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APPLICATION FORMS AND FEES
GENERAL CERTIFICATION APPLICATION INFORMATION
FORMS
The following forms are in Adobe Acrobat PDF format.
Please read all instructions completely.
Pursuant to Connecticut General Statutes Section 10-221d, the State Board of Education must complete a criminal history records check on each applicant for an initial issuance or renewal of a certificate, authorization or permit. Each applicant seeking an initial issuance or renewal of a certificate, authorization or permit must also submit to a records check of the Department of Children and Families’ child abuse and neglect registry established pursuant to Connecticut General Statutes Section 17a-101k. Periodically, the State Board of Education is required to submit the database of all persons who hold any certificate, authorization or permit for follow-up records checks.
For Individual Use
- ED 125 Statement of Preparing Higher Education Institution [PDF, 70KB]
- ED 126 Statement of Professional Experience [PDF, 59KB]
- ED 170A Short Form Application for Connecticut Initial Educator Certificate [PDF, 120KB]
- ED 170 General Application for Certificate [PDF, 231KB]
- ED 172A Application for Initial Educator Certificate for Holders of Temporary 90-Day Certificates [PDF, 130KB]
- ED 176A Application to Convert Standard or Permanent Certificate [PDF, 134KB]
- ED 179 Application for Continuation of Professional Educator Certificate [PDF, 242KB]
- ED 183 Application for Renewal of Connecticut Initial Educator Certificate [PDF, 138KB]
- ED 184 Application to Remove Course Work Deficiency And/Or Assessment Deferral [PDF, 79KB]
- ED 185 Application For Five-Year Renewable Coaching Permit [PDF, 107KB]
- ED 187 Request for Duplicate Certificate [PDF, 84KB]
- ED 192 Application for Connecticut Academic Assessment Waiver [PDF, 436KB]
For District Use
- ED 172 Application for Temporary 90-Day Certificate [PDF, 100KB]
- ED 173 Application for Temporary Authorization for a Minor Assignment [PDF, 96KB]
- ED 173A Application for Extension of Early Childhood Endorsement (Grades N-3) to Elementary (Grades K-6) [PDF, 96KB]
- ED 174 Application For Substitute Teacher Authorization For Candidates Who Have Not Completed A Bachelor’s Degree [PDF, 329KB]
- ED 175 Application for Extension of Substitute Teacher Authorization Beyond the 40-Day Limit [PDF, 96KB]
- ED 177 Application for Durational Shortage Area Permit (DSAP) [PDF, 76KB]
Note: Under NCLB, districts must ensure that all appropriate testing has been successfully completed prior to application for DSAP.
- ED 186 Application for Temporary Emergency Coaching Permit [PDF, 100KB]
- ED 188 Application for Nonrenewable Adult Educator Authorization [PDF, 89KB]
- ED198 Adjunct Arts Instructor Permit [PDF, 636KB]
- ED199 Application for Resident Educator Certificate [PDF, 322KB]
Notes:
- Additional documentation or fees may be required to complete the application.
- Completed forms must be returned via postal mail and contain authentic signatures. Photocopies will not be accepted.
- Do NOT return the form via e-mail or fax.
If you require further information or have a technical question regarding this site, contact us
Content Last Modified on 10/26/2012 2:28:13 PM
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