Please read the instructions before filling out this form. This form should only be completed after you have applied for your certification through PDE's Teacher Information Management System (TIMS).
All fields are required unless otherwise stated.
Tell us about yourself so we can locate your academic records.
Tell us where we can 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.
Tell us about the certification you are applying for. Remember you must first apply via PDE's TIMS online application system, and then include the relevant information from your application below.
Certificate subject area(s) associated with this TIMS application (select all that apply)