Licensure Requirements Agreement Form

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.

SSUID*

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

Last Name*

First Name*

License Area*

Select or enter value

SSU Email*

Agreement Details and Acknowledgements

Students must initial below each statement.

I have been advised to make every effort to have the initial MTELs (Communication & Literacy) completed and officially received by SSU from the testing agency, prior to the end of my first full year in the program and all other exams prior to February 1/October 1 the semester before beginning the practicum (e.g., deadline to declare my intent to pursue the practicum). These advised deadlines are subject to timelines and test availability, so I will not be asked or required to apply for an MTEL waiver at any point before Fall 2024.*

Student Initials Here

I acknowledge that even as I continue to make degree progress in the program—through Practicum and earning my masters—that my teaching license will not be issued by the Massachusetts Department of Elementary and Secondary Education until I have passed all required MTELs for my program. Most importantly, I understand that not having a license may impede my ability to be hired for a full-time teaching job.*

Student Initials Here

I understand that after I graduate from the degree program indicated above, Salem State University is unable to provide any MTEL preparation support and that it is in my best interest to utilize the available MTEL preparation support offered by SSU while I am a current student to prepare for the exams and take them as soon as I am able.*

Student Initials Here

I understand that the Massachusetts Department of Elementary and Secondary Education requires: “all programs that endorse students for teacher licensure to administer “gateway assessments” to “evaluate candidate readiness prior to the practicum in order to… identify at-risk candidates and provide them with the necessary supports and guidance to improve or exit the program….” (DESE, 2018).*

Student Initials Here

To meet this requirement, I will be assigned to take up to eight assessments scheduled at different intervals of my program. The initial licensure handbook linked below includes an explanation of the assessments and timetables in detail.*

Link to handbook: Initial License Student Handbook

Student Initials Here

I understand that I have enrolled in a field-based program which requires that I spend hours observing, engaging and teaching live pupils in school classrooms throughout the course of my studies in addition to my practicum. Per the state mandate that, “Field-based experiences are in settings with diverse learners (e.g., students from diverse ethnic, racial, gender, socioeconomic, and exceptional groups)," it is my responsibility to ensure that I have experiences with diverse learners in my Stage 2 pre-practicum and Stage 3 practicum experiences. Therefore, if I have a fellowship or am employed in a full-time job, if the classroom I am assigned to has homogenous student learner population, I must seek teaching additional opportunities to teach in settings with diverse learners.*

Student Initials Here

I acknowledge receipt of this agreement, have initialed beside each of the statements above, and understand that Salem State University will enforce the guidance indicated above through the end of the 2024-2025 academic school year at the earliest.*

Please sign your full name below

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