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CONTRACT FOR PREPA RI NG TO BE A TEACHE R Note: PPS students ask fo r the Counseling Contract Last Name

First Name

cell #



SSN DOB Program: PLEASE FILL OUT THE ABO VE AND BRING THIS FORM WITH THE MATERIALS LISTED BELOW TO THE CREDENTIAL ANALYST in Room 101D e-mail (619) 260-4821 fax 849-8138 #1, 2 and 3 MUST BE COMPLETED BEFORE APPLYING FOR STUDENT TEACHING or PPS fieldwork You wil l not be cleared f or student teaching or PPS f ieldwork placement if this f orm is not reviewed and signed by you and the Credential Analys t. To be initialed by Credential Analyst:

Preparation #1 Cert if ica t e of Clearan ce Obtain certificate of clearance application packet from the Student Services Center. Complete livescan AND apply for clearance through CTC. Submit verification to Credential Analyst. Preparation #2 Basic Skills Require m e n t (CBES T or equi va le n t ) Submit copy of passing verification to the Credential Analyst. Preparation #3 Subje ct Matt er Co mpet ence /CSE T Exa ms f or teaching credent ia ls Submit copy of CSET passing results to the Credential Analyst. To register for the exams visit OR complete an approved examination waiver program form with an education faculty advisor - submit a copy to the Credential Analyst. Not required for Early Childhood Education Specialist

Date of ve r if i ca tio n of abo ve to Of f ice of Fie ld E xp erien ces: Preparation #4 On line Technology course e-mail verification (not required for PPS/special ed.) Preparation #5 O f f i cia l transcripts Submit transcripts for every college or university attended. These transcripts are in addition to the transcripts submitted to USD for admission. Transcripts will be checked for: BA Degree co mp le t ed or in progress U.S . Const it ut io n f or teach in g credent ia ls: Political Science 125 or History 117 at USD or equivalent course or exam Preparation #6 English Lingu ist ics Course f o r teaching credent ia ls Complete English 318E or Ed 558XB through USD Continuing Education. If using Continuing Education course 558XB submit official sealed transcript. Preparation #7 CPR (Multiple and Single Subject only) Submit copy of infant child and adult CPR certification valid upon completion of credential program Preparation #8 GPA Complete all credential/education coursework with grade of B or better and appropriate overall GPA Preparation #9 RICA (Multiple Subject, Mild/Moderate and Moderate/Severe only) Take the Reading Instruction Competency Exam (RICA) as soon as the Teaching of Reading course (Ed 383P/583P) has been completed and submit copy of passing verification to Credential Analyst. To register visit

Bilin gua l Emphasis : submit language and culture exams to Credential Office I have received a copy of the Credential Handbook

Student Signature

Date of Meeting

Credential Analyst Signature Date 2009 MRH Room 101D e-mail (619) 260-4821 fax 849-8138

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