Please note: Teaching experience that was a result of a Teacher
Practicum is not eligible for work experience recognition.]
FEE POLICY The required fee of $175.00 (Canadian funds) as well
as the completed application form and required documentation must
be received by the Office of the Registrar before an application
for a teacher s certificate will be evaluated or issued. The fee is
non-refundable unless
the application is withdrawn and in the event that no staff time
has been invested in processing the application. The application
fee must be paid by cheque or by money order made out to: The
Minister of Finance. Or, it can be paid in cash in person at the
Office of the Registrar. Forward the application and all supporting
documents to:
The Office of the Registrar
Certification and Standards Section
Department of Education, Early Learning and Culture
Suite 101, Holman Centre
250 Water Street, Summerside, PEI C1N 1B6
PAYING BY CREDIT CARD:To pay the $175.00 evaluation fee by
credit card, you must complete the Province of Prince Edward Island
Request to Pay by Credit Card Over the Phone Form.
PROCESSING TIME:Applications are processed on a first in, first
out basis. Please
allow three (3) weeks from the date when all required
documentation has been received by the Office of the Registrar.
INQUIRING ABOUT THE STATUS OF YOURAPPLICATION:If you having
questions concerning the receipt by the Office of
the Registrar of transcripts and/ or other documents or to
inquire about the status of your application, you are kindly asked
to contact the Office of the Registrar via e-mail at:
[email protected] In the subject line of your email please write
Status Update Requested. In the body of your e-mail clearly
identify yourself, the nature of your application and your
inquiry.
OBTAINING ASSISTANCE:Other inquiries may be directed to the
Registrars Administrative Assistant by calling (902) 438-4130.
FOR FURTHER INFORMATIONWhen seeking information on teacher
certification in general,
on applying for substitute teacher authorizations and on
obtaining recognition for teaching experience outside of Prince
Edward Island please visit the Certification and Standards web site
found at:
http://www.gov.pe.ca/go/reghttps://www.princeedwardisland.ca/sites/default/files/forms/statement_of_professional_standing_0.pdfhttps://www.princeedwardisland.ca/sites/default/files/forms/payment_form.pdfhttps://www.princeedwardisland.ca/sites/default/files/forms/eelc_evaluation_of_teaching_exp_2016.pdfhttps://www.princeedwardisland.ca/sites/default/files/forms/eelc_alliedworkexp_eval_2015.pdfhttps://www.princeedwardisland.ca/en/information/education-early-learning-and-culture/teacher-certification
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Application Form for an Academic Teacher's Certificatefor
applicants who completed their Teacher Education Program Outside of
Canada
1. REQUIRED DOCUMENTATION Please indicate the documents you are
enclosing (Enclosed) with this application form, thedocuments which
you have requested (Requested) to be sent on your behalf and any
documentation which is not applicable to your application
(N/A).
Enclosed Requested N/A
1. Proof of Identity such as a copy of your birth
certificate
2. Proof of eligibility to accept employment in Canada such as a
copy ofyour social insurance card
3. Copy of a Criminal Background Check current to within three
(3) monthsof the date of submission of the application.
4. Copy of a Vulnerable Sector Screen current to within three
(3) monthsof the date of submission of the application.
5. Proof of completion of all post-Secondary studies in the form
of officialtranscripts sent directly from the relevant
post-secondary institution(s)
6.Proof of completion of a recognized pre-service teacher
educationprogram in the form an official transcript of marks from
the universitywhere you completed this program
7. Proof of your authorization to teach in the jurisdiction in
which youcompleted your teacher education program in the form of a
copy of yourteaching certificate even if you never taught there
8. Proof of professional teaching status from the jurisdiction
where youcompleted your teacher education program in the form of an
officialStatement of Professional Standing sent directly to the
Office of theRegistrar from the regulatory body even if you never
taught there
9. Proof of certification form all jurisdictions where you
taught and/ orwere certified to teach outside of the jurisdiction
where you completedyour teacher education program in the form of a
copy of the relevantteachers certificate even if you never taught
there
10. Proof of Professional Status such as a Statement of
ProfessionalStanding from ALL other jurisdictions where you have
taught and /or havebeen certified to teach even if you never taught
there
11. $175.00 evaluation fee in the form of a cheque or money
order madeout to the Minister of Finance, by credit card or in cash
in person.
2. IDENTIFICATION
First Name Middle Name Surname*
Date of Birth Place of Birth
Social Insurance Number:
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*If you were educated or previously certified in a name other
than that used above please indicate your former name below. Also,
please provide copies ofdocumentation to support this legal name
change such as a copy of your Marriage Certificate, Divorce
Certificate, Certification of Name Change, Court Order
Other Name:
Describe the document you are providing to support the name
change:
3. CONTACT INFORMATION
MAILING ADDRESS:
Street, P.O. Box:
Community, Town, City: Province, State:
Country: Postal Code:
Telephone Number: E-mail Address:
4. EDUCATION
HIGH SCHOOL EDUCATION
Name and Address of High School:
Grade Completed Year Completed
POST SECONDARY EDUCATION Official transcripts are required for
ALL post secondary study that youcompleted. Official Transcripts
must be sent directly to the Office of the Registrar at the
aboveaddress from the Post-Secondary Institution.
TEACHER EDUCATION PROGRAM Indicate here the program that you
completed that is recognized forTeacher Certification in the
jurisdiction where it is offered.
Name and Address of Post Secondary Institution Where You
Completed YourPre-Service Teacher Education Program:
Name of Credential Achieved:
Dates Attended: From: To:
OTHER Indicate here degrees, diplomas, certificates, course work
completed etc.
Name and Address of Post Secondary Institution Name of
Credential Achieved:
Dates Attended: From: To:
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Name and Address of Post Secondary Institution: Name of
Credential Achieved:
Dates Attended: From: To:
Name and Address of Post Secondary Institution: Name of
Credential Achieved:
Dates Attended: From: To:
Include additional studies on separate sheet.
LANGUAGE OF
INSTRUCTION
Primary Secondary Post-Secondary Post Secondary Post
English English English English
French French French French
Other Other Other Other
5. PREVIOUS TEACHING EXPERIENCE Please include name of school(s)
and school board(s)/ district (s) whereyou taught, number of years.
To receive credit for out-of-province experience see below.*
Name and Address of School: Name and Address of School
District
From: To:
Name and Address of School: Name and Address of School
District:
From: To:
Name and Address of School: Name and Address of School
District:
From: To:
*To obtain service recognition for your previous teaching
experience outside of Prince Edward Island, you must applyusing the
application form found on the web site at:
http://www.gov.pe.ca/forms/pdf/1916.pdf
6. EMPLOYMENT IN PRINCE EDWARD ISLAND
APPLYING TO PEI SCHOOL BOARDS Indicate to which employer you
wish to have your certification information sent.
Public Schools Branch Commission scolaire de langue franaise
Department of Education Other
APPLYING TO SUBSTITUTE TEACH Holders of a valid PEI Teachers
Certificate are eligible to
substitute teach in PEI public schools. Please indicate if you
wish to receive a Verification of Eligibility as a Substitute
Teacher.
Yes, please issue a Verification of Eligibility as a Substitute
Teacher No, I do not wish to be issued a Verification of
Eligibility as a Substitute Teacher
If yes, please indicate the school board (s) where you would
like your Authorization to Substitute for aTeacher to be sent.
Public Schools Branch Commission scolaire de langue franaise
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7. PERSONAL BACKGROUND DISCLOSURE QUESTIONS All questions in
this section must be answeredunless otherwise indicated. For every
affirmative answer (yes), please attach a written explanation on
aseparate piece of paper referencing the question number
1. Have you ever been convicted, given an absolute or
conditional discharge, or received a pardon for acriminal offence
or are there any outstanding charges against you?
9Yes 9 No
2. Have you ever had an application for a teachers certificate
in any other jurisdiction rejected?
9Yes 9 No
3. Have you ever been found guilty of misconduct by a teaching
authority or other educationalorganization?
9Yes 9 No
4. Have you ever, for any reason other than non-payment of fees
had a teachers certificate suspendedor revoked in another
jurisdiction?
9Yes 9 No
5. Have you ever had an application for an Authorization to
Substitute for a Teacher suspended orrevoked?
9Yes 9 No
Submission of an application that is misleading or false, in
whole or in part, may lead to the denial ofcertification.
DECLARATION
Under Section 98 of the Education Act, the Registrar may refuse
or suspend a teacher's license to a person who misrepresents his or
her qualifications in an application for a teachers license or who
fails to possess the qualifications required under the Act at the
time the teachers license was issued.I declare that all information
given on this application is true, correct and complete to the best
of my knowledge and I hereby authorize the Department of Education,
Early Learning and Culture to verify the above information. I
accept responsibility for advising the Department of Education,
Early Learning and Culture for advising, in writing, of any change
to the information contained in the Personal Background Information
section.
Signature Date
Personal information on this form is col lected under sect ions
98 and 100 of the Education Act R.S.P.E. I . 1988, Cap. E-02 and wi
l l be used for the purpose of ver i fy ing identity and educat
ional credentia ls . I f you have any quest ions about this col
lect ion of personal information, you may contact the Off ice of
the Registrar , Cert i f icat ion and Standards Sect ion,
Department of Educat ion, Ear ly Learning and Culture, Holman
Centre Suite 101, 250 Water Street , Summerside, PEI C1N 1B6
Telephone 902-438-4130
ndesrosiersText BoxRESET FORM
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Name: Describe the document you are providing to support the name
change: 3 CONTACT INFORMATION MAILING ADDRESS Street PO Box:
Community Town City: Province State: Country: Postal Code:
Telephone NumberRow1: Email AddressRow1: Name and Address of Post
Secondary Institution Where You Completed Your PreService Teacher
Education Program: Name of Credential Achieved: Dates Attended From
To: Name and Address of Post Secondary Institution: Name of
Credential Achieved_2: Dates Attended From To_2: Name and Address
of Post Secondary Institution_2: Name of Credential Achieved_3:
Dates Attended From To_3: Name and Address of Post Secondary
Institution_3: Name of Credential Achieved_4: Dates Attended From
To_4: Other_2: Name and Address of School: From: To: Name and
Address of School_2: Name and Address of School District_2: From_2:
To_2: Name and Address of School_3: Name and Address of School
District_3: From_3: To_3: Signature: Date: Check Box2: Check Box3:
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Box55: Check Box56: Text57: Check Box58: Check Box59: Check Box60:
Text61: Name and Address of School District: Other_5: Check Box62:
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Check Box73: Check Box74: Check Box75: Check Box76: Check Box77:
Check Box78: Check Box79: Text80: Text4: REQUEST TO PAY BY CREDIT
CARD OVER THE PHONE Text6: APPLICATION FOR A STATEMENT OF
PROFESSIONAL STANDING Text8: APPLICATION FOR SERVICE
RECOGNITIONText10: APPLICATION FOR ALLIED WORK EXPERIENCE
RECOGNITIONText12: REQUEST TO PAY BY CREDIT CARD OVER THE PHONE
FORMText14: TEACHER CERTIFICATION AND STANDARDS WEB SITE