Verification for admin licensure 02
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This document is an employment verification form for administrative licensure. It requests information such as the applicant's name, address, date of birth, employment details including dates of service, position title, subjects taught, and percentage of full-time work. An authorized official from the applicant's school district employer must confirm the employment information and sign the form. The bottom section provides licensing requirements for specific administrative licenses, such as a minimum of three years of teaching experience.
Verification for admin licensure 02
- 1. Educator Licensing 1500 Highway 36 West EMPLOYMENT VERIFICATION FOR ED # 02415-02 Roseville, MN 55113-4266 ADMINISTRATIVE LICENSURE Process Number Name Address City State/Province/Region Zip/Postal Code Country Telephone Number Date of Birth School, Employment or Place Where Experience Was Earned Dates of Service (address including city and state) From: To: Grade Subject(s) Taught Position Title if Non-Teaching If not Full-Time, Indicate % of Full-Time I confirm that this information is correct Print name of authorized official Name of school district employer Signature of authorized official Address Title City, State, Zip Code Date Telephone Number Email For superintendent or principal licensure, the applicant must verify three years of full-time, successful teaching experience in a position for which the applicant held a valid teaching license. For local vocational program director licensure, the applicant must verify three years of experience in vocational/career and technical education in Minnesota while holding the appropriate license. Two of the three years must have been spent in teaching or in work experience coordination. One of the three years may have been earned as a licensed Local Vocational Program Supervisor or earned while holding a variance as a Local Vocational Program Director. For director of special education licensure, the applicant must verify two years of full-time or consecutive years of half-time or more special education teaching or special education employment in a position for which the applicant held a valid license for the position. For all administrative license applications, do not include student teaching/practicum experiences or experiences gained while not properly state authorized/licensed for the position. Do not include leaves-of-absence. Feb-04-2008 13:21.16 Page 1 of 1 cel02_Employment_Verif_for_Admin_Licensure/