Nj Highly Qualified Teacher Statement Of Assurance

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Assurance
Statement
FORM G
NJ Highly Qualified Teacher Statement of Assurance
Teacher’s Name: ____________________________________________________________________
School Building: __________________________________County LEA Code:__________________
Certification(s) Held:
I I
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Elementary Education
Teacher of the Handicapped
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Middle (Content Area(s): ______________________________)
Teacher of the Blind/VI
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Secondary (Content Area(s): ____________________________)
Teacher of the Deaf/HH
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K-12 (Content Area(s): ________________________________)
Teacher of ESL
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Emergency Certified (Not eligible to become Highly Qualified)
1. According to the attached New Jersey Highly Qualified Teacher Identification Form(s),
I have satisfied the federal definition of a Highly Qualified Teacher for the certificate(s) I hold in
the following content area(s). (Check all that apply):
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Elementary Generalist (full-day, all subjects)
Science
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Social Studies (Economics, History, Civics, Geography)
Mathematics
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Language Arts Literacy (English, Reading, Language Arts)
World Languages
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Visual and Performing Arts
2. According to the attached New Jersey HOUSE Standard: Content Knowledge Matrix Form(s),
I have satisfied the definition of a Highly Qualified Teacher for the certificate(s) I hold in the
following content area(s). (Check all that apply):
I I
I I
Elementary Generalist (full-day, all subjects)
Science
I I
I I
Social Studies (Economics, History, Civics, Geography)
Mathematics
I I
I I
Language Arts Literacy (English, Reading, Language Arts)
World Languages
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Visual and Performing Arts
3. According to the attached New Jersey HOUSE Standard: Content Knowledge Matrix Form(s),
I DO NOT YET satisfy the definition of a Highly Qualified Teacher for the certificate(s) I hold in
the following content area(s). (Check all that apply):
I I
I I
Elementary Generalist (full-day, all subjects)
Science
I I
I I
Social Studies (Economics, History, Civics, Geography)
Mathematics
I I
I I
Language Arts Literacy (English, Reading, Language Arts)
World Languages
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Visual and Performing Arts
I assure that the information presented on this and all attached forms is complete and accurate.
____________________________________
________________________________
____________________
Signature of Teacher
Signature of School Official
Date
37
The New Jersey Model for Identifying Highly Qualified Teachers

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