Request Licensure Documentation

If you are requesting documentation verifying enrollment in or completion of a licensure program, please complete this form. If you are seeking recommendation for a MN license, please review the requirements listed on our Licensing page.

If you have additional questions, please contact: Teaching.License@bemidjistate.edu

* Indicates Required Information

Date

MM slash DD slash YYYY

Contact Information

Enter your contact information

Name(Required)

First Last

Previous Last Name

(if applicable)

Email(Required)

NOTE: Our emails occasionally go straight to your SPAM folder! If you haven't heard back from us check your spam folder.

Enter Email Confirm Email

Phone Number

Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

BSU Student ID (Tech ID)(Required)

8-digit BSU Tech ID Number - If you do not remember it, please provide your date of birth or the last four digits of your Social Security Number.

Are you currently licensed?

Choose what level of licensure you are at

Current License(Required)

Not Licensed

Currently Hold Tier 1, 2, 3 or 4 in MN

Currently Hold a Substitute License in MN

Please provide your MN File Folder Number. You can find your FFN using the Minnesota License Lookup page:

MN File Folder Number

If you are currently licensed in MN please provide your current MN File Folder Number. You can search for your FFN here: https://public.education.mn.gov/LicenseLookup/educator

Guide to Determining What Type of Documentation You Are Requesting

This guide will help you determine what type of documentation you need.

Section 6: Verification of Completion for Tier 3 or 4 MN License
1. You completed an approved licensure program at BSU and
2. You are applying for a Tier 3 or 4 license in MN
Out-of-Field Permission
1. You are currently licensed in MN and
2. You are seeking an Out-of-Field Permission for another licensure area and
3. You are enrolled in a licensure program at BSU
Section 8: Verification of Enrollment for Tier 2 MN License
1. You do not currently hold a Tier 2, 3, or 4 license in MN and
2. You are enrolled in a licensure program through BSU
  1. For FasTrack candidates this includes completion of ED 5000 and
  2. Enrollment in courses for this or next semester
Section 8: Verification of Meaningful Progress for Tier 2 MN License
1. You hold or have held a Tier 2 license in MN and
2. You are enrolled in a licensure program through BSU and
3. You are making meaningful progress towards your licensure program and
4. You wish to renew your Tier 2 License
Out-of-State Licensure Recommendation
1. You completed an approved licensure program at BSU and
2. You are seeking licensure in another state (not MN)

What type of licensure documentation are you requesting?

Requesting(Required)

Section 6: Verification of Program Completion (Tier 3 or 4 MN License)

Out-of-Field Permission

Section 8: Verification of Enrollment (Tier 2 MN License)

Section 8: Verification of Meaningful Progress (Tier 2 MN License)

Out-of-State License Recommendation

Enrollment Verification Letter

This option is appropriate if you:

a. Are applying for Tier 2 MN License

b. Do not currently hold a Tier 2, 3 or 4 license in MN

c. Are enrolled in a licensure program through BSU

d. Are enrolled in courses this semester (or the upcoming semester)

e. Have completed ED 5000 (does not apply to SPED candidates) (FasTrack Only)

If you can answer "Yes" to all of the above, please fill out the remaining pieces (below) and click submit.

Section 9: Verification of Meaningful Progress

This option is appropriate if you:

a. Hold or have held a Tier 2 license in MN

b. Are enrolled in a licensure program through BSU

c. Are making meaningful progress towards your licensure program

d. Wish to renew your Tier 2 license

If you can answer "Yes" to all of the above, please fill out the remaining pieces (below) and click submit.

Section 6: Verification of Program Completion

This option is appropriate if you:

a. Have completed an approved licensure program at BSU

b. Have official scores on file for all required licensure exams

c. Are applying for a Tier 3 or 4 license in MN

If you can answer "Yes" to all of the above, please fill out the remaining pieces (below) and click submit.

Licensure Field(s)

What Tier are you applying for?

Tier 3

Tier 4

Online Processing Number

If you have completed PELSB's online application for an initial Tier 3 license you were issued a "Processing Number." Please provide your Processing Number.

Please indicate which program you completed.(Required)

On Campus

DLiTE

FasTrack

Licensure Only

Special Education

Please indicate which program you are enrolled in.(Required)

On Campus

DLiTE

FasTrack

Licensure Only

Special Education

What license(s) are you pursuing?(Required)

Select all that apply. Hold CTRL and Left Click Mouse to Select Multiple Options.

Plan of Study

If you COMPLETED any of the following programs, please upload an approved plan of study WITH A FACULTY SIGNATURE (below). Your application will not be processed if the form is not signed.

1. SPED (ASD, EBD, SLD)
2. FasTrack Program
3. Health Add-On
4. DAPE Add-On
5. Other Licensure Only (not seeking a degree)

Max. file size: 16 MB.

Out-of-State License Recommendation

This option is for candidates who are applying for a license in any state other than MN.

Describe Your Request(Required)

Please include above what Content Area(s), Grade Levels, and State you are requesting (below).

Out-of-State Application

If you are requesting completion of a form, please attach the form here. Make sure to read the entire form - there may be a part (usually on top) for you to fill out.

Max. file size: 16 MB.

Other

If you would like to add any other information, please do so below.

CAPTCHA

Elementary Education (K-6)
Preprimary (Age 3-PreK)
Middle School Communication Arts & Lit (5-8)
Middle School Math (5-8)
Middle School Science (5-8)
Middle School Social Studies (5-8)
Communication Arts & Lit (5-12)
Math (5-12)
Social Studies (5-12)
Health (5-12)
Physical Education (K-12)
DAPE (P-12)
Chemistry (9-12)
Earth & Space Science (9-12)
Life Science (9-12)
Physics (9-12)
Music: Instrumental (K-12)
Music: Vocal (K-12)
Special Education - ABS
Special Education - ASD
Special Education - EBD
Special Education - SLD
Visual Arts Education (K-12)
CTE: Communications Technology (7-12)
CTE: Construction Careers (7-12)

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