Application For Wyoming Certification Of Teachers, Administrators, And Other Personnel (Page 3 of 8) in pdf

APPLICATION FOR WYOMING CERTIFICATION OF TEACHERS,

ADMINISTRATORS, AND OTHER PERSONNEL

Complete Section B of this form. Send this page to the Dean of the Department of Education of the college where you

completed the teacher and administration preparation program for which this application is made. Instruct the Dean to

return the completed page directly to you. An Institutional Recommendation must be obtained for every

endorsement area requested. Education Administration and School Counselor require both teaching and administration

Institutional Recommendations. Please make copies as needed.

Section B. To be completed by applicant. Please print or type.

Social Security Number: _________-________-_________ Date of Birth:____________________________

Name____________________________________________________________________________________

Last

First

Middle

Former

College and/or University Courses. Please list all colleges and universities at which courses toward degrees and or

certification programs were completed. Note: Official transcript(s) must accompany your application for each

entry that you list below. All transcripts must bear the registrar's seal. Transcripts that are marked "Issued to

Student" will be accepted, if official. Attach separate sheet if necessary.

Name of College or University and State Years Attended

Degree Earned and Year

Major Fields

________________________________ ____________

___________________

______________

________________________________ ____________

___________________

______________

________________________________ ____________

___________________

______________

Section C. Institutional Recommendation. To be completed by College/University. Please print or type.

To the Dean: Please complete this section and return the page to the applicant.

The applicant's major certification area is in the field of________________________________________________

(example: Elementary Education, Social Studies, Principal, School Nurse)

This applicant's grade level specialization is _________________________________________________________

(example: Early Childhood, K-6, Elementary, Middle, Secondary, K-12)

This certifies that the above-named applicant has successfully completed this institution's state-approved program for the

preparation of educational personnel, is in good standing, and has the knowledge and competencies essential for

education service. Please affix your college seal; application cannot be processed without seal.

Is this person eligible to hold a standard certificate or license in your state? Yes_____ No_____ If not, please indicate

any remaining requirements:

____________________________________________________________________________________________

Name______________________________________________ Title_____________________________________

Signature___________________________________________ Date_____________________________________

Dean or Designated Officer

College or University___________________________________________________________________________

Institution Which is State Approved and Regionally Accredited

(SEAL)

To the Dean:

If applicant is not eligible for institutional recommendation, please do not sign Section C. Please return this form to the applicant,

with an explanatory statement. Additionally, if you know of any reason that this applicant should not teach in Wyoming schools, please send a

statement of the reason on a separate sheet to the WPTSB, 2300 Capitol Ave., Hathaway Bldg 2nd floor, Cheyenne, WY 82002.

Application For Wyoming Certification Of Teachers, Administrators, And Other Personnel Page 3

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