Request Licensure Documentation

If you are requesting documentation verifying enrollment in or completion of a licensure program, please complete this form. If you are seeking recommendation for a MN license, please review the requirements listed on our Licensing page.

If you have additional questions, please contact: Teaching.License@bemidjistate.edu

* Indicates Required Information

Date

Contact Information

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Name(Required)

First Last

Previous Last Name

(if applicable)

Email(Required)

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Enter Email Confirm Email

Phone Number

Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

BSU Student ID (Tech ID)(Required)

8-digit BSU Tech ID Number - If you do not remember it, please provide your date of birth or the last four digits of your Social Security Number.

Are you currently licensed?

Choose what level of licensure you are at

Current License(Required)

Not Licensed

Currently Hold Tier 1, 2, 3 or 4 in MN

Currently Hold a Substitute License in MN

Please provide your MN File Folder Number. You can find your FFN using the Minnesota License Lookup page:

https://public.education.mn.gov/LicenseLookup/educator

MN File Folder Number

If you are currently licensed in MN please provide your current MN File Folder Number. You can search for your FFN here: https://public.education.mn.gov/LicenseLookup/educator

Guide to Determining What Type of Documentation You Are Requesting

This guide will help you determine what type of documentation you need.

1. Enrollment Verification Letter for Tier 2 MN License

a. You do not currently hold a Tier 1, 2, 3 or 4 license in MN and

b. You are enrolled in a licensure program through BSU

2. Section 9: Verification of Meaningful Progress for Tier 2 MN License

a. You hold or have held a Tier 2 license in MN and

b. You are enrolled in a licensure program through BSU and

c. You are making meaningful progress towards your licensure program and

d. You wish to renew your Tier 2 license

3. Section 6: Verification of Program Completion for Tier 2, 3 or 4 MN License

a. You have completed an approved licensure program at BSU and

b. You are applying for a Tier 2, 3 or 4 license in MN

4. Out-of-State License Recommendation

a. You are seeking licensure in another state (not MN)

What type of licensure documentation are you requesting?

Choose what license documentation is needed

Requesting(Required)

Enrollment Verification Letter (Tier 2 MN License)

Section 9: Verification of Meaningful Progress (Tier 2 MN License)

Section 6: Verification of Program Completion (Tier 2, 3, or 4 MN License)

Out-of-State License Recommendation

Enrollment Verification Letter

This letter verifies your enrollment in a licensure program with BSU. If you are a FasTrack student, you must have successfully completed ED 5000 and be enrolled in courses for next semester.

This option is appropriate if you:

a. Are applying for Tier 2 MN License

b. Do not currently hold a Tier 2, 3 or 4 license in MN

c. Are enrolled in a licensure program through BSU

d. Are enrolled in courses this semester (or the upcoming semester)

e. Have completed ED 3000 (FasTrack Only)

If you can answer "Yes" to all of the above, please fill out the remaining pieces (below) and click submit.

Section 9: Verification of Meaningful Progress

Verifies you are making meaningful progress towards your licensure program. You must have successfully completed at least one course each semester and be enrolled currently or for the next semester.

This option is appropriate if you:

a. Hold or have held a Tier 2 license in MN

b. Are enrolled in a licensure program through BSU

c. Are making meaningful progress towards your licensure program

d. Wish to renew your Tier 2 license

If you can answer "Yes" to all of the above, please fill out the remaining pieces (below) and click submit.

Section 6: Verification of Program Completion

Verifies completion of a licensure program. Please note: We cannot provide you with a signed Section 6 unless we have official test scores on file for required MTLE Pedagogy and Content exams.

This option is appropriate if you:

a. Have completed an approved licensure program at BSU

b. Have official scores on file for all required licensure exams

c. Are applying for a Tier 2, 3 or 4 license in MN

If you can answer "Yes" to all of the above, please fill out the remaining pieces (below) and click submit.

Licensure Field(s)

Please provide information regarding the Tier you are applying for, the program you completed, and the licensure content area(s) you are pursuing.

What Tier are you applying for?

Tier 2

Tier 3

Tier 4

Online Processing Number

If you have completed PELSB's online application for an initial Tier 3 license you were issued a "Processing Number." Please provide your Processing Number.:

Please indicate which program you completed.(Required)

Select all that apply.

On Campus

DLiTE

FasTrack

Licensure Only

Special Education

What license(s) are you pursuing?(Required)

Select all that apply. Hold CTRL and Left Click Mouse to Select Multiple Options.

Additional Documentation

Plan of Study

If you completed any of the following options, please upload an approved plan of study with a faculty signature (below):

1. SPED (ASD, EBD, SLD)
2. FasTrack Program
3. Health Add-On
4. DAPE Add-On
5. Other Licensure Only (not seeking a degree)

Max. file size: 16 MB.

Out-of-State License Recommendation

This option is for candidates who are applying for a license in any state other than MN.

Describe Your Request(Required)

Please include above what Content Area(s), Grade Levels, and State you are requesting (below).

Out-of-State Application

If you are requesting completion of a form, please attach the form here. Make sure to read the entire form - there may be a part (usually on top) for you to fill out.

Max. file size: 16 MB.

Other

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If you would like to add any other information, please do so below.

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