Request for PA Certification Recommendation

This form should be completed AFTER you have applied for your certification through PDE's Teacher Information Management System (TIMS). You will have up to 3 months to complete your TIMS application. After 3 months, you MUST resubmit this form. If you have questions about how to apply for certification, visit: Apply for Certification

About You

Tell us about yourself, so we can locate your academic records.

Name

First NameLast Name

Last 4 Digits of Social Security Number: XXX-XX-

TUID #

Date of Birth

Date

Gender

Contact Information

Tell us where can we contact you if we have questions about your certification. If you are graduating soon and planning to move, please include contact information that will still be valid after graduation.

Non-Temple Email - strongly encouraged

example@example.com

Primary Address

Street Address

Street Address Line 2

CityState

Zip Code

Country

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

If you answered yes to the employment questions please list the name of the school or organization. If you answered no, please put N/A.

Are you currently employed or have been offered a position in the field in which you are seeking certification?

About Your Certification

Tell us about the certification you are applying for. Remember, you must FIRST apply via PDE's TIMS on-line application system and then include the relevant information from your application below. Visit TIMS online

PPID Number From Your TIMS Application

Which preparation program did you complete for this certification?

Students Seeking Special Ed Certification prior to January 2022 Did you complete the Special Ed expansion program to add to an existing Pk-8 SPED cert?

Certification Type

Subject Area and Grade (ex. English 7-12)

Special Note: If you completed a DUAL Cert program (ex. PreK-4 and Special Ed K-8), you should enter BOTH subjects here.

Month - Program Completion

Month

Year - Program Completion

Year

Month - Degree Completed

Year - Degree Completed

GPA Standard Deviation Policy: The Grade Point Average (GPA) Allowance, or Sliding Scale Policy, developed by PDE enables an applicant to use their preparation program GPA to meet a qualifying score for their content, and, if applicable, general knowledge assessments. The scores and corresponding GPA spans are outlined on the Certification Testing Chart (Excel). The GPA Allowance does not change the passing score(s) or pass/fail result(s) but allows the acceptance of GPA qualifying score(s) for certificate issuance.

Please tell us how you met the testing requirements

Test Requirement - Met With

GPA

COMPLETE AND SUBMIT

That's it! Click the SUBMIT button below to send your request to the Certification Office. You'll receive an email confirmation that your request was successfully submitted.

Administrative Use Only

(intentionally left blank)

Certificate Type Code

Subject Area Code, e.g. 61-2825

Date Recommended for Certification

Date

Did you submit in Banner?