Request for Change/Action
Office of Educator Services
8301 Parklane Road
Columbia, SC 29223
http://ed.sc.gov/educators/certification
(803)896-0368 | fax
certification@ed.sc.gov | email
To initiate action, please complete and submit this form along with supporting documentation to the above address. Requests may be submitted
by mail, fax, email, or hand-delivery. Transcripts must be official; opened or faxed transcripts will be marked “unofficial”.
Not all requests will result in correspondence being sent. An official copy of the educator certificate will be provided only when an educator
qualifies for a South Carolina certificate for the first time. All subsequent changes, additions or modifications to a certificate may be confirmed
and printed by the educator from the View Certification Status page on our secure website at http://ed.sc.gov/educators/certification.
Please print clearly or type the following information:
Last Four Digits of SSN:
and/or Complete Certificate ID Number:
Please indicate all options that apply to your request
1. Update contact information as provided
2.
Official transcripts/certificates from __________________________________ have been:
Doctoral
level
A
dvance certificate
to
the:
MA level MA+30 level |
Area: _____________
Class level advancement
Initial c
ertification
7
.
Add
additional years
of
experience
(
Submit
the
Verification of Teaching Experience form)
8
.
Send an official copy of my current certificate. The $10.00 fee (check or money order only) is enclosed.
Renewal
Adding the area/endorsement __________________
6
.
Add a one-year extension to my professional
certificate for the 20___/20___ school year
3.
Pre-approve
the
attached course/program
f
rom ___________________________________ for the purpose of
:
9
.
Other: __________________________________________________________________________________________
By signing below, I acknowledge that I have read and understand the provided information concerning the effective date of
my credential and authorize the SCDE to initiate the actions indicated.
Signature: _______________________________________________________ Date: ____________________
Effective dates of credential changes are established in State Board of Education Regulation 43-53 Credential Classification. If the Office of
Educator Services receives an educator’s request and all required documentation between
May 1 and November 1: The
change in status, if approved, will be effective July
1
of
the
same
calendar year.
November 2 and April 30: If the educator submitted the request
within 45 days of fulfilling the requirements, the
change in status, if approved, will be effective on the date that all requirements were satisfied.
November 2 and April 30: If the educator submitted the request more than 45
days after fulfilling the requirements, the change in
status, if approved, will be effective on the date that all information was received by the SCDE.
Ordered
Submitted
Last Name: __________________________ First Name: _____________________ MI: ___ Former Name: ____________
Address: ________________________________________ City: _______________________ State: ____ Zip: __________
Email: _____________________________________ Home Phone: (____)___________ Work Phone: (____)____________
Update name based on submitted verification of a legal change of name
BA+18 level
4.
Determine remaining requirements for ____________________________
Advance certification if eligible
5
.
Evaluate my Initial certificate for advancement to the:
Professional certificate
Limited Professional certificate
Please submit a formal letter detailing your request if additional space is needed.
2
A
.
2
B.
2
C.
Add the certification area/endorsement _______________________________________________
Renew my professional certificate
click to sign
signature
click to edit
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