Educator Licensure
Forms
Appeal Forms • Applications for Licenses / Certificates • Providers of Workshops, etc. • Registration/Updates • Requests for Approval
Below you will find the online version of the forms from our office. Each form is saved in the PDF format. Please take the printed form and submit to your local Regional Office of Education.
Note: The following documents are in 
.pdf format and may contain form fields. In order for them to work correctly please visit http://www.adobe.com to download the latest version of Adobe Reader.
.pdf format and may contain form fields. In order for them to work correctly please visit http://www.adobe.com to download the latest version of Adobe Reader.
Requests
for Priority Review of Certification Applications
Instruction
Sheet for filling out a Form ONLINE
Appeal
Forms
| Form # | Form Name |
|---|---|
| 77-17 (8/12) |
Appeal to RPDRC of LPDC's Recommendation for Nonrenewal of a Standard/Master Certificate or Regional Superintendent's Recommendation for Non-issuance of a Standard Certificate |
| 77-18 (9/12) |
Appeal to State Teacher Certification Board |
Applications for Licenses/Certificates
| Form # | Form Name |
|---|---|
| OOS (1/13) |
Certification Checklist for Out-of-State Applicants |
| 73-01 (8/12) |
Application for Alternative Certificate |
| 73-03C (8/12) |
Teaching Certificates: Early Childhood,
Elementary, Secondary, Special, Substitute, Provisional
Vocational, Transitional Bilingual, Resident Teacher,
Part-time Provisional Option to split a special certificate to elementary and secondary certificates |
| 73-03D (8/12) |
Application for School Service Personnel or Administrative Certificate |
| 73-03E (8/12) |
Application for Master Certificate |
| 73-03F (8/12) |
Visiting International Teacher Certificate |
| 73-05 (8/12) |
State-Approved Program Verification |
| 73-06 (8/12) |
Grade Verification Form |
| 73-23 (8/12) |
Provisional Vocational Certificate |
| 73-52 (9/12) |
Endorsement of Elementary, Secondary or Administrative Certificate |
| 73-52A (9/12) |
Application for Teacher Leader Endorsement of Issued Certificate |
| 73-54 (1/13) |
ACT Plus Writing/SAT Score Report Verification Form for A Certificate/License |
| 73-60 (1/13) |
ACT Plus Writing/SAT Score Report Verification Form for Admission to an Illinois Preparation Program |
| 73-63 (8/12) |
Request for Issuance of Provisional Certificate |
| 73-86 (8/12) |
Short-term Emergency in Special Education |
| 73-91 |
Obsolete per PA 97-607 |
| 73-91A (8/12) |
Foreign Credentialing for Substitute and/or Para-Professional Certificate |
| 73-93 |
Obsolete per PA 97-607 reinstatement requirements have changed |
| 73-93A (8/12) |
Reinstatement Application - College Coursework |
| 73-93B (8/12) |
Reinstatement Application - $500.00 Penalty Fee |
| 73-94 (8/12) |
Interim Certification as School Counselor Intern |
| 73-99 | Obsolete per PA 96-0689 |
Providers
of Workshops, Conferences, Seminars, etc.
Registration/Updates
of Certificates
| Form # | Form Name |
|---|---|
| 73-10 (8/12) |
Certificate Registration Form |
| 73-71 (8/12) |
Certification Update/Duplicate Certificate Request/Name or address change |
| 73-83 (8/12) |
Verification of Teaching Experience for Removal of Limitations on Limited Learning Behavior Specialist I (LBS I) Endorsement |
| 73-85 (8/12) |
Request for Review of File to Remove Limitations on LBS I |
| 73-92 (8/12) |
Certificate of Completion for LBS I Training Sequence |
Requests
for Approval
| Form # | Form Name |
|---|---|
| 73-26 (5/10) |
Request for Evaluation of Approval Areas of Special Education |
| 73-42 (8/12) |
Approval of Other Special Education Personnel |
| 73-44 (8/12) |
Notification of School Service Personnel Intern Eligibility Status |
| 73-49 (8/12) |
Approval as a Bilingual or ESL Teacher |
| 73-51 (8/12) |
Request for Approval of a Speech and Language Paraprofessional |
| 73-53 (8/12) |
Educational Interpreter Log |
| 73-67 (9/12) |
Bilingual Special Education Approval |
| 73-72 (9/12) |
Nonpublic School Request for Approval of Other Special Education Personnel |
| 73-95 (8/12) |
Paraprofessional Approval/Approval for Paraprofessional Employment in Title I Positions |
| 73-96 (9/12) |
Request for Authorization to Employ Teacher in Position Otherwise Unfilled |
| 77-35 (9/12) |
Request for Approval as an Educational Interpreter |
| 77-36 (1/10) |
Request to Report Status of Bilingual Teacher, Special Education, and Rural School Teacher as Highly Qualified for NCLB Purposes |
| 78-81 (2/13) |
Proof of Previously Issued Teacher Aide Approval |
