attach documents/information previously submitted.
I am seeking the Sheltered Instruction Qualification through the following Option Select Only One (1):
Option 1: Completion of Six (6) college credits in TESOL-related foundational EL knowledge from an accredited college or
university or program. Attach official transcript (copies acceptable).
Option 2: Completion of two (2) three (3) credit HIDOE-sponsored ESL or TESOL PDE3 courses.
PDE3 Course Name:___________________________________________ Section # & date completed: _______________
PDE3 Course Name:___________________________________________ Section # & date completed: _______________
Option 3: Completion of seventy-two (72) seat hours of TESOL-related HIDOE non-credit PD workshops or courses.
If workshop(s) or course(s) were taken for Audit credit(s), complete the Verification of Audit Credit for Sheltered Instruction
Professional Development Seat Hours
.
If additional space is required, please attach a separate sheet
Option 4: Out-of-state TESOL endorsement earned from another state. Attach Endorsement.
Option 5: TESOL HQ or TESOL licensure status in lieu of 6 credits. You do not need to submit additional information if you
have a TESOL HQ or License.
If you need to submit documentation to meet this requirement, please refer to the
HQ
Documentation Coversheet
, document 2a in the ESSA Hawaii Qualified Teacher Handbook.
Option 6: Microcredentials in TESOL. Attach your eight (8) stacks of the National Education Association ELL
Micro-credential.
Option 7: Combination of Options 1 and 2 above: Completion of Three (3) college credits in TESOL-related foundational EL
knowledge from an accredited college or university or program, attach official transcript
and
Completion of One (1) three (3)
credit HIDOE-sponsored ESL or TESOL PDE3 courses, provide course information:
PDE3 Course Name:___________________________________________ Section # & date completed: _______________
By typing my name below, I certify that the above information is accurately reported to the best of my knowledge. Any
misrepresentation or falsification of information on this form may result in sanctions including termination from employment or
disciplinary action.
