Instructions For Completing And Submitting The State Of Connecticut Application For Examination Or Employment (Form Ct-Hr-12) (Fillible) (Page 4 of 12) in pdf

Instructions For Completing And Submitting The State Of Connecticut Application For Examination Or Employment (Form Ct-Hr-12) (Fillible) Page 4

PAGE THREE

________________________________________

_______________________ ____

Last Name

First Name

______________________________________________________________________

Examination Title or Position Title

SECTION 5: APPLICANT EDUCATION (continued)

B. College Education

1.) ______________________________________ ______________________ ___

__________

Name of College or University Attended

City

State

Country*

Is this college accredited**? __Yes

__No

Dates of Attendance: From: ___/_____To:___/_____

(MM/YYYY)

Type of degree completed: __Associate

__Bachelor

__Master

__Doctorate

__Law

__None

If ‘None’ please indicate the number of credit hours completed: ____

If a degree was conferred, complete the following information for this college/university:

_____________________________________

________________________________________

Major Course of Study

Major Course of Study (only if double major)

2.) ______________________________________ ______________________ ___

__________

Name of College or University Attended

City

State

Country*

Is this college accredited**? __Yes

__No

Dates of Attendance: From: ___/_____To:___/_____

(MM/YYYY)

Type of degree completed: __Associate

__Bachelor

__Master

__Doctorate

__Law

__None

If ‘None’ please indicate the number of credit hours completed: ____

If a degree was conferred, complete the following information for this college/university:

_____________________________________

________________________________________

Major Course of Study

Major Course of Study (only if double major)

3.) ______________________________________ ______________________ ___

__________

Name of College or University Attended

City

State

Country*

Is this college accredited**? __Yes

__No

Dates of Attendance: From: ___/_____To:___/_____

(MM/YYYY)

Type of degree completed: __Associate

__Bachelor

__Master

__Doctorate

__Law

__None

If ‘None’ please indicate the number of credit hours completed: ____

If a degree was conferred, complete the following information for this college/university:

_____________________________________

________________________________________

Major Course of Study

Major Course of Study (only if double major)

Attach additional sheets (labeled with “Section 5 – continued” and include your name and examination

number/title or position title in upper right corner) if you attended more than three (3) colleges/universities.

* - If the institution of higher learning is located outside of the United States, you are responsible for providing documentation from a recognized USA

accrediting service which specializes in determining foreign education equivalencies. The responsibility for and the costs associated with obtaining this

equivalency information rest with you, the applicant.

** - In order to receive educational credit towards admittance to an examination, the institution must be recognized by the CT Department of Higher

Education as an accredited institution ( ).