UNIVERSITY/COLLEGE LICENSURE RECOMMENDATION
Application Document
This form must be completed and signed by an authorized officer at a Utah University/College to recommend a candidate,
who has an existing Utah Professional Educator Teaching License, for an additional license area and/or endorsement.
Check/money order payable to U.S.O.E.
License Area: $55 (fee includes copy of license)
Endorsement: $35 (fee does not include copy of license)
APPLICANT INFORMATION
Name: Last
First
Middle
Date of Birth
Mailing Address:
City
State
Zip
CACTUS I.D.:
Phone Number:
Email Address:
LICENSE AREA(S) ENDORSEMENT (if applicable)
Praxis Reports (s): If the Praxis score is not posted in CACTUS, please attach a copy of the report.
DEGREES (list any new degree)
University:
State:
Date Awarded:
Degree:
Maj
or:
This certifies that the applicant has completed the requirements in the approved program for
this license area and/or endorsement and that all information submitted in accurate:
Printed Name of Officer/Title
Date
This document with original signature and fee must be mailed in together.
Mail to:
University Recommendations
Utah State Office of Education
Educator Licensing
250 East 500 South
P O Box 144200
Salt Lake City, UT 84114-4200