Credential Application for Single Subject - California State University

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Credential Application for Single Subject - California State University Powered By Docstoc

1.   Congratulations on the completion of your program! Your next step is to apply for your credential.
     Applications are available online under your specific program at
     Return all completed application forms along with any additional items not previously submitted

     evaluation and processing. It is advised that you make copies of your documents prior to submitting
     for your file (refer to checklist with the online application) to the Credentials Office or by mail for

     them to our office.

2.   You will need a personal, permanent email address that will be valid for a minimum of one year. An
     email address from a school district will not be accepted. These internet providers have spam
     blockers that prohibit CTC from corresponding with you. If necessary, create a new email address through
     Gmail, Yahoo or Hotmail. Please make sure your email address is legible.

3.   The Credential Office will review documents, verify eligibility, and recommend for the credential
     using the online Commission on Teacher Credentialing (CTC) processing system. Applications will

     weeks before your application is processed. Requests submitted with coursework in progress will be
     be processed in the order in which they are received. Depending upon volume, it may take several

     partially processed, then held. Processing will be completed at the end of the quarter when grades have
     been posted and all components of the program have been met. If additional documentation is required,
     you will be notified via email by the Credential Office.

4.   Once the Credential Office has submitted the online recommendation, you will be notified, by
     email, from CTC, to complete the online portion of the application including the ‘Personal and

     processing system requires a credit card to complete this step. After making the online payment, an
     Professional Fitness’ questionnaire and payment portion of the process. Please note that the CTC

     email will be sent to you with a confirmation number. This payment confirmation email may be used to
     verify your recommendation status with an employer.

     Provided that there are no extenuating circumstances, CTC will send you an e-mail confirming that the
     credential has been issued and instructions on how to obtain a copy. The Commission no longer prints or
     provides an official copy of your document. You are advised to save all confirmation emails until
     your credential has been posted to the CTC website

     For general questions regarding the application process please contact us at:
     661/654-2110 (Bakersfield Campus) or 661/952-5080 (Antelope Valley Campus).

                                               **CTC Fee Restoration **
          Effective July 1, 2012, Credential application fees for new and renewal documents will be $70.00. All
                  online transactions are subject to a $2.00 service fee in addition to the application fee.
   Multiple/Single Subject Credential Application Checklist

     Eligibility for the Preliminary SB 2042 Multiple or Single Subject Credential
                          requires verification of the following:

    Bachelor’s Degree from a regionally-accredited college or university: copy of official

    Passage of CSET or appropriate Subject Matter Waiver signed by the Department Chair of your

     teaching. Please be advised that we cannot process your application prior to the grades being
    Successful completion of all teacher preparation program coursework, including student

     posted on your CSUB transcript.

    CBEST: copy of official scores.

    U.S. Constitution: Course (copy of official transcripts) or exam (copy of certificate).

    CTAP Level I computer technology: course or equivalent certification.

    Passage of the four CalTPA tasks.

    Completion of a current CPR certification, covering “Infant, Child & Adult”. Attach a front and
     back Xerox copy of your current CPR card that meets the criteria of the American Heart
     Association or the American Red Cross.

    Valid Certificate of Clearance, Emergency/Sub. Permit or Intern Credential: posted on the
     CTC website.

    RICA: required for Multiple Subject Students only: copy of official passing scores.

    Verification of CSU Exit Survey. Attach a copy of survey completion page.

Verification of these items may already be on file. If you are uncertain what is in your file, please
contact your Evaluator.

Multiple/Single Subject: Jayme Barton, 661/654-3075 or
Bakersfield Campus:

Eric Anderson 661/952-5083 or
Antelope Valley Campus:
                                 California State University, Bakersfield
                                          School of Social Sciences and Education
              Credential Application for On-line Recommendation
                                                           Please type or print clearly
Social Security #:                  -             -             CSUB ID:                                    Date of Birth:       /       /
Full Legal Name as you would like it to appear on your credential document:
First:__________________________ Middle: _________________ Last: ______________________________
All Former/Maiden Name(s):
Mailing Address:
City:                                             State:            Zip:             Ethnicity:                                 Gender:
Contact Information: Primary (                    )                                 Secondary (                 )
E-Mail Address:
                                                                  (School district emails are not acceptable)

Please Select Type of Credential applying for:
   Preliminary:                                     Internship:                                           Added Authorizations:
         SB2042 Multiple Subject                                SB2042 Multiple Subject                      Multiple Subject to an existing
         SB2042 Single Subject                                  SB2042 Single Subject                         Single Subject Credential
              Subject Area:                                     Education Specialist
                                                                  o Mild/Moderate Disabilities
                                                                                                             Single Subject to an existing
         Education Specialist                                     o Moderate/Severe Disabilities                Multiple Subject Credential
                 o Mild/Moderate Disabilities                   Administrative Services                     Subject Areas:
                 o Moderate/Severe Disabilities                 Pupil Personnel Services
         Administrative Services
                                                                                                             Supplementary Authorization
                                                     Certificate of Eligibility
   Professional Clear:                                                                                     Subject Areas:
                                                                Administrative Services
         Education Specialist
                 o Mild/Moderate Disabilities        Pupil Personnel Service                                Subject Matter Authorization
                 o Moderate/Severe Disabilities
                                                                School Counseling                           Subject Areas:
         Administrative Services
         Pupil Personnel Service
                 o School Counseling

I authorize CSU, Bakersfield’s School of Social Sciences and Education to forward my credential application and materials via the online
submission process to the Commission on Teacher Credentialing for issuance of the credential I have requested. I certify that the information I have
submitted is true and correct.

Signature:                                                                                            Date:
Return completed applications to the Credentials Office - Bakersfield Campus: Education Bldg. Room 102, Antelope Valley
Campus: Teacher Education Dept. Bldg. 300 or by mail to the address below. Due to confidentiality of information, applications
cannot be faxed or emailed.

Bakersfield: California State University, Bakersfield                             Antelope Valley: California State University, Bakersfield/AV
             School of Social Sciences and Education                                               Teacher Education Dept.
             22 EDUC                                                                               32 AVC
             9001 Stockdale Highway                                                                43909 30th Street West
             Bakersfield, CA 93311-1022                                                            Lancaster, CA 93536                  1/13 sp
                                CREDENTIAL SERVICES REQUEST
California State University, Bakersfield charges a fee for all credential services. You are required to pay a non-
refundable fee of $30.00 for all credential applications. Please take this form along with your fee to the
Cashier’s Office. Submit the verification of payment along with your application to the Credentials Office If
you are submitting your application materials by mail, please include a cashier’s check or money order made
payable to CSUB.

CSUB ID#:                                                                   Date:

                   First                                Middle                          Last

City                                                                            State          Zip


Phone:         (           )                                     (          )
                                     Home                                                      Cell

Credential applying for:

Note: This $30.00 credential service fee does not include the application processing fee required by the
      Commission on Teacher Credentialing.

Bakersfield: California State University, Bakersfield                Antelope Valley: California State University, Bakersfield/AV
             School of Social Sciences and Education                                  Teacher Education Dept.
             22 EDUC                                                                  32 AVC
             9001 Stockdale Highway                                                   43909 30th Street West
             Bakersfield, CA 93311-1022                                               Lancaster, CA 93536                  1/13 sp

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