Attestation of LESS Than 3 Years of Acceptable Classroom ...

The University of the State of New York THE STATE EDUCATION DEPARTMENT

Office of Teaching Initiatives 89 Washington Avenue Albany, New York 12234

highered.tcert

Attestation of LESS Than 3 Years of Acceptable Classroom Teaching Experience for the Initial Reissuance

(as required per Commissioner's Regulations Part 80-1.8)

Requirements for Initial Reissuance of a certificate include 75 clock hours of acceptable professional development and/ or 50 clock hours of acceptable continuing teacher and leader education (CTLE), a satisfactory level of performance on the New York State Teacher Certification Examination content specialty test(s) in the area required for the certificate sought, and LESS than 3 full school years of acceptable classroom teaching experience.

Submit this form when you have applied and paid for the certificate in TEACH, passed the required examination(s) and submitted the required PD/CTLE. If you submit this form too early, you may be requested to complete a new one. This requirement will not be marked as "met" on your Initial Reissuance application until all other requirements for certification have been satisfied. You may submit this form by email to tcert@ with the subject line of Attestation of less than 3 years exp., or you may mail to the address listed above.

Section I:

First

Last

Middle

Name:

Name:

Initial:

Last 4 Digits of your

Date of Birth: ___ / ___ / ___

Social Security Number: ___________________

Initial Reissuance certificate title(s) you are completing this form for:

Section II: Attestation I confirm that I have LESS than 3 years of acceptable classroom teaching experience.

Signature: Date:

Please note, applicants who have already completed 3 or more years of acceptable classroom teaching experience, ( ), are not eligible to receive an initial reissuance. The following link contains detailed information concerning the requirements for Professional certification:

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