REQUEST FOR AUTHORIZATION - North Carolina Department …
REQUEST FOR AUTHORIZATION
OF GRADUATE SALARY
The Licensure Section shall authorize salary on the master’s level (or other appropriate) salary schedule for professional educators who hold master’s degrees or advanced degrees from a regionally accredited IHE.
The regional accrediting agencies are: Middle States Association of Colleges and Schools, New England Association of Schools and Colleges, North Central Association of Colleges and Schools, Northwest Commission on Colleges and Universities, Southern Association of Colleges and Schools, and Western Association of Schools and Colleges.
Please print or type.
last name first name middle name maiden
social security number LEA number school number
salary level requested: _________________________________________________
area of assignment: _________________________________________________
percent of day spent in that assignment: _________________________________
school year for which approval is requested: ____________________________
I certify that this individual’s assignment qualifies him or her for placement on the graduate salary schedule.
superintendent or personnel officer date
email address
Public Schools of North Carolina
Department of Public Instruction
Licensure Section
6365 Mail Service Center Form G
Raleigh, North Carolina 27699-6365 January 2009
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