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Carson-Newman University
Verification of Experience Form
Applicant Information
I,
Applicant's Full Name
*
, certify that I am currently employed at
School Name
*
School County/District
*
City, State
*
Program that you are applying to:
*
M.Ed. in Educational Leadership with Principal License
M.Ed. in Educational Leadership Non-Licensure
Principal Licensure Only
M.Ed. Curriculum and Instruction
M.Ed. Curriculum and Instruction with Coaching Emphasis
M.Ed. Curriculum and Instruction with Reading Specialist Licensure
M.Ed. Curriculum and Instruction with Special Education Emphasis
M.Ed. Curriculum and Instruction with ESL Emphasis
Ed.S. w/Administrative Leadership Licensure
Ed.S. with Curriculum and Instruction Concentration
Ed. D. w/Administrative Leadership Licensure
Ed.D. in Educational Leadership with Curriculum and Instruction Concentration
Ed. D. w/Administrative Leadership Non-Licensure
Ed. S. w/Administrative Leadership Non-Licensure
Employer Authorization Form
Please initial the following statement if you agree:
I grant permission for my employer to verify that I have successfully completed two (2) years of education working experience, as required by the state, to be recommended for the Tennessee ILL-B (Beginning) Administrator License.
*
I grant permission for my employer to verify that I am currently employed within the above named school system.
*
I understand that all practicum hours completed throughout the course of my program must be completed within my school district in the state of Tennessee.
*
Applicant's Signature
*
Applicant Date
*
+
Administrator Infomation
To the Student:
Please provide the name and contact information of the member of your administration team who is able to verify you meet Carson-Newman University’s admissions criteria.
School or District Administrator's Name
*
School or District Administrator's Email Address
*
Administrator's Current Employer:
*
Upon submission of this request, a Verification of Experience form will be sent electronically to the school or district administrator provided above.