Application for Admission - Professional Certification Program
Texas A&M University-Commerce
Application Date: / /

Full, Legal Name
*Last *First  

Other Last Names (Maiden) 

*Social Security Number  - - (Required by State Board of Educator Certification/TEA for reporting purposes)

*A&M Commerce CWID 

*Date of Birth   - -
*Ethnicity     *Race1                  *Race2
Contact Information
*Permanent Address 
*City  *State  *Zip 
*Home Phone  - - Work Phone  - - Cell Phone  - -
*Verify Email  
*(Please use an e-mail address that you check often.)
Professional Certification Program
*Type of Professional Certification Seeking:  

List Degrees awarded: (List Bachelor's Degree first)
Name of Institution
Degree Awarded
Country(If out of US)
- -
- -
- -
- -
*Do you hold a Texas Teaching Certificate?
Do you currently hold a Master's Degree?
 If not, do you have:         
           Master's Degree Plan on file for the Certification sought?

*Have you taught for at least 1 years in a Texas Education Agency (TEA) Accredited School?  
(Master Reading teacher requires three years)

Note: Service Record documenting years of acceptable classroom teaching experience in a TEA recognized school will be required prior to recommendation for certificate.

Please note this is an application form only and does not constitute admittance to any program.