Existing Certificate Request Form
Please complete all items below to assist in completing your request. If you have a portal account, please log on
to access a copy of your certificate. Requests received from educators who have access to the portal will not
be processed. This fillable form can be mailed, faxed or emailed. Incomplete requests will not be processed.
All educator certificates will be emailed to the educator in a PDF format within 5 business days.
Name (as it appears on your certificate):____________________________________
Birth Date: __________________
Last Four Digits of Social Security Number: ______________
Current Address: _____________________________________________________
Daytime telephone number complete with area code: ______________________
Email address: _____________________
I hereby authorize the office of Certification Branch to email my certificate.
Fax: (410) 333-8963
Maryland State Department of Education
Attention: Certification Branch
200 West Baltimore Street, 6th Floor
Baltimore, MD 21201
200 West Baltimore Street • Baltimore, MD 21201 • 410-767-0100 • 410-333-6442 TTY/TDD