Ode (9-digit) Work Telephone Number Email Address Applicants who have entered the profession of teaching through interim (emergency) licensure or trade, industry, technical and health occupations interim licensure and are seeking to complete the requirements for regular licensure may meet the student teaching requirement through a supervised clinical practice option meeting the conditions outlined in the attached Education Standards and Practices Board (ESPB) Administrative Rule 67.1-02-04-07.
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How to use or fill out the INTERIM LICENSURE CLINICAL PLAN AUTHORIZATION Or - Nd online
Filling out the INTERIM LICENSURE CLINICAL PLAN AUTHORIZATION is a crucial step for applicants seeking regular licensure in education. This guide will help you understand each component of the form and provide step-by-step instructions to complete it online with confidence.
Follow the steps to successfully complete the authorization form.
- Locate and click the ‘Get Form’ button to download the form and open it in your preferred editing software.
- Enter your name in the format 'Last, First, Middle Initial' within the designated field. If you prefer, you can also provide your current address, including city, state, and zip code.
- Fill in your home telephone number, work telephone number, and email address in the respective fields. This information will be used for communication regarding your clinical practice.
- Complete the section indicating the name of the teacher participating, the school term during which the clinical practice plan will be accomplished, and the name of the school district and building where you are employed.
- Provide details about the college and the name of the teacher education supervisor overseeing your clinical plan.
- Collect the necessary signatures from all required individuals, including the school administrator, mentor teacher, content area specialist, college/university dean, and yourself as the applicant, ensuring to also date each signature.
- Review the 'Plan-on-File' section for relevant dates, including the start date, expiration date, and effective date, ensuring that the information is accurate and complete.
- Once all fields are filled out and signatures obtained, save your changes to the document and prepare to submit it. You can choose to download, print, and share the form as required.
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