Application for Michigan Substitute Teacher Permit

APPLICATION FOR MICHIGAN SUBSTITUTE TEACHER PERMIT

The Michigan Department of Education issues four types of permits to meet different school staffing needs when a properly certified and endorsed teacher is not available. Permits are granted to an employing school or school district. They are not portable between schools and are not held by an individual However, if a Daily Substitute Permit is applied for by the GOISD , it will cover all schools

within the ISD .

( * = Required ) * First Name:

Middle Name:

* Last Name:

Suffix

* SSN: * Gender: * Ethnicity: * Date of Birth: * Country: * Address Line 1:

Address Line 2:

* City: * State/Province: * Zip/Postal Code:

* Primary Phone:

Secondary Phone:

* Email:

r Check this box if you have ever been in the U.S. Armed Forces

r Check this box if you are presently in the National Guard/Reserves

Education History (LIST ALL DEGREES EARNED)

College/University Attended

Degree

Vear Completed

Signature of Ap plicant_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Dat e_ _ _ _ _ _ _ _ _ _ __

It is the policy of the Gogebic-Ontonagon Intermediate School District that no person shall, on the basis of race, color, national origin, sex (including sexual orientation and transgender identity) , disability, age, height, weight, marital or family status, religion, military status, ancestry, genetic information or any other legally protected category, (collectively, "Protected Classes"), be subjected to discrimination in its programs and activities, including employment opportunities.

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