Verification Of Highly Qualified Status Page 2

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Form OS-HQ Instructions
Note: Completion of this form is not mandatory. However, effective July 1, 2006, all individuals
teaching core academic subjects must be “highly qualified” based on criteria defined in the federal No
Child Left Behind legislation. The information requested on this form can be used in making the
determination regarding your “highly qualified” status and may be a critical factor in determining your
eligibility for employment.
 Fill in your complete personal information in the boxes above the broken line.
 Send the form to the certification/licensure office in the Department of Education of the state in
which you are a fully licensed and highly qualified teacher.
 The certification/licensure office in that state must complete the information below the broken line
and return the form to you. Do not ask them to submit the form directly to the NC Licensure
Section. It must be returned to you so that you can include it in your NC licensure
application packet.
 Upon receipt of the completed form, please include it in your initial application packet for NC
teacher licensure and submit the entire packet to the address indicated in the packet instruction.
 Note: If you are a newly hired teacher in a NC school system, you may submit this form, along
with your complete application packet to the personnel office of your school system. That office
will include their Verification of Employment form and submit your packet to the Licensure
Section for processing.

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