Request Licensure Documentation 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 InformationDate Date Format: MM slash DD slash YYYY Contact InformationName* First Last Previous Last Name (if applicable) Email* Enter Email Confirm Email Phone NumberMailing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands BSU Student ID (Tech ID)*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?Current License*Not LicensedCurrently Hold Tier 1, 2, 3 or 4 in MNCurrently Hold a Substitute License in MNPlease provide your MN File Folder Number. You can find your FFN using the Minnesota License Lookup page: https://public.education.mn.gov/LicenseLookup/educatorMN File Folder NumberIf 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/educatorGuide to Determining What Type of Documentation You Are Requesting1. 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?Requesting*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 RecommendationEnrollment Verification LetterThis 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 ProgressThis 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 CompletionThis 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)What Tier are you applying for?Tier 2Tier 3Tier 4Please indicate which program you completed.*Select all that apply. Hold CTRL and Left Click Mouse to Select Multiple Options. On CampusDLiTEFasTrackLicensure OnlySpecial EducationWhat license(s) are you pursuing?*Select all that apply. Hold CTRL and Left Click Mouse to Select Multiple Options.Elementary Education (K-6)Preprimary (Age 3-PreK)Middle School Communication Arts & Lit (5-8)Middle School Math (5-8)Middle School Science (5-8)Middle School Social Studies (5-8)Communication Arts & Lit (5-12)Math (5-12)Social Studies (5-12)Health (5-12)Physical Education (K-12)DAPE (P-12)Chemistry (9-12)Earth & Space Science (9-12)Life Science (9-12)Physics (9-12)Music: Instrumental (K-12)Music: Vocal (K-12)Special Education - ASDSpecial Education - EBDSpecial Education - SLDAdditional DocumentationPlan of StudyIf you completed any of the following options, please upload an approved plan of study (below): 1. SPED (ASD, EBD, SLD)2. FasTrack Program3. Health Add-On4. DAPE Add-On5. Other Licensure Only (not seeking a degree)Out-of-State License RecommendationThis option is for candidates who are applying for a license in any state other than MN.Describe Your Request*Please include above what Content Area(s), Grade Levels, and State you are requesting (above).Out-of-State ApplicationIf 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. OtherIf you would like to add any other information, please do so below.