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Verification Form for Consistently High Performing Teachers
Submit this form at time of license application for exemption from
next license cycle
Educators who meet the State Board of Education definition of consistently high performing teacher as
outlined below are exempt from the requirement to complete any additional coursework or continuing
education units for the renewal of a professional educator license for the next renewal cycle.
Name: State ID:
Submission Date:
Building/Assignment:
Type of Certificate/License:
Issue Date:
Expiration Date:
Initial Eligibility Requirements (must meet both of the following criteria):
Hold at least a five-year professional teaching license; AND
Receive the highest final summative rating on evaluations for at least four of the past five years during
the current licensure cycle.
School Year
1
st
Year
2
nd
Year
3
rd
Year
4
th
Year
5
th
Year
Final
Summative
Rating
Approved by Beavercreek City
Schools LPDC June 2017, Page 1
Final Eligibility Requirements (Must also meet at least one of the following additional criteria for at
least three of the last five years during the current licensure cycle):
Hold a valid Senior or Lead Professional Educator License (attach a copy);
Serve in a leadership role for a national or state professional academic education organization (attach a
copy of verification);
Serve on a state-level committee supporting education (attach a copy);
Receive state or national education recognition or award (attach a copy).
Hold a locally recognized teacher leadership role that enhances educational practices by providing
professional learning experiences at district, regional, state or higher educational level;
Leadership Role
Admin. Signature
Teacher Signature
Year 1
Year 2
Year 3
*By signing this you are in agreement that the leadership role listed meets the criteria listed above.
Certification that the eligibility criteria have been met:
Teacher/Educator Signature: _______________________________________ Date: _____________
LPDC Rep. Signature: ____________________________________________ Date: ______________
Administrator Signature: __________________________________________ Date: ______________
Potential Locally Recognized Leadership Roles for Consistently High Performing Teachers
Definition presented by ODE: Held a locally recognized teacher leadership role that enhances educational
practices by providing professional learning experiences at a district, regional, state, or higher educational
level.
● Department Chair with a supplemental contract
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Schools LPDC June 2017, Page 2
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● Lead professional development – at least two per school year
● Official Mentor
● Cooperating teacher – Field placement for more than 8 weeks
(Optional)
Teacher Reflection:
In what ways does this position enhance educational practices by providing professional learning
experiences at a district, regional, state, or higher educational level?
Consistently High Performing Teacher Information
An educator who meets the State Board of Education's definition of consistently high-performing teacher
is exempt from the requirement to complete any additional coursework for the renewal of a professional
educator license for the next renewal cycle.
Eligibility criteria for 5-year Professional, Senior or Lead Licenses:
During the current licensure cycle, a consistently high-performing teacher has:
1. Received the highest final summative rating on evaluation, as defined by Revised Code sections
3319.111 and 3319.112 where applicable for at least four of the past five years.
And
2. Met at least one of the following additional criteria for at least three of the past five years
a. Held a valid senior or lead professional educator license:
b. Held a locally recognized teacher leadership role that enhances educational practices by providing
professional learning experiences at a district, regional, state or higher educational level;
c. Served in a leadership role for a national or state professional academic education organization;
d. Served on a state-level committee supporting education; or
e. Received state or national educational recognition or award.
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Guidelines items:
Approved by Beavercreek City
Schools LPDC June 2017, Page 3
● Teachers renew license with 180 hours (6 semester hours) but could also complete the attached form to
be exempt from collecting 180 hours for the future renewal license. The form has to be submitted in
advance of the renewal since this has to be recorded in CORE.
● Leadership activity list to help determine locally recognized teacher leadership roles.
● Only teacher licenses can be renewed through this method. If a person holds more than a teacher
license, they must still collect 180 hour for non-teaching licenses.
● Final Summative Rating is based on eTpes ratings. Teachers who are on off-cycle evaluations carry
forward their last final rating.
Approved by Beavercreek City
Schools LPDC June 2017, Page 4
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