Certification Application

Millersville University Request to Recommend Form
Please Note: You must register for your TIMS account at https://www.mypdeapps.pa.gov prior to submitting this request form to the Department of Field Services.

In order to complete this form, you will need the following information:

• Information about your required Certification Tests:

This includes both your Pre-Service Tests (UG students only) and Content Area Tests

You will need the Test Codes, Titles, Date you took or intent to take the tests, and Scores (if you have them)

• If you are a Post Bacc. or Masters student, you will need the date and location of your original Bachelor’s degree.

• You will need your PPID number that is assigned to you in TIMS.

The PPID number is 7-digits, and is not your Application ID number!
Background Information
Full Name

First NameLast Name
Former Name (If applicable)
M#
Address where you want your verification letter sent.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Personal E-mail
Cell Phone Number*

Area CodePhone Number
Home Phone Number

Area CodePhone Number
Area of Certification*
If you are seeking certification in two areas, please use the second drop down box below to select the additional area.
Area of Certification
Area of Certification
Supervisory Area
If you are seeking certification in a supervisory area, please list the area.
Are you adding any endorsements onto your Instructional I? *
If so, what endorsement are you adding?
If other, what is the subject area?
Pre-Service Testing Information
Which test are you using to satisfy the Pre-Service Testing Requirement?*

PAPAPraxis IPraxis CoreSATACTCombination Method (Multiple test options)ACT 136 Test WaiverN/A (PBC or Master's Student)
Using the boxes below, fill in the information regarding your Pre-Service Tests. Use the "save" button to save your response, and to add additional rows. See below for an example of how to fill in the boxes. If you need help, contact the Department of Field Services.
Pre-Service Test Results - If this does not apply to you please put N/A.*
Certification Content Testing Information
Using the boxes below, fill in the information regarding your Certification Content Area Tests. Use the "save" button to save your response, and to add additional tests as needed. See below for an example of how to fill in the boxes.

**IF you DO NOT know what tests you need to take, immediately contact the Department of Field Services.**
Certification Content Test Results*
Program Completion Information
Student Type*

UndergradPost-BaccalaureateMasters
Date of Graduation or Completion of Certification Program*

MonthDayYear
College Attended for Bachelor's Degree*
Date of Initial Degree*

MonthDayYear
Date you registered for your TIMS account with the State*

MonthDayYear
Your TIMS PPID#*
Request for Verification Letter
A verification letter will be issued ONLY after the semester has ended, and upon successful completion of ALL academic requirements. We must also receive confirmation that a completed application has been filed with the Pennsylvania Department of Education through the TIMS application portal.

This entails:

* Completion of the "MU Request for Recommendation" form for the Department of Field Services.

* All final grades have been posted (This includes Student Teaching)

* Fully executed PDE 430 forms from supervisors are on file

* An electronic certification application has been submitted to PDE through the TIMS (Teacher Information Management System) portal.

If you are completing a baccalaureate degree, a verification letter will be issued ONLY to students with a "clear" Degree Audit that states: *** All requirements have been met ***
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
*

I acknowledge that I understand all of my certification requirements (as referenced above) must be met before I will be issued my verification letter.
*

I verify that all information I have entered here is true and complete to the best of my knowledge
Any additional comments or information you would like to provide to us:
Electronic Signature*
Date*

MonthDayYear

Request for Authorization of Special Program Completion
Program Area*
If you are applying for certification in more than one special program, please use the additional drop down boxes to select the additional areas.
Program Area
Program Area
Supervisory Area
If you are seeking certification in a supervisory area, please list the area.
Name of Your Program Advisor*

First NameLast Name
Date Program Completed*

MonthDayYear
I certify that I will have completed all my course requirements as of the date listed for certification. I am requesting verification from my Program Coordinator in order for the Certification Officer to recommend me to the Pennsylvania Department of Education for certification in my program area.
Electronic Signature*
Date*

MonthDayYear
Should be Empty:

Millersville University Request to Recommend Form

Background Information

Pre-Service Testing Information

Certification Content Testing Information

Program Completion Information

Request for Verification Letter

Request for Authorization of Special Program Completion