Licensure Requirement Waiver Request

Licensure Requirement Waiver Request

The purpose of this form is for any education major to receive approval from the McKeown School of Education as to whether the school would ever consider endorsing a candidate if the change of the degree tracker (undergrads) or plan of study (grads) were modified for graduation.

Submitter Type*

Indicate your status as the form submitter.

Select

Submitter Email

SSU Email Address of Student Submitter*

Please indicate your SSU email address where a copy of the decision will be sent. NOTE: Non-SSU emails will result in an automatic denial of the request.

Lead Faculty*

Indicate the program's lead faculty member who sanctioned this request. For example, if you are a student, please select your lead faculty member/advisor. Faculty and Staff should list themselves.

Select

Student's SSU ID*

Begins with "0." Do not use the leading "S."

Student Name (Last, First)*

License Area*

Select or enter value

Licensure Pathway*

Select or enter value

Waiver Request Type*

Select the option(s) that best describe(s) the type of request. If not listed, please select "Other."

Select

Associated Course(s)

Justification Description*

Please write a brief justification for why the student in question should be considered for a waiver.

NOTE: If the reasons include the student has already taken the coursework, has completed the requirement due to experience or already has a license, please also upload evidence for the claim under "Evidence Upload." Failure to do so will result in an automatic denial.

What type of evidence do you have to support the justification?*

Course Transfer - Course description and Syllabus

Documented Experience (e.g., resume)

Competency Testing

Competency Review Letter (from DESE)

Screenshot from ELAR displaying active License

Other (please describe in Comments)

Other Comment

Evidence Upload

Drag and drop files here or

Send me a copy of my responses

Privacy Notice|Report Abuse