Fillable Printable Certificate of Compliance - California
Fillable Printable Certificate of Compliance - California
Certificate of Compliance - California
California Department of Education
Revised November 2014
California Department of Education
ESEA TEACHER RE QUIREMENTS: Certificate of Compliance
If you have questions please referto the ESEA TeacherRequirements Resource Guide on the CDE Website.
Teacher’s Name (as it appears on credential):
District(complete; no abbreviations):
ESEA Core Academic Subject:
Special Settings: If any of the special settings indicated below apply to this certificate of compliance, transferability
of this compliance may be limited.
Check the box(es) that ap ply to this teaching assignment from the opt io n/s available.
Special Education
Charter School
Special Classes or Schools as defined inCAEd Code Section 44865
Alternative Pathway to Graduation course as defined in CAEd Code Section 51225.3(b)
CA Ed Code Local TeachingAssignment OptionNone
1.Bachelor’s degree
Name of accredited institution conferring the degree:
2.Appropriate California Authorization for this Assignment
Check one box
Professional Clear, Preliminary or Clear Multip le su b ject Credential
Professional Clear, Preliminary or Clear Single Subject Credential:
Subject
Professional Clear, Preliminary or Clear Special Education Creden tial
Other: Type
Supplemental Authorization: Type
Subject Matter Authorization: Type
Charter School do cu ment does not require a credential for this assignment p er CA Ed Code Section
47605[l]
Check one box to determine the appropriate optio n/s:
“New” to the profession teacher. Date of issuance o n original creden tial or intern permit:
“New” elementary school teachers must select Exam option.
“New” middle/high school teachers may select Exam or Coursework option.
“Not new” to the profession teacher. Date of issuance on original credential or intern permit:
“Not new” elementary school teachers may select Exam or HOUSSE option.
“Not new” middle/high school teachers may selectthe Exam, Coursework, Advanced Certification or
HOUSSE options.
3.
Demonstrat ed core academic subject area competence by completi ng one of the follow ing :
Check one b ox from th e option/s a vailable.
EXAM
CTC approvedsubject matter exam, includingbut not limitedto the CSET, MSAT, or NTE, in the core subject area
SUBJECT MATTER WAIVER PROGRAM
(secondary only)
Completed a CTC approved subject matter program in the core subject
OTHERCOURSEWORK (secondary only)
Undergraduate major in the core subject
Undergraduate major equivalent in the core subject (32 non-remedial semester units)
Graduate degree in the core subject
Advanced Certification (secondary only )
National Board Certification in the core subject
Subject Matter Verification Process for Middle and High School level teachers in
Special Settings (VPSS)
HOUSSE
Completed California’s High Objective Uniform State Standard of Evaluation (HOUSSE) in the
core subject (See Sec. 3.3 of the TRRG, Form 2 and/or Form 3.)
Signature of Teacher: ______________________________________________________________
Signature of Superintendent (or designee): _____________________________________________
