Application For Educator'S License - Arkansas Department Of Education Page 2
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1
2PLAF
This portion is to be completed by Arkansas institutional officials only, not by the applicant.
PROGRAM OF STUDIES VERIFICATION FOR PROVISIONAL/STANDARD LICENSURE
This verifies that
has satisfactorily completed the requirements for
Provisional NTL/TFA/Teacher Corps
Provisional NTL/MAT/MED/MTLL
licensure in ___________________________________________
Provisional
Area(s) and Level(s) of Licensure
(Missing AR. History or Testing)
Standard
Standard U-Teach
Standard NTL-MAT/MED/MTLL
This applicant has completed the professional development required for initial licensure
.
OR
PROGRAM OF STUDIES VERIFICATION FOR ADDING AREAS OF LICENSURE
This verifies that
has satisfactorily completed
Program of study
Degree requirements
Required PRAXIS Assessment
Internship
Portfolio
for adding the additional area(s) of
Area(s) and Level(s) of Licensure
_______________________
Institution
Date
Institution Licensure Officer
COLLEGE SEAL
FOR DEPARTMENT USE ONLY
TYPE
HIGHEST DEGREE
LOWEST DEGREE
YEAR __________________________________
___________ DEGREE CODE
___________ DEGREE CODE
TYPE _________________________________
STATE CODE
STATE CODE
Effective Date
__________________________
Expiration Date
________________________
___________ ARKANSAS COLLEGE /
__________ ARKANSAS COLLEGE /
UNIVERSITY CODE
UNIVERSITY CODE
Area and/or Level of Licensure
09/02/2015
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Parent category: Education