ࡱ> dfc'` 4Ibjbj 0P# 2"""""""6&%&%&%8^%\%t615:&(((((`Y*%+hp4r4r4r4r4r4r46h[9r4i"-((--r4""((4///-d"("(p4/-p4//2""2(.& ~7*&%.|2,3D4<152,9.929"2@+h+J/?,<{,2+++r4r4]/d+++15----6$ Z$~ "$6Z~"666"""""" Request to Expedite a NYS Teacher Certification Application For Schools Not Served by a BOCES Regional Certification Office Do not submit this request unless you have checked the status of the application and requirements on TEACH. There must be an application on file in TEACH and the fee must be paid. The application should have a status in TEACH of Ready for Review. If the application is Not Ready for Review or Review Complete Pending Information you must submit transcripts and/or other supporting documents along with this request. If you are not sending transcripts or documents: email this completed form to  HYPERLINK "mailto:OTIADMIN@nysed.gov" otiadmin@mail.nysed.gov; in the subject line of your email, indicate Box ES. If you are sending official transcripts*and/or documentation to the Office of Teaching Initiatives: mail this request and the documentation to the NYS Education Department, Office of Teaching Initiatives, Room 5N, Albany, New York 12234, Attention: BOX ES. Transcripts: must be original (not photocopy) official (not student copy) transcripts in a sealed college/institution envelope. Applicant s Name (Last)  FORMTEXT      (First)  FORMTEXT       SSN (last 4 digits)  FORMTEXT      New Application?  FORMCHECKBOX  Yes  FORMCHECKBOX  No If no, has documentation been submitted to NYSED?  FORMCHECKBOX  Yes, date ___/___/_____  FORMCHECKBOX  NoCertificate Title Requested  FORMTEXT       Verify the following:  FORMCHECKBOX  Application and fee on file  FORMCHECKBOX  Passed all required exams  FORMCHECKBOX  Required workshops completed  FORMCHECKBOX  All academic requirements met  FORMCHECKBOX  Fingerprint application and prints on file  FORMCHECKBOX  OFFICIAL transcripts are being sent or are verified received in TEACH ONLINE SERVICESTitle of Position Offered FORMTEXT      Employing School District, School or Agency  FORMTEXT      School District Address  FORMTEXT       Name of School District Superintendent/Chief School Officer   FORMTEXT       Superintendent/Chief School Officer Contact informa<|}~* 5 8 \ x y  T V Ǿdzxl]QhLh5h:CJhLh5CJOJQJaJh|2h50J5CJ"jh|2h55CJUjh|2h55CJUhLh5CJ h55CJh|2h55CJhyh5CJaJh55CJaJh|2h55CJaJhjRYh5CJ$aJ$hyh5>*CJaJh%h5CJaJh%h5CJ aJ <|}7 * [ V   $ L \ $$Ifa$gd  $Ifgd  $h^ha$gd5 $ & Fa$gd5 $ & Fa$gd5$a$gd5]gd5H2I   $ & : < > H J \ ^ r t v ɴɜɴrXH9h|2h5CJOJQJ^JhjRYh55OJQJ\^J3jh|2h5CJOJQJU\^JmHnHu.j]h|2h5CJOJQJU\^J"jhCJOJQJU\^J.jh|2h5CJOJQJU\^J(jh|2h5CJOJQJU\^Jh|2h5CJOJQJ\^Jh|2h55CJ aJ h|2h55CJhLh5CJaJ h5CJ\ \^h_VV $Ifgd  $Ifgd kd$$IflF'*06    4 layt  $$Ifa$gd   "$24PRT\^&(DڨxfN.jh|2h5CJOJQJU\^J#h|2h5CJ OJQJ\^JaJ .jrh|2h5CJOJQJU\^J.jh|2h5CJOJQJU\^J3jh|2h5CJOJQJU\^JmHnHu.jh|2h5CJOJQJU\^J(jh|2h5CJOJQJU\^Jh|2h5CJOJQJ\^J^PR\P $$Ifa$gd kd$$Ifl4F'* 06    4 laf4yt  $$Ifa$gd  $Ifgd DFHPRGHVóÓyóggO.jh|2h5CJOJQJU\^J#h|2h5CJ OJQJ\^JaJ 3jh|2h5CJOJQJU\^JmHnHu.jh|2h5CJOJQJU\^Jh|2h55hjRYh55OJQJ\^Jh|2h5CJOJQJ\^J(jh|2h5CJOJQJU\^J.jZh|2h5CJOJQJU\^Js,{{{{{{{ $Ifgd {kd$$Ifl4$0'*064 laf4yt VWXst,-;<=>FrzëÓ{cQQ"h|2h56CJOJQJ\^J.jh|2h5CJOJQJU\^J.jvh|2h5CJOJQJU\^J.jh|2h5CJOJQJU\^J.jh|2h5CJOJQJU\^Jh|2h5CJOJQJ\^J(jh|2h5CJOJQJU\^J.jh|2h5CJOJQJU\^J  hjl~հf~ݰN~.j3 h|2h5CJOJQJU\^J.j h|2h5CJOJQJU\^J3jh|2h5CJOJQJU\^JmHnHu.j h|2h5CJOJQJU\^Jh|2h5CJOJQJ\^J(jh|2h5CJOJQJU\^Jh|2h55hjRYh55OJQJ\^J#h|2h5CJ OJQJ\^JaJ  $Ifgd  $$Ifa$gd hkdb $$Ifl4*064 laf4yt hjxoo $Ifgd  $$Ifa$gd {kdg $$Ifl4U0* 064 laf4yt {{{ $Ifgd {kd $$Ifl4$0* 064 laf4yt jlnzzqqq $Ifgd  $$Ifa$gd ykd $$Ifl40* 064 laf4yt jlnp8 8 888$8&8(82848V8X8l8ʵʝsqʵYʵ.jih|2h5CJOJQJU\^JUhjRYh55OJQJ\^J3jh|2h5CJOJQJU\^JmHnHu.jN h|2h5CJOJQJU\^J(jh|2h5CJOJQJU\^Jh|2h5CJOJQJ\^J h|2h5CJ OJQJ^JaJ h|2h55h|2h55CJ aJ  8 8868T8V8~88zzqqqqqqq $Ifgd  $$Ifa$gd ykd $$Ifl40* 064 laf4yt  tion   FORMTEXT       E-Mail Address  FORMTEXT       Telephone Number  Name of Individual Submitting Request on behalf of the district/school   FORMTEXT        FORMTEXT       Email AddressOffice of Teaching Initiatives Use Only: Date Received:  FORMTEXT       Date Completed:  FORMTEXT       Was Certificate Issued:  FORMCHECKBOX  Yes  FORMCHECKBOX  NoIf no, check reason for not issuing:  FORMCHECKBOX  Exams  FORMCHECKBOX  Workshopl8n8p8z8|888888496989:9N9P9R9\9^9b9d9x9z9|99ӹөoөWӹөө?ӹ.jh|2h5CJOJQJU\^J.jh|2h5CJOJQJU\^J h|2h5CJ OJQJ^JaJ h55h|2h55h|2h55CJ aJ hjRYh55OJQJ\^Jh|2h5CJOJQJ\^J3jh|2h5CJOJQJU\^JmHnHu(jh|2h5CJOJQJU\^J.jh|2h5CJOJQJU\^J888496989`9b9sgg^^^^ $Ifgd  $$Ifa$gd kdQ$$Ifl4F* 06    4 laf4yt 99999999::2:4:6:@:B:r:t:::::::::::;ξξΑw_wG.j]h|2h5CJOJQJU\^J.jh|2h5CJOJQJU\^J3jh|2h5CJOJQJU\^JmHnHu.juh|2h5CJOJQJU\^J(h|2h5B*CJOJQJ\^JphhjRYh55OJQJ\^Jh|2h5CJOJQJ\^Jh5CJOJQJ\^J(jh|2h5CJOJQJU\^Jb9999kd$$Ifl4F* 06    4 laf4yt  $Ifgd J$Eƀ" Ifgd 9999P:R:::,;v;HHHH{rrrrrrrrrrr $Ifgd wkd$$Ifl4*   064 laf4p yt  $$Ifa$gd  ;;; ;";v;x;;;;;;;;;<HHH"H$H&HRHTHpHrHtHHHH۫ۓۑya.jh|2h5CJOJQJU\^J.j1h|2h5CJOJQJU\^JU.jh|2h5CJOJQJU\^J.jEh|2h5CJOJQJU\^J.jh|2h5CJOJQJU\^Jh|2h5CJOJQJ\^J(jh|2h5CJOJQJU\^Js  FORMCHECKBOX  Coursework  FORMCHECKBOX  Fingerprints Notes:  FORMTEXT            9/10/12 NON-BOCES EXPEDITED SERVICE HHHHHHHHHHHHHHHH,I.I0I2I4Iӹө~sohh$OLhCJaJhCJaJh jh U hoIh5hjRYh55OJQJ\^Jh|2h5CJOJQJ\^J3jh|2h5CJOJQJU\^JmHnHu(jh|2h5CJOJQJU\^J.jh|2h5CJOJQJU\^JHHHHHHHHHHHH.I{sqqqqqqqqo$a$gd5{kd$$Ifl4N0q*  064 laf4yt  $Ifgd  .I0I2I4I$a$gd5.:p / =!"#$% DyK OTIADMIN@nysed.govyK Lmailto:OTIADMIN@nysed.govyX;H,]ą'cvDText15vDText15$$If!vh555#v#v#v:V l065554yt vDText13tDeCheck1tDeCheck2tDeCheck3tDeCheck4$$If!vh55 5#v#v #v:V l406555 4f4yt vDText12$$If!vh55u"#v#vu":V l4$06554f4yt tDeCheck8tDeCheck8tDeCheck9vDeCheck10vDeCheck10vDeCheck10$$If!vh5+#v+:V l40654f4yt vDText11$$If!vh5}5#v}#v:V l4U06,55 4f4yt vDText10$$If!vh5}5#v}#v:V l4$06,55 4f4yt tDText8$$If!vh5}5#v}#v:V l406,55 4f4yt tDText9$$If!vh5}5#v}#v:V l406,55 4f4yt tDText6tDText7$$If!vh5}55 #v}#v#v :V l406,55 54f4yt tDText4vDText17$$If!vh5}55 #v}#v#v :V l406,55 5/ 4f4yt $$If!vh5+#v+:V l4   0654f4p yt tDText2tDText3tDeCheck5tDeCheck6vDeCheck14vDeCheck15vDeCheck16vDeCheck16vDText16$$If!vh55+#v#v+:V l4N065 5 /  / / 4f4yt @`@ 5NormalCJPJ_HmH sH tH P`P 5 Heading 1$$@&a$5CJOJQJ\^JDA@D Default Paragraph FontRi@R  Table Normal4 l4a (k(No ListB>`B 5Title$a$5CJ(OJQJ\^JDJ`D 5Subtitle$a$5OJQJ\^J6U`6 5 Hyperlink >*B*ph4 `"4 5Footer  !4@24 5Header  !V P<|}7*[Vwxy./bs,345qrs   V W X l m R w   ! 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