Follow the steps to complete your application form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In Part I, fill in your personal information using blue ink and uppercase letters. Include your last name, first name, middle initial, social security number, gender, birth date, and address (street only, no P.O. Box). Make sure to also provide a contact number and an email address.
3. Complete the race/ethnicity section by selecting your relevant category. This field is optional.
4. List your bachelor’s degree details by providing the state or country and the month/year the degree was awarded for each entry.
5. Answer the three questions regarding past convictions, dismissals, or credential actions. If you answer ‘YES’ to any question, prepare a signed statement of explanation and attach it.
6. In the applicant attestation section, certify the accuracy of the information provided by signing and dating the form.
7. Move to the second page, where you will find the statement from the preparing higher education institution. Ensure an authorized official completes this section, including their signature and the institution's seal.
8. If applicable, check the box for additional endorsements and submit the required official transcripts with your application.
9. Prepare your payment, ensuring that it is a $200 money order, cashier’s check, or certified bank check payable to 'Treasurer, State of Connecticut.'
10. Finally, mail your completed form along with the payment and transcripts to the address provided at the top of the form.

Complete your CT ED 170A application online for a smooth processing experience.