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Verification Of Occupational Experience For Career And Technical Education (Cte) Certificates - Arizona Department Of Education

ARIZONA DEPARTMENT OF EDUCATION-CERTIFICATION UNIT

Mailing Address: P.O. Box 6490, Phoenix, AZ 85005-6490 • Telephone: (602) 542-4367

Verification of Occupational Experience for Career and Technical Education (CTE) Certificates

GENERAL INFORMATION

 This form is used by an employer or school district superintendent to verify occupational work experience to

meet the requirements for a CTE teaching certificate.

 CTE certification applicants may not verify their own work experience. All sections of this form must be

completed by the applicant’s current or former supervisor, or a district superintendent. Applicants who

were self-employed may have work experience verified by an accountant, attorney, or business partner.

Educator ID or Social Security Number of CTE Applicant:

This is to verify that

(Name of Applicant - please print)

Was employed by:

(Business name)

Dates of employment:

Total hours of employment:

Position(s) held:

Applicant’s job title:

Applicant’s job duties:

I certify the above information to be true and correct.

Signature

Date

Title

Contact Phone

Mailing Address

Revised 8-24-2016

Verification Of Occupational Experience For Career And Technical Education (Cte) Certificates - Arizona Department Of Education