Request for Change/Action
Division of School Effectiveness
Office of Educator Services
8301 Parklane Road
Columbia, SC 29223
http://ed.sc.gov | web
(803)896-0368 | fax
licensure@ed.sc.gov | email
To initiate action, please complete and submit this form along with supporting documentation to above address. Not all requests will result in correspondence being sent.
Please utilize the Educator Licensure section of our website (http://ed.sc.gov) to check the status of your request(s).
Requests may be submitted by mail, fax, email, or hand-delivery to the contacts listed above. Transcripts must be official; opened or faxed transcripts will be marked
“unofficial”. Our office may be able to accept electronic transcripts from acceptable companies; please contact our office for more information.
Please print clearly or type the following information:
SSN: - - and/or License ID Number:
Last Name: __________________________ First Name: _____________________ MI: ___ Former Name: ____________
Address: ________________________________________ City: _______________________ State: ____ Zip: __________
Email: _____________________________________ Home Phone: (____)___________ Work Phone: (____)____________
Employing School District (if applicable): __________________________________________________________________
Change my name and/or address as listed above. I am currently applying for/participating in alternative licensure.
Please indicate the nature of your request in the area below:
1. Alternative Licensure: Evaluate my file for the following licensure area(s)____________________________________________.
2. Evaluate my file for the license area __________________________________________________________ and add if applicable.
3. Evaluate and/or advance my license to the:
Bachelor’s +18 level Master’s level Master’s +30 level | Area: ______________________ Doctorate level.
4. Add a one–year extension to my professional license for the 20_____/20_____ school year.
5. Add additional years of experience. (Utilize the Verification of Teaching Experience form.)
Apply experience from _____________________________ for add-on purposes.
6. Renew my professional license. All required documentation has been submitted or is enclosed.
7. Send me an official copy of my current license. The $10.00 fee (check or money order only) is enclosed.
8. Approve the attached course/program from _________________________ for the purpose of _________________________.
(Attach a detailed course/program description from the college or university.)
9. Other: __________________________________________________________________________________________________
__________________________________________________________________________________________________
Signature: _________________________________________________________ Date: ____________________
Effective Date of Credential
If the State Department of Education (SCDE) receives the 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 SDE.
Status of requests can be confirmed from the Educator Licensure website. An official copy of the educator license will be provided only when an educator qualifies for
a South Carolina license for the first time. All subsequent changes, additions or modifications to a license may be confirmed and printed by the educator from the
View Licensure Status page on our secure website at http://ed.sc.gov.
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