Licensure Requirements Agreement Form

This form is designed for Salem State University students currently pursuing an initial educator’s license during the 2024-2025 academic year amid the COVID-19 pandemic response and recovery. This form does not replace any forms that may also be required by the School of Graduate Studies. Students are required to complete this form prior to registering for additional coursework required by the program in the next consecutive semester.

 

Please include your full student ID number starting with a 0 and without an S.

 
 
 
 
 

Agreement Details and Acknowledgements

Students must initial below each statement.

 

Student Initials Here

 

Student Initials Here

 

Student Initials Here

 

Student Initials Here

 

Link to handbook: Initial License Student Handbook

Student Initials Here

 

Student Initials Here

 

Please sign your full name below