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TEACHERS COLLEGE Columbia University OFFICE OF TEACHER EDUCATION 525 West 120 th Street, Zankel Hall 411 (Box 97), New York, NY 10027 Tel#: 212-678-3502 FAX#: 212-678-3153 EMAIL: ote@tc.edu ONLINE: www.tc.edu/teachercertification Teachers College (TC) Requirements Certification Check List New York State Education Department (NYSED) Requirements Complete your IRDF and submit to the Office of Teacher Education (OTE) Zankel Hall 411 Include ALL Official UNDERGRADUATE & Other NON-TC transcripts Workshops: Child Abuse Workshop proof School Violence Prevention Workshop proof HBSS 4116 (taken in-lieu of Child Abuse/School Violence Workshops) Recorded on the NYSED-TEACH System: Child Abuse School Violence Prevention For those applying for NYS Permanent or Professional Certificate: Provide a copy of the COMPLETED Verification of Experience form (3 years for Professional or 2 years for Permanent) with this form. Original Verification of Experience form MUST be mailed (by the candidate) to the NYSED. On the NYSED TEACH System: Electronically apply for certificate Pay $50 per certificate Take/pass New York State Teacher Certification Exams (NYSTCE) (If applicable): LAST (Liberal Arts & Science Test) ATS-W (Assessment in Teaching Skills Written) CST (Content Specialty Test) BEA (Bilingual Education Assessment) applicable only to Bilingual Extension candidates SLA (School Leadership Assessments) applicable only to Ed Leadership candidates Fingerprint Clearance For those in the Literacy Specialist Reading Specialist Programs ONLY: You must provide a copy of a VALID state issued teacher certification. FYI & ATTENTION NYSED General Core Liberal Arts and Science Pre-requisites: NOTE: Prior to a Teachers College institutional recommendation, the following MUST be met: Pre-K & Elementary Level: 6 credits (each) in: Math (courses taken under MATH Dept. ONLY) Science (courses taken under SCIENCE Dept. ONLY) English History Foreign Language Secondary Level: 3 credits (each) in: Math (courses taken under MATH Dept. ONLY) Science (courses taken under SCIENCE Dept. ONLY) English History Foreign Language Submit your IRDF (and ALL supporting documents) to: The Office of Teacher Education & School-based Support Services (OTE/SSS) 525 W. 120 th Street Box 97 New York, NY 10027 ATTN: Faride Suarez, Associate Director of Certification Compliance If you are expecting to graduate, the OTE will not be able to process your IRDF/NYSED recommendation until your degree has been awarded. NYSED - TEACH Online: Go to: www.highered.nysed.gov/tcert/teach Kindly follow all NYSED application steps & update your NYSED TEACH Education History information. As per the NYSED, after satisfactorily completing all the above Teachers College and NYSED requirements AND having been institutionally recommended, your initial certificate should be issued in approximately 24-48 hours. Check your NYSED - TEACH Account Information System for updates and certificate status. * * Remember to keep a copy of all your documents for your records. * *

TEACHERS COLLEGE Columbia University OFFICE OF TEACHER EDUCATION 525 West 120 th Street, Zankel Hall 411 (Box 97), New York, NY 10027 Tel#: 212-678-3502 FAX#: 212-678-3153 EMAIL: ote@tc.edu ONLINE: www.tc.edu/teachercertification Institutional Recommendation Data Form (IRDF) for New York State Certification Kindly complete and return this form to the Office of Teacher Education (OTE) - Zankel Hall 411. If applying for multiple certifications, you MUST complete an IRDF s for EACH Certificate Title - Please use BLUE or BLACK ink ONLY (NO PENCIL). General Information Name: Last First Middle TC#: Other Last Name(s) previously used: SS#: (required by NYSED for certification purpose) Mailing Address: Date of Birth: City State Zip / / Email Address: Telephone #: Gender: Male Female I will be graduating in May Teachers College Graduation Periods NOTE: Candidates already with a conferred degree may submit the IRDF as soon as the IRDF is completed. I will be graduating in October. I will be taking courses during : SUMMER A SUMMER B None I will be graduating in February Degree Type: MA M Ed MS Ed D Certification Information Certification Type: Initial Professional Permanent Trans-B (PCF ONLY) Provisional (School Psychologist & School Counseling ONLY) Conferred Degree Date: / / Certification Title: Fill out the section below ONLY if you have been previously certified in New York State and/or in any other state: Previous Certificate Title: Previous Certificate Type: Initial Provisional Permanent Trans-B Other: Enclosures All candidates MUST submit the following required documents Official Undergraduate & other non-tc transcripts in sealed in original envelope. Note: Teachers College transcripts will be supplied by OTE. Child Abuse (CA) Workshop Form AND School Violence Prevention (SVP) Workshop Form NOTE: NOTE: HBSS 4116 Recorded on the NYSED TEACH System: CA AND SVP For Candidates completing a program in Literacy Specialist Reading Specialist ONLY. Kindly provide a copy of a VALID state issued teacher certification. An institutional recommendation will not be entered until proof is provided. For Permanent Professional candidates ONLY. Kindly provide a copy of the COMPLETED Verification of Experience form (3 years for Professional or 2 years for Permanent) with this form. Original Verification of Experience form MUST be mailed (by the candidate) to the NYSED. Signature I declare and affirm that the statements made in this data form, including accompanying documents, are true, complete and correct. I understand that any false or misleading information in, or in connection with, my data form may be cause for denial or loss of certification and may result in criminal prosecution. Candidate Signature: Date Signed: For Office Use ONLY Official Undergraduate Transcript Transcript: CA SVP CA SVP HBSS 4116 NYSED-TEACH: CA SVP Institutional Code: 471500 Program Code: Major Code Processing Stamps Processing Comment: MTH = SCI = HIST = Date Received Stamp First Entry By: ENG = FL = Final Entry By: REG Cleared = Date received from REG =

Arts and Humanities Art and Art Ed. MA 40 (Int/Prf) 27831 Art and Art Ed. Visual Arts (All grades) Arts and Humanities Art and Art Ed. MA 34 (Prf) 29384 Art and Art Ed. Visual Arts (All grades) Arts and Humanities Music and Music Ed. MA 40 (Int/Prf) 29375 Music and Music Ed. Music (All Grades) Arts and Humanities Music and Music Ed. MA 32 (Prf) 29376 Music and Music Ed. Music (All Grades) Arts and Humanities Music and Music Ed. EdM 60 (Int/Prf) 32112 Music and Music Ed. Music (All Grades) Arts and Humanities Tchng of English MA 38 (Int/Prf) 29338 English Language Arts 7-12 English Language Arts 7-12 Arts and Humanities Tchng of English MA 34 (/Prf) 29399 English Language Arts 7-12 English Language Arts 7-12 Arts and Humanities Tchng of English (PCF) MA 34 (Int/Prf) 29527 Alt. Cert. - Adolescence Ed.: English (Trans B) English 7-12 Arts and Humanities TESOL MA 38-41 (Int/Prf) 27825 TESOL ESOL Arts and Humanities TESOL (PCF) MA 39 (Int/Prf) 29528 Alt. Cert. - ESOL (Trans B) ESOL Arts and Humanities Tchng of Soc. Studies MA 38 (Int/Prf) 29372 Teaching of Soc. Studies Social Studies 7-12 Arts and Humanities Tchng of Soc. Studies MA 32 (Prf) 29373 Teaching of Soc. Studies Social Studies 7-12 Biobehavioral Sciences Physical Ed. MA 32 (Int/Prf) 28683 Physical Ed. Physical Ed. (All Grades) Biobehavioral Sciences Curriculum & Teaching in Physical Ed. MA 32 (Prf) 28684 Physical Ed. Physical Ed. (All Grades) Biobehavioral Sciences Speech Language Pathology MS 50-74 (Int) 29484 Speech Language Pathology Speech & Language Disabilities (All Grades) Bilingual Ext. Biobehavioral Sciences Speech Language Pathology MS 50-74 (Int) 29483 Speech Language Pathology Speech & Language Disabilities (All Grades) Biobehavioral Sciences Speech Language Pathology MS Prf 29488 Speech Language Pathology Speech & Language Disabilities (All Grades) Counseling & Psychological Counseling EdM 60 (Prv/Perm) 05113 School Counselor School Counselor Clinical Psychology Bilingual Ext. Elem. Bilingual Ext. Sec. Counseling & Psychological Counseling MA 32 (Prv) 05109 School Counselor School Counselor Clinical Psychology Curriculum & Teaching Curriculum & Teaching MA 32 (Prf) 29477 Curriculum & Teaching (Elem Ed.) Curriculum & Teaching Curriculum & Teaching MA 32 (Prf) 29478 Curriculum & Teaching (Sec. Ed.) English 7-12 Math 7-12 Social Studies 7-12 Biology 7-12 Chemistry 7-12 Physics 7-12 Earth Science 7-12 Curriculum & Teaching Early Child. Ed. MA 40 (Int/Prf) 29370 Early Child. Ed. Early Childhood Birth-2 Curriculum & Teaching Child./ Early Child. Ed. (Dual Cert.) MA 40 (Int/Prf) 27833 Child./ Early Child. Ed. Early Childhood Birth-2 Curriculum & Teaching Early Child. Ed. (PCF) MA 40 (Int/Prf) 28774 Alt. Cert. - Early Child./ Sp. Ed. (Trans B) Early Childhood Birth-2 Sp. Ed. Birth-2 Curriculum & Teaching Inclusive Elem. Ed. MA 40 (Int/Prf) 27834 Inclusive Elem. Ed. Biology 7-9 Ext. Chemisrty 7-9 Ext. Gifted Ed. Ext. Curriculum & Teaching Inclusive Elem. Ed. (Dual) MA 51 (Int/Prf) 29404 Inclusive Elem. Ed. Dual Sp. Ed 1-6 Curriculum & Teaching Literacy Specialist MA 32 (Int/Prf) 29479 Tchng Literacy Literacy Birth-6 Curriculum & Teaching Early Child. Sp. Ed. MA 40 (Int/Prf) 29371 Early Child. Sp. Ed. Sp. Ed. Birth-2 Curriculum & Teaching Early Child./ Early Child. Sp. Ed. (Dual Cert.) MA 48 (Int/Prf) 28773 Early Child. Sp. Ed. Early Childhood Birth-2 Sp. Ed. Birth-2 Curriculum & Teaching Gifted Ed. MA 32 (Int/Prf) 29401 MA Ext. Program (In-Service) Gifted Ed. Ext.

Curriculum & Teaching Learning Disabilities MA 34-40 (Int/Prf) 29402 Tchng SWD - Learning dis/abilities Sp. Ed. 1-6 Sp. Ed. Generalist 5-9 Sp. Ed. English 5-9, 7-12 Sp. Ed. Social Studies 5-9, 7-12 Sp. Ed. Math 5-9. 7-12 Sp. Ed. Biology 5-9, 7-12 Sp. Ed. Chemistry 5-9, 7-12 Sp. Ed. Earth Science 5-9, 7-12 Sp. Ed. Physics 5-9, 7-12 Curriculum & Teaching Disability Students in Ed. MA 32 (Int/Prf) 29403 Disability Studies in Ed. Sp. Ed. 1-6 Sp. Ed. Generalist 5-9 Sp. Ed. English 5-9, 7-12 Sp. Ed. Social Studies 5-9, 7-12 Sp. Ed. Math 5-9. 7-12 Sp. Ed. Biology 5-9, 7-12 Sp. Ed. Chemistry 5-9, 7-12 Sp. Ed. Earth Science 5-9, 7-12 Sp. Ed. Physics 5-9, 7-12 Health & Behavioral Studies Reading Specialist - Applied Educational Psy MA 34 (Int/Prf) 29476 Reading Specialist Literacy Birth-6 Literacy 5-12 Health & Behavioral Studies Applied Developmental EdM 66 (Perm) 85389 Applied Developmental School Psychology & Learning Psy: School Psy & Learning Psy: School Psy Health & Behavioral Studies Applied Developmental EdM 66 (Int/Prf) 30271 Applied Developmental Bilingual Ext. & Learning Psy: School Psy Learning Psy: School Psy w/ Bilingual Ext. Health & Behavioral Studies Applied Educational Psy: School Psy EdD 95 (Prv/Perm/Lic.Qual)* 05093 Applied Educational Psy : School Psy School Psychology Psychologist Health & Behavioral Studies Applied Educational Psy: School Psy PhD 95 (Lic. Qual)* 28458 Applied Educational Psy: School Psy Psychologist Health & Behavioral Studies Applied Behavior Analysis MA 32 Int/Prf 29406 Tchng SWD - Early Child./ Child. / Sp. Ed. Birth-2 Applied Behavior Analysis Sp. Ed. 1-6 Early Childhood Birth-2 Health & Behavioral Studies Blindness & Visual Impairment EdM 76 (Int/Prf) 29439 Blindness & Visual Impairment/ Child. Ed. Blind & Visually Impaired (All Grades) Health & Behavioral Studies Blindness & Visual Impairment EdM 76 (Int/Prf) 29440 Blindness & Visual Impairment / Blind & Visually Impaired (All Grades) Early Child. Ed. Sp. Ed. Sp. Ed. Birth-2 Health & Behavioral Studies Blindness & Visual Impairment EdM 76 (Int/Prf) 29441 Blindness & Visual Impairment/ Adolescence Ed. Blind & Visually Impaired (All Grades) Biology 7-12 Chemistry 7-12 Earth Science 7-12 Physics 7-12 Math 7-12 Social Studies 7-12 English 7-12 Health & Behavioral Studies Blindness & Visual Impairment MA 45 (Int/Prf) 29436 Blindness & Visual Impairment Blind & Visually Impaired (All Grades) Health & Behavioral Studies Blindness & Visual Impairment EdM 54 (Int/Prf) 29438 Blindness & Visual Impairment Blind & Visually Impaired (All Grades) Health & Behavioral Studies Deaf & Hard of Hearing EdM 60 (Int/Prf) 27826 Deaf & Hearing Impaired/ Elem. Ed. Deaf/ Hearing (All Grades) Health & Behavioral Studies Deaf & Hard of Hearing EdM 60 (Int/Prf) 27827 Deaf & Hearing Impaired/ Adolescence Ed. Deaf/ Hearing (All Grades) English 7-12 Biology 7-12 Chemistry 7-12 Earth Sciences 7-12 Physics 7-12 Math 7-12 Social Studies 7-12 Health & Behavioral Studies Deaf & Hard of Hearing EdM 60 (Int/Prf) 29410 Ed. of the Deaf & Hard of Hearing Deaf/ Hearing (All Grades) Health & Behavioral Studies Deaf & Hard of Hearing EdM 60 (Int/Prf) 30294 Deaf Ed. & Reading Specialist Deaf/ Hearing (All Grades) & Reading Specialist (Dual Cert.) Literacy 5-12 Literacy Birth-6 Health & Behavioral Studies Tch Stds w/ Dis Mental Retardation/ Autisum MA 47 (Int/Prf) 29957 Tch Stds w/ Dis Mental Retardation/ Autisum Sp. Ed. 1-6 Sp. Ed. 5-9 Middle Childhood Generalist 5-9 Health & Behavioral Studies Intelectual Disabilities/ Autisum & Elem./ Child. Ed. EdM 60 (Int/Prf) 29407 Tchng SWD - Child./ Intelectual Disabilities/ Autisum Sp. Ed. 1-6

Health & Behavioral Studies Intelectual Disabilities/ Autisum & Early Child. Ed. EdM 60 (Int/Prf) 29405 Tchng SWD - Early Childh./ Sp. Ed. Birth-2 Intelectual Disabilities/ Autisum Early Childhood Ed. Birth-2 Health & Behavioral Studies Teaching the Severe & Multiple Handicapped MA 32 (Int/Prf) 29203 Teaching the Severe & Multiple Handicapped Severe/Multiple Disabilities Ann Health & Behavioral Studies Tchng of ASL as a Foreign Language MA 45 (Int/Prf) 27832 Teaching of ASL as a Foreign Language AMSLAN 7-12 International & Bilingual/ Bicultural Ed. MA 33-40 (Int/Prf) 27821 Bilingual/ Bicultural Child. Ed. Transcultural Studies Bilogy 7-9 Ext. Chemisrty 7-9 Ext. Bilingual Teacher Ext. Chinese 7-9 Ext. Generalist 5-9 International & Bilingual/ Bicultural Ed. MA 33 (Int/Prf) 27823 Bilingual/ Bicultural Child. Ed. Generalist 5-9 Transcultural Studies (leads to 2nd Int.cert., should not lead to Child. Ed.) Bilogy 7-9 Ext. Chemistry 7-9 Ext. Bilingual Teacher Ext. Chinese 7-9 Ext. International & Bilingual/ Bicultural Ed. Ext. Adv/Cert 15 (Int/Prf) Ext 27956 Bilingual/ Bicultural Ed. Ext. Bilingual Ext. Transcultural Studies International & Bilingual/ Bicultural Ed. (PCF) MA 33 (Int/Prf) 27822 Alt. Cert. - Bilingual/ Bicultural Child. Ed. Transcultural Studies (Trans B) Biology 7-9 Ext. Chemistry 7-9 Ext. Bilingual Teacher Ext. Chinese 7-9 Ext. Generalist 5-9 Math, Sci & Tech Math Ed. MA 32 (Int/Prf) 29396 Mathematics Ed. Mathematics 7-12 Math, Sci & Tech Math Ed. MA 32 (Prf) 29379 Mathematics Ed. Mathematics 7-12 Math, Sci & Tech Math Ed. MS 60 (Prf) 29380 Mathematics Ed. Mathematics 7-12 Math, Sci & Tech Math Ed. MSED 60 (Prf) 29381 Mathematics Ed. Mathematics 7-12 Math, Sci & Tech Math Ed. (PCF) MA 32 (Int/Prf) 29498 Alt. Cert. - Mathematics Ed. (Trans B) Mathematics 7-12 Math, Sci & Tech Tchng Biology MA 36 (Int/Prf) 28676 Biology 7-12 Biology 7-12 Math, Sci & Tech Tchng Biology (PCF) MA 34 (Int/Prf) 29414 Alt. Cert. - Biology 7-12 (Trans B) Biology 7-12 Biology 5-6 Ext. Math, Sci & Tech Tchng Chemistry MA 36 (Int/Prf) 28675 Chemistry 7-12 Chemistry 7-12 Math, Sci & Tech Tchng Chemistry (PCF) MA 34 (Int/Prf) 29413 Alt. Cert. - Chemistry 7-12 (Trans B) Chemistry 7-12 Chemistry 5-6 Ext. Math, Sci & Tech Tchng Earth Science MA 36 (Int/Prf) 28673 Earth Science 7-12 Earth Science 7-12

Math, Sci & Tech Tchng Earth Science (PFC) MA 34 (Int/Prf) 29412 Alt. Cert. - Earth Science 7-12 (Trans B) Earth Science 7-12 Earth Science 5-6 Ext. Math, Sci & Tech Tchng Physics MA 36 (Int/Prf) 28674 Physics 7-12 Physics 7-12 Math, Sci & Tech Tchng Physics (PCF) MA 34 (Int/Prf) 29411 Alt. Cert. - Physics 7-12 (Trans B) Physics 7-12 Physics 5-6 Ext. Math, Sci & Tech Technology Specialist MA 36 (Int/Prf) 28608 Technology Specialist K-12 Ed. Technology Specialist Mental Health Counceling Mental Health Counceling EdM Lic. Qual* 30033 Mental Health Counselor Mental Health Counselor Organization & Leadership Public School Building Leadership MA 32 (Int/Prf) 29181 Public School Building Leadership School Building Leadership (SPA only) Organization & Leadership Public School Building Leadership EdM 60 (Int/Prf) 29182 Public School Building Leadership School Building Leadership Organization & Leadership Public School District Leadership EdD 90 (Prf) 29184 Public School District Leadership School District Leadership Organization & Leadership Inquiry in Education Leardership Practice EdD 90 (Prf) 29183 Inquiry in Ed. Leadership Practice School District Leadership * = Form 2 - Diana Maul