WASHINGTON STATE CAREER AND TECHNICAL EDUCATION TEACHER RENEWAL AND CONTINUING CERTIFICATE REQUIREMENTS

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1 WASHINGTON STATE CAREER AND TECHNICAL EDUCATION TEACHER RENEWAL AND CONTINUING CERTIFICATE REQUIREMENTS The state of Washington issues the following certificates. Apply for the certificate for which you meet the requirements. INITIAL-RENEWAL CAREER AND TECHNICAL EDUCATION CERTIFICATE: Hold or have held a CTE initial certificate. Must complete 3 quarter credits or 30 clock hours of CTE teacher training. CONTINUING CAREER AND TECHNICAL EDUCATION CERTIFICATE: Hold or have held a CTE initial certificate or CTE Initial-Renewal certificate. Must have 2 years of Career and Technical Education classroom teaching. Must complete 9 quarter credits or 90 clock hours of CTE teacher training Req. (Rev. 9/15)

2 CHECKLIST FOR CTE TEACHER CERTIFICATE IN WASHINGTON Form SPI/CERT 4076A - Application for Initial Renewal or Continuing CTE Teacher Certificate Form SPI/CERT 4076F - Verification of Teaching/Coordination Experience Form SPI/CERT 4076V - Verification of Credit/Clock Hours Fee: $ $39 (OSPI) = $40 SEND YOUR COMPLETE APPLICATION PACKET AND FEE TO OSPI, FISCAL OFFICE, P.O. BOX 47200, OLYMPIA, WA I am enclosing a COMPLETE Washington teacher certification application. Signature Date 4076 App. Inst. (Rev. 9/15)

3 APPLICATION FOR CAREER AND TECHNICAL EDUCATION CERTIFICATE INITIAL RENEWAL OR CONTINUING Date ESD No. Fee $40 Receipt No. CERTIFICATE INFORMATION 1a. CERTIFICATE REQUESTED Teaching 1b. Worksite Learning Coordinator 3-Year (Renewal of Initial) 5-Year (Continuing) 2. PROGRAM AREA OR COURSES 5. OF BIRTH TELEPHONE: ( ) HOME ( ) 8. Have you ever held a Washington teacher, administrator, educational staff associate, or career and technical education certificate? If yes, what was your certificate number? 9. Have you held an educational certificate in another state? If yes, list all such states here. Complete FORM SPI/CERT 4020C if you do not hold a current valid Washington certificate. 8. YES NO 9. YES NO 10. From what regionally accredited college or university did you receive your bachelor s degree? 11. From what college/university did you complete your approved career and technical education teacher preparation program? (If different from #10 above) AFFIDAVIT I,, certify (or declare) under penalty of perjury under the laws of the State of Washington that the foregoing and all information included in this application is true and correct. If the answers to any question on the application or the moral character and personal fitness section on the application change prior to my being granted certification, I must immediately notify Career and Technical Education Certification at OSPI. Signature Date City/State THIS FORM MUST BE INCLUDED IN THE APPLICATION PACKET - ATTACH YOUR CHECK TO THIS FORM. APPROVED BY CAREER AND TECHNICAL EDUCATION CERTIFICATION USE ONLY GS - General/Specific Safety CERTIFICATE MAILED CERTIFICATE TYPE(S) ISSUE EXPIRATION CLASSIFICATION 4 - New 2 - Renewal R - Renewal N - Continuing FORM SPI/VCERT 4076A (Rev. 9/15)

4 CONTINUING CERTIFICATE: VERIFICATION OF CAREER AND TECHNICAL EDUCATION TEACHING/COORDINATION EXPERIENCE SECTION I TO BE COMPLETED BY APPLICANT Fill out this section and send the form to your employer(s). If verifying experience for more than one employer, photocopy this form and send to each employer. Include this form in your application packet after it is returned to you OF BIRTH 5. TELEPHONE: ( ) ( ) HOME WA CERT. NO. If you are applying for the continuing career and technical education certificate, you will need to verify appropriate teaching or coordination experience on this form. Applicants must meet the experience requirement listed below for the continuing certificate: Verification of two years of appropriate service in the respective role (teacher/coordinator). Substitute service in the role may be used. Career and technical education experience may be full-time or part-time. SECTION II TO BE COMPLETED BY EMPLOYER (OR HIS/HER DESIGNEE) Based on personnel records, this statement MUST be prepared and signed by the superintendent, the personnel director, or career and technical education administrator of the school district, or skills center where the applicant was employed. Work experience may be full or part-time in a career and technical education program. Stamped signatures MUST be initialed by the individual using the stamp. Please return the completed form directly to the applicant. SCHOOL DISTRICT APPLICANT S POSITION TITLE FROM TO Teaching/coordination was in an approved career and technical education program? YES NO PRINTED NAME TITLE OF PERSON COMPLETING FORM SIGNATURE TELEPHONE ( ) RETURN COMPLETED FORM TO APPLICANT FORM SPI/VCERT 4076F (Rev. 9/15)

5 VERIFICATION OF CREDITS/CLOCK HOURS SECTION I OF BIRTH 5. TELEPHONE: ( ) HOME ( ) 6. CERTIFICATION NO. SECTION II Candidate must hold a continuing CTE teaching certificate to renew. Complete, since the issuance of the MOST RECENT continuing CTE teaching certificate, one of the following: Six (6) quarter hours or sixty (60) clock hours of CTE training in the subject matter certified to teach; OR Three (3) quarter hours or thirty (30) clock hours of CTE teacher training in the subject matter certified to teach and three (3) quarter hours or thirty (30) clock hours of technical education/upgrading; OR Three (3) quarter hours or thirty (30) clock hours of CTE teacher training in the subject matter certified to teach and three hundred (300) hours of occupational experience. For details on the documents needed and process to obtain this certificate, please see the application. CLASS TITLE PROVIDER (COLLEGE/UNIVERSITY/APPROVED AGENCY) CLASS COMPLETED NUMBER OF HOURS C - CLOCK Q - QUARTER S - SEMESTER Circle One: Attach additional list if necessary. CLOCK HOURS TOTAL QUARTER CREDITS FORM SPI/VCERT 4076V (Rev. 9/15) SEMESTER CREDITS