Certification Forms

Teacher

• 4020E -Program Completion Verification 
• 4020E-1-Alternative Program Completion Verification
• 4020F-1-Experience Verification
• 4020G-Issues of Abuse Course Verification
• 4024-First Peoples' Language, Culture, and Oral Traditions Application
• 4030-Foreign Trained Teacher Recommendation
• 4050E-Teacher Program Enrollment Verification

Career & Technical Educator

• 4020G-Issues of Abuse Course Verification 
• 4076F-CTE Continuing Teaching/Coordination of Experience Verification
• 4074E-CTE Director Program Completion Verification 
• 4075E-College/University Route Program Completion Verification
• 4075E-1-College/University Route Conditional Program Enrollment Verification 
• 4075G-Business and Industry Route Program Completion Verification
• 4075G-1-Business and Industry Route Conditional Program Enrollment Verification
• 4075H-Teaching Experience Verification
• 4075S-Specific Safety Documentation Verification 
• 4075V-Non-Teaching Experience Verification
• 4075W-Worksite Learning Course Completion Verification

Administrator

• 4001D-Continuing Principal Certificate Verification of Hours
• 4001E-Administrator Program Completion Verification
• 4001F-Principal Prerequisite Experience Verification
• 4001R-Residency Administrator Reissuance Application
• 4020F-1-Experience Verification

Educational Staff Associate

• 4020F-1-Experience Verification
• 4020G-Issues of Abuse Course Verification
• 4020S-Suicide Prevention Training Verification
• 4025E-1-ESA Master's Degree Program Enrollment Verification
• 4026E-1-ESA Program Enrollment Verification
• 4098E-Psychologist and Counselor Program Completion Verification
• 4099E-Other ESA Roles Program Completion Verification

Paraeducator

• 1128-10-Paraeducator Fundamental Course of Study (FCS) Verification
• 1128-11-Paraeducator Subject Matter Coursework Verification

Clock Hour In-Service 

• 1125-General Clock Hour In-Service Registration
• 1125-E-STEM, Equity, and Leadership Clock Hour In-Service Registration
  • Form 1125 and 1125-E is given only to the approved clock hour provider for distribution and is not available via our website. Providers should contact the Professional Educator Standards Board or Professional Certification Department to obtain the form. 
• 1126-Approved Professional Certificate Program Team Member
• 1126-1-Professional Growth Team Member
• 1128-1-Mentor and Field Experience Supervisor of Training
• 1128-2-National Board Assessment/Certification
  • Additional National Board Forms
• 1128-4-First Peoples' Language, Culture, or Oral Tribal
• 1128-5-ProTeach Portfolio External Assessment
• 1128-6-Teacher Performance Assessment Scorer
• 1128-7-ProTeach Assessment Scorer
• 1128-8-Annual Professional Growth Plan (PGP) Verification
• 1128-9-School Accreditation Site Team
• 1128-12-Professional Educator Advisory Board Member
• 1128-13-Educator Preparation Program Review Team Member

Military Personnel

• 4020H-Active Duty Military Service Verification