Jim and Judy Watson COE Student Services
Credential Processing (CE 102)
5500 University Parkway
San Bernardino, CA 92407-2393
Website: credentials.csusb.edu
Telephone#: (909) 537-7401
INSTRUCTIONS FOR THE APPLICATION FOR CREDENTIAL
RECOMMENDATION MULTIPLE SUBJECT SB 2042 (PRELIMINARY)
The submission of the Application for Credential Recommendation (includes all required documentation) initiates a program evaluation and the formal
credential recommendation by a Credential Analyst to the Commission on Teacher Credentialing (C.T.C.). Complete applications may be submitted via
email to credrec@csusb.edu at the beginning of the last term of program coursework and after all of the program requirements have been
successfully completed. Please note that all candidates must be officially and unconditionally admitted to the University and to the appropriate credential
program (includes separate admission to the Bilingual Added Authorization) in order to be formally recommended for the credential by CSUSB.
The recommended credential issuance date will be the official program completion date (includes coursework, CPR, and/or examination(s), if applicable) -OR-
if three months have passed since the official program completion date, the recommended credential issuance date will be the date the completed application
was officially accepted by Credential Processing.
The results of the program evaluation will be sent to the e-mail address provided on the Application for Credential Recommendation within approximately 10 –
15 business days from the submission date of the complete application. Applications with coursework-in-progress will not be formally recommended to
C.T.C. until 2 - 4 weeks after CSUSB grades have been posted.
REQUIRED DOCUMENTATION
It is the applicant’s responsibility to verify that all credential requirements are successfully completed and that all required documentation is at the Jim and
Judy Watson, College of Education Student Services prior to or at the time of submission of the Application for Credential Recommendation.
APPLICATION FOR CREDENTIAL RECOMMENDATION: All applicants must complete sections 1, 2, and 3 (signature required). Incomplete
applications and forms will be returned to the applicant for completion and resubmission.
PROCESSING FEE: All applicants are required to submit confirmation of payment of the *$25 CSUSB non-refundable processing fee. Please see the Fee
Receipt for processing fee payment instructions.
BASIC SKILLS REQUIREMENT: All applicants must have submitted verification of successful completion of the Basic Skills Requirement to the Jim and
Judy Watson COE Student Services.
SUBJECT MATTER COMPETENCE: All applicants must have submitted verification of successful completion of Subject Matter Competence to the Jim
and Judy Watson COE Student Services.
**RICA: All applicants that have taken and passed the Reading Instruction Competence Assessment (RICA) examination, are required to submit verification
of successful completion via a valid official copy of the Electronic Score Report (unique bar code required).
**TEACHER PERFORMANCE ASSESSMENT: All applicants that have taken and passed the CalTPA, are required to submit verification of successful
passage via the official copy of the electronic CalTPA Cycle Performance Summary Score Report (unique bar code required).
CPR CERTIFICATION: All applicants are required to submit verification of a current and valid (on-line CPR training is not acceptable) CPR certification
card that includes Infant, Child & Adult CPR training. The certification card needs to include the month, day and year of completion.
U.S. CONSTITUTION: All applicants are required to submit official verification of successful completion (C- or better) of a college-level course or
examination covering the United States Constitution completed at a regionally accredited college or university.
COLLEGE/UNIVERSITY TRANSCRIPTS: All applicants that have completed any of the program coursework at another institution are required
to submit the updated original official transcript(s) and verification of the approved equivalency via a Request for Course Substitution or program
plan approved and signed by the Program Coordinator.
PROGRAM PLAN: All applicants are required to have a current Program Plan completed and signed by the Program Coordinator. NOTE: Bilingual Added
Authorization candidates are required to have a Program Plan reflecting the Bilingual Added Authorization course of study completed and signed by the
Bilingual Program Coordinator.
CERTIFICATE OF CLEARANCE: All applicants are required to have a valid Certificate of Clearance or California credential/permit recorded with C.T.C.
Applicants who have not held a valid Certificate of Clearance or California credential/permit for more than 18 months must submit a copy of a recently
completed Request for Live Scan Service (Form 41-LS) with the credential application.
PROGRAM VERIFICATION LETTER: Bilingual Added Authorization applicants are required to submit a Program Verification Letter completed and
signed by the Bilingual Program Coordinator verifying the successful completion of program and exit interview in order to be eligible for the Preliminary
credential recommendation.
*Fee subject to change.
**Executive Order N-66-20 and Assembly Bill 130 allows a candidate to defer completion of the RICA and/or CalTPA for eligibility of the Clear credential however, the candidate
will need to demonstrate they meet the deferment criteria. Complete the Assessment Deferment Statements form, if applicable.
MSAppPrelim 11-21
Jim and Judy Watson COE Student Services
Credential Processing (CE 102)
5500 University Parkway
San Bernardino, CA 92407-2393
Website: credentials.csusb.edu
Telephone #: (909) 537-7401
APPLICATION FOR CREDENTIAL RECOMMENDATION
It is the applicant’s responsibility to verify that all credential requirements are successfully completed and that all required
documentation is on file at the Jim and Judy Watson College of Education Student Services Office prior to or at the time of
Application for the Credential Recommendation. NOTE: To complete this form, download and/or print this pdf document.
1. PERSONAL IN
FORMATION
Student Identification Number: __________________________________________
Applicant’s Name: ____________________________________________________________________________________
First Middle Last
All Former/Maiden Name(s): ____________________________________________________________________________
Address: ____________________________________________________________________________________________
Number and Street City State Zip Code
Home/Cell Phone: _________________________________ Work Phone: __________________________________
Email Address (MyCoyote or Personal): ___________________________________________________________________
Applicant
’s signature: ____________________________________________________ Date: __________________________
App4CredRec 06-20
2. CREDENTIAL INFORMATION
CREDENTIAL TYPE (select one): __________________________________________________________________________________
CREDENTIAL TERM (select one): __
P
_______
RELIMINARY
________________________________________________________________________
SUBJECT AREA (select one, if applicable): ___
N
_
/A
______________________________________________________________________
ADDED AUTHORIZATION (select one, if applicable): __
N
__
/A
____________________________________________________________ Have
you passed the RICA examination (select one)? ___________________________________________________________________ Have you
completed the CalTPA cycles 1 and 2 (select one)? _____________________________________________________________
List all CSUSB program coursework for which you are currently enrolled, if applicable (Example: EDUC 603, EDUC 631):
______________________________________________________________________________________________________________
3. TRANSCRIPT AUTHORIZATION, DECLARATION AND DATE
I, the aforementioned, authorize Credential Processing to order and/or submit my transcript(s), if applicable to the Commission on
Teacher Credentialing (C.T.C.). I understand that with the submission of the application, I am required to follow through with
C.T.C.’s online application no later than 90 days after the credential recommendation date. Non-compliance will result in having
to reprocess an Application for Credential Recommendation with the appropriate fees. I hereby certify under penalty of perjury
that all the required documentation and foregoing information submitted for this applicable is true and correct.
SELECT ONE
SELET ONE
SELECT ONE
click to sign
signature
click to edit
1. PERSONAL INFORMATION
Student Identification Number: ________________________ Credential Program: ________________________________
Applicant's Name: _____________________________________________________________________
2. ASSESSMENT DEFERMENT
Reading Instruction Competence Assessment (RICA):
___ I certify that I was unable to complete the RICA due to COVID-19 related testing center closures.
___ I understand by deferring completion of the RICA for eligibility of the Preliminary credential, I will be required to provide
proof of passage of the RICA for eligibility of the Clear credential.
California Teaching Performance Assessment (CalTPA):
___ I certify that I meet the following four (4) requirements in order to defer passage of the CalTPA:
o I was placed or employed in a local education agency impacted by school site closure related to COVID-19.
o I was in the process of completing the CalTPA.
o I was unable to complete the CalTPA due solely to school closures.
o I completed my teacher preparation program (within the 2019 - 2020, 2020 - 2021 or 2021 - 2022 academic year) and
all other Preliminary teaching credential requirements for eligibility of the Preliminary credential.
Please note that the Credential Analyst will be verifying with the appropriate Program Coordinator as to whether or
not the applicant does meet the CalTPA deferment requirements.
___ I understand by deferring completion of the CalTPA for eligibility of the Preliminary credential, I will be required to
provide proof of passage of the CalTPA for eligibility of the Clear credential.
Applicant's Signature: ________________________________________________ Date: _______________________
ADS 11-21
Jim and Judy Watson COE Student Services
Credential Processing (CE 102)
5500 University Parkway
San Bernardino, CA 92407-2393
Website: credentials.csusb.edu
Telephone #: (909) 537-7401
ASSESSMENT DEFERMENT STATEMENTS
Assembly Bill 130 extended the deferment option for both the Reading Instruction Competence Assessment (RICA) and California
Teaching Performance Assessment (CalTPA) if the applicant met the eligibility criteria. All applicants electing to defer passage of
either the RICA and/or CalTPA will be required to complete sections 1 and 2 (initial next to each statement). NOTE: If electing to defer
both assessments, please be sure to initial all four statements.
NOTE: Candidate must provide written documentation with their application verifying closure of the testing center.
Select One
click to sign
signature
click to edit
Jim and Judy Watson C
OE Student Services
Credential Processing (CE 102)
5500 University Parkway
San Bernardino, CA 92407-2393
Website: credentials.csusb.edu
Telephone#: (909) 537-7401
FEE RECEIPT INSTRUCTIONS
All applicants are required to pay the $25 non-refundable processing fee via one of the methods below.
NOTE: Confirmation of the payment must be submitted with the Application for Credential Recommendation.
IN PERSON
Pay in-person at Student Financial Services (UH-35) with payment (cash, check, money order, traveler's check, cashier's
check or pin-based ATM accepted). Due to the current COVID-19 situation, the pay in-person option is not
available.
ON-LINE (MyCoyote Account)
Pay on-line via your MyCoyote account with an electronic check or credit card (American Express, Discover, MasterCard
or VISA accepted) following these steps:
Sign in to your MyCoyote account via the CSUSB Home page at http://www.csusb.edu/
Select Student Center
Select Make a Payment under the Finances Section
Read Statement and Select Next
Select Make Payment (top menu)
Select College of Education Student Services (right menu)
Select Credential Service Fee
Manually enter fee amount (refer to the application/request instructions for the required processing fee)
Select Add to Basket
Checkout and make your payment
ON-LINE (Without MyCoyote Account)
Pay on-line via Campus eMarket (available for applicants that do not have a valid MyCoyote account) with an electronic
check or credit card (American Express, Discover, MasterCard or VISA accepted) following these steps:
Go to the Campus eMarket page at https://commerce.cashnet.com/eCampus
Select College of Education Student Services
Enter the required information
Check the appropriate box (refer to the application/request instructions for the required processing fee)
Select Add to Basket
Checkout and make your payment
FRPM 06-20