CERTIFICATION UPDATE APPLICATION PACKET ... - Teach …

Application Type - CU

CERTIFICATION UPDATE APPLICATION PACKET INSTRUCTIONS

Dear Applicant: By completing the Certification Update Application you can request name changes, degree additions, higher certificates, reinstatements, renewals, and evaluations for additional endorsements. Upon receipt of the completed forms and appropriate processing fee as noted below, a certification case will be opened in the Louisiana Teacher Certification Management System (TCMS) which is trackable online. If additional information is needed or feedback is provided, that information can be viewed online by checking the Status of a Certification Application here. Hard copy evaluations will be provided via U.S. mail or email using the address of the applicant or the address of the school system if the application was signed by the system's authorized signatory.

Changing Name

(Use Pages 4 & 5)

To request a change of name on a certificate, submit a completed application (pages 4 and 5), a copy of a marriage license or document of legal name change, and the required $25 certification processing fee.

Adding a Degree(s)

(Use Pages 4 & 5)

To request the addition of a degree(s) to a certificate, submit a completed application (pages 4 and 5) and an official transcript. When adding a +30 endorsement, excess graduate credits earned in the master's degree program should be verified by the dean of the graduate school of the appropriate university. A $25 certification processing fee is required.

Requesting a Higher Certificate*

(Use Pages 4, 5, & 6)

*Requests for higher level certificates are required to be submitted directly from Louisiana employing school system.

To request a higher level certificate, the Louisiana employing school system will submit an official transcript (when applicable) and completed application (pages 4, 5 and 6). A $25 certification processing fee is required for Level 2 or 3, and a $50 fee is required for the Level 1.

Teachers with a Type C or Level 1 certificate are required to complete three years of successful teaching experience in their certified area and have three years of successful final evaluation ratings as verified through the Compass Information System (CIS) to be issued a Level 2 certificate.

Teachers with a Type C, Level 1 or Level 2 certificate are eligible for a Level 3 certificate if they hold a master's degree, teach for five years in the certified area, and have three successful years of final evaluation ratings out of five verified through CIS. To request a higher level certificate, the employing authority will submit an official transcript (when applicable) and completed application (pages 4, 5 and 6). A $25 certification processing fee is required.

Teachers with an OS certificate are eligible for a Level 1 certificate if they have met the Praxis requirements or Praxis exclusion requirements. Praxis exclusion requires that you have at least three years of successful teaching experience in another state, as verified by your employing system; and one year of teaching on the OS in a Louisiana approved public or an approved private school system. To request a Level 1, submit a completed application (pages 4, 5 and 6). A $50 certification processing fee is required.

1

Reinstatement of Certificate**

(Use Pages 4, 5, & 6)

**Requests for certification reinstatement can only be submitted directly from

Louisiana employing school system.

Type A, B, A*, and B* certificates are considered lapsed when an educator permits a period of five or more consecutive calendar years of disuse to accrue. To request reinstatement, the Louisiana employing school system would request the full reinstatement once the educator has earned six semester hours of credit from a regionally accredited university/college. The credit must be earned within the five year period immediately preceding reinstatement of the certificate. The employing school system may request a one-year reactivation of the certificate while the educator completes the coursework related to the certification area(s). A $25 certification processing fee is required.

Reinstatement coursework is not required for lapsed Type C, Level 1, 2, or 3 certificates since these educators are required to be evaluated for effectiveness via Compass for renewal of the certificates, and would only need the Louisiana employing school system to request an extension of the certificate to permit time for the educator to be evaluated. A $25 certification processing fee is required.

Renewing Certificates***

(Use Pages 4, 5, & 6)

***Requests for certification renewal must be submitted directly from Louisiana

employing school system.

To request a higher level certificate, the Louisiana employing school system will submit an official transcript (when applicable) and completed application (pages 4, 5 and 6). A $25 certification processing fee is required.

? Type C and Level 1 are valid for three years initially and may be extended thereafter for a period of one year at the request of a Louisiana employing school system. Level 1 certificates are limited to two such extensions.

? Level 2 or Level 3 m ay be extended with by successfully meeting the standards of effectiveness verified in the Compass Information System (CIS) for at least three of the five years covered by the certificate, pursuant to Bulletin 130 and R.S. 17:3902.

? Louisiana employing school systems may request a one-time three year renewal of a Level 1 certificate or a one-time five year renewal of the Level 2 or 3 certificate if the holder was unable to successfully meet the standards of effectiveness due to administrative error in the local implementation of the evaluation system any year prior to the 2015-2016 school year.

? Level 2* or 3* certificates issued to individuals in nonpublic schools and will be extended with completion of 150 Continuing Learning Units (CLU). Documentation of the CLUs is maintained by the educator and employing nonpublic school system. Verification of the CLUs is recorded on the CLU page of this application packet (page 7).

Evaluation and/or Addition of Teaching Endorsements

(Use Pages 4, 5, & 6)

To request an evaluation and/or to add teaching endorsements to a teaching certificate, teachers must

submit official transcripts if not already submitted to the certification office, PRAXIS scores (if applicable),

and a completed application (pages 4, 5, & 6). A $25.00 certification processing fee is required. You are

authorized two evaluations/add-ons per $25.00 fee submitted. If you are uncertain as to the name of a

specific certification area offered in Louisiana, please refer to Bulletin 746.

Status Change - Non-Practicing/Freezing Certification Validity

(Use Pages 4 & 5)

Certification renewal is contingent upon effective teacher/leader evaluations. A teacher/leader must

be employed within a Louisiana school system, in a role evaluated via Compass, in order to renew

certification. If a teacher/leader is no longer serving in a Louisiana school system or is serving in a

2

role which is not evaluated via Compass, the certificate will need to be placed into non-practicing

status, preserving or freezing the validity on the certificate, so that when/if the educator returns to a role where evaluated, validity will remain on the certificate. Effective date for non-practicing status should be indicated on the application and the date should be within the validity of the current certificate. No processing fee is required.

Teachers/leaders returning to service in Louisiana or returning to a role evaluated via Compass may

apply through their employing Louisiana school system for an extension of their certificate for the

number of days remaining in the renewal period of the certificate. A $25 certification processing fee is required.

Certification/Examination Verification

(Use Pages 4 & 5)

To request certification or examination verification, by way of completing a form or providing a letter, the

educator must submit a completed application (pages 4 & 5) and include any documents that need to be

completed by the Louisiana Department of Education. A $10.00 processing fee is required.

Submitting Application

Refer to transaction type(s) above to determine which pages of the application to submit.

Please submit a complete application packet (including required documentation) through the online educator certification portal. The following items are required as part of a complete application packet:

Certification Update Application form with all information provided

Official transcripts (if applicable and/or if not already submitted to the certification office)

Copy of marriage license (if applicable)

PRAXIS Exam(s) (if applicable) - Options for submitting exam score(s) to the Louisiana Department of Education are as follows:

1. Scores can be electronically sent to the LDOE from Educational Testing Services, or 2. Score reports from Educational Testing Services can be submitted with your application packet.

Experience Verification form or letter signed by the appropriate employing authority verifying teaching experience (if applicable)

Professional Conduct form with all questions answered, signed, and dated by the applicant

Supplemental Documentation (if applicable) ? forms or documents which need to be completed for verification by the Louisiana Department of Education (e.g. other state's documents used to verify certification or Praxis exams)

Copy of Online Payment Confirmation for Certification Processing Fee

Non-refundable certification processing fee appropriate to the requests you are submitting; please refer to instructions above or to the payment schedule here.

Certification fee is payable to the LDOE online at

Contact Information: All questions regarding certification requirements or the process, can be answered by contacting the certification staff through the online educator certification portal.

All applications will be evaluated in the order in which they are received. You can check the status of your certification application online HERE.

3

CERTIFICATION UPDATE APPLICATION

PLEASE TYPE OR PRINT IN INK

Social Security Number ______ - ______ - ______

Date of Birth _________________________

Name of Applicant:_____________________________________________________________________

(First)

(Middle)

(Maiden)

(Married)

Address: _____________________________________________________________________________

(Street)

(City)

(State)

(Zip Code)

Phone: Home: (____) __________ Work: (____)___________ Email Address:_______________________ LA Certificate Type/Number: ____________ Online Payment Confirmation # ________________________

Name Change: (name to be added or deleted) (Adding married name, attach a copy of marriage license, birth certificate or court document showing

name change; no documentation is needed for deleting of married name(s).)

Married Name to be added or deleted:

My name should read on my certificate as follows:

Addition of Degree(s): (Enclose official transcripts with your packet.)

Master's Degree

Master's Plus 30 Graduate Hours

Specialist Degree

Doctorate Degree

Evaluate or Add the following endorsement(s): (Endorsements should be listed as they officially appear in Bulletin 746.)

Higher Level Certificate: (Applications for higher certificates MUST BE signed and sent by the Louisiana employing school system. If employed in a nonpublic,

private, or diocesan school, use the Nonpublic Higher Application. If request is for Educational Leader certification, use the Educational Leader application.)

Level 1

Level 2

Level 3

Type A

Reinstatement of Certificate: (Applications for higher certificates MUST BE signed and sent by the Louisiana employing school system.)

Reinstatement of certificate due to 5-year break in teaching/service. Applicant must show evidence of six semester hours of coursework completed within the past five year period when there has been a five year break.

Reactivate standard certificate for one year while completing the required coursework for full reinstatement.

Renewal of Certificate: (For educator who has not been out of teaching for a five year period. Application for renewal must be signed and sent by the Louisiana

employing school system.).

Renew Type C or Level 1

Renew Level 2 or Level 3

Renew Level 2* or 3* (include CLU page)

Status Request Change: (Returning to practice request requires the signature of the Louisiana employing school system.)

Louisiana Certificate Type/Number (specify which certificate or certificates):

Non-practicing Status (Freeze)

Effective Date:

Reason:

Return to Practicing Status (Unfreeze) Effective Date:

Reason:

Certification/Examination Verification:

Copy or Verification of Exams

Verification of Certification (Enclose additional instructions, explaining your request if a verification letter

is needed with specific details.)

I agree that my electronic signature as entered below is the legal equivalent of my manual signature on this application.

Signature of Applicant: ________________________________________________ Date: _____________

Louisiana Employing School System: ________________________________________________________

Signature of Authorized LA Employing School System:

Date: _____________

4

PLEASE TYPE OR PRINT IN INK

PROFESSIONAL CONDUCT FORM

(All questions must be answered)

NAME OF APPLICANT: (Include First, Middle, Maiden, and Married) ADDRESS:

Social Security Number:

______ - ______ -______

DATE OF BIRTH:

Each Question must be answered:

Please Check YES NO

1. Have you ever had any professional license/certificate denied, suspended, revoked, or voluntarily surrendered? If YES, in which state?____________________________

2. Are you currently being reviewed or investigated for purposes of such action as stated in #1 or is such action pending? If YES, in which state?_____________________________

3. Have you ever been convicted of any felony offense, been found guilty or entered a plea of nolo contendere (no contest), even if adjudication was withheld?

If yes, please provide the following information:

Date of Conviction: ____________________

State of Conviction: _____ Court Jurisdiction of Conviction: __________________

4. Have you ever been convicted of a misdemeanor offense that involves any of the following: a. Sexual or physical abuse of a minor child or other illegal conduct with a minor child. b. The possession, use, or distribution of any illegal drug as defined by Louisiana or federal law.

5. Have you ever been granted a pardon or expungement* for any offense as stated in #3 or #4?

NOTICE---EXPUNGEMENTS, FIRST OFFENDER PARDONS, PRE-TRIAL DIVERSIONS: Criminal Background Checks (CBCs) conducted for purposes of employment will be conducted in accordance with La. R.S. 17:15 and La. R.S. 15:587.1. Pursuant to Louisiana law R.S. 15:587.1., background checks shall disclose ALL ARRESTS, COURT ACTION and CONVICTIONS, (Including but not limited to expungements, first offender pardons and pre-trial diversion), and a copy of the report shall be provided to the Louisiana Department of Education (LDE), in addition to the potential employer or LA Education Agency (LEAs)s.

*Per BESE policy set forth in Bulletin 746, Louisiana Standards for State Certification of School Personnel, Section 903.C, "failure to disclose actions such as first offender pardons, pre-trial diversion, expungements, etc. is grounds for certification denial and/or revocation."

If you answered "YES" to any questions, #1 through #5, you must provide court certified copies of all documents and proceedings, civil records of Federal, State and/or District School Board actions, or other relevant documents that provide full disclosure of the nature and circumstances of EACH separate incident in your application packet.

I affirm and declare that all information given by me in the responses to items #1 through #5 above is true, correct, and complete to the best of my knowledge. I understand that any misrepresentation of facts, by omission or addition, may result in criminal prosecution and/or the denial or revocation of my teacher certificate. I agree that my electronic signature as entered below is the legal equivalent of my manual signature on this document.

SIGNATURE OF APPLICANT:

DATE:

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download