APPLICATION FOR CERTIFICATION AND
GRADUATION
Education Division
Complete the following information. Review all of the following with your advisor. When both
you and your advisor have signed the form, verifying all information, submit the form to the
Division Office, 153 Biddle.
1. Name
2. Student ID#_____________________________
3. Program
(List each program for which you are seeking certification)
4. Minor (if applicable)
5. Advisor
6. Term you will Graduate
7. Permanent Address
8. Permanent Phone
9. Will you complete your program upon receiving passing grades in student
teaching and the student teaching seminar? Yes____ No____
If you answered no to #9, describe in the space below the requirements you
will need to complete after the student teaching term and when these
requirements will be fulfilled?
10. Have you verified that you have or will meet all program requirements
indicated on your Degree Progress Report? Do not submit this application
until you can
answer yes to this question and your advisor has reviewed your
audit with you.
Yes____ No____
11. Will you be submitting your online application to TIMS - Pennsylvania
Department of Education which includes your physician’s health certificate
form with signature and a payment (approx. $100.00). Print your TIMS Cover
Sheet and submit a copy to the Division.
Yes ____ No____
12. Place a check mark in the appropriate block to indicate how you have
completed or will complete each of the certification test requirements (e.g.
PAPA, PECT, PRAXIS)
CERTIFICATION TESTS
PASSED PRIOR TO
STUDENTTEACHING
TAKING DURING
STUDENT TEACHING
INDICATE DATE
BELOW
WILL TAKE AFTER
STUDENT TEACHING
INDICATE DATE
BELOW
Content Area Test (or Areas)
13. At the end of this term the Chairperson of the Education Division will prepare
a letter for you verifying to prospective employers that you are eligible for PA
Teacher certification if you meet all of the following state and division
requirements:
x You have completed all program requirements at the end of this term
including successfully completing student teaching and earning a
qualifying score on your professional portfolio
x You are eligible for graduation at the end of this term
x You have passed all required certification tests
x You must submit a copy of your test scores, student teaching time report
and this application to the Division office by the last day of student
teaching.
If you meet these requirements, a letter will be mailed to you approximately
one week following your final day of student teaching. Please do not ask for
this letter prior to this date. This letter may allow you to teach in
Pennsylvania, at the discretion of the employer.
Please be advised that the Chair of the Education Division, by state directive,
cannot write a letter if you have not passed all required certification tests. You may
speak with the Registrar if you would like verification that you are eligible for
graduation, but this will not make you eligible for teaching.
Applicant's Signature _____________________________Date _______________
Advisor’s Signature _______________________________Date _______________
ED-14, September, 2012
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