Credential Application Form

This form is to be used by all candidates enrolled in credential preparation programs at the Kalmanovitz School of Education (KSOE). Additional information regarding the credential process can also be found through the Credential Office website.

ACKNOWLEDGMENT

Candidates should only use this form after they have completed and submitted all requirements of the program.

First Name

Middle Initial

Last Name

SMC ID Number

Date of Birth

Please provide month, day and year. Example format: 00/00/0000

Personal Email

Type of Credential

If Single Subject, specify subject area

Informational Text

Acknowledgement

By submitting this document I am indicating that I have met the following requirements and I am ready for the Credential Analyst to begin reviewing my credential application for submission to the CTC:

I have met all KSOE program requirements.
The above email and phone number will be valid for 90 days.
I understand that I must pay for my credential on the CTC website within 90 days of receiving my CTC recommendation email.
I have confirmed that my CTC account has accurate and current contact information for me ()

I have read and agree to the statement above.

I agree

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Credential Application Form

Acknowledgement