M.S.A.D. 49 (SSSC) Teacher Certification

New Teachers

Name:________________________   SS #:_____________________

                                                        Date of Certificate’s

Building:_______________________  Expiration:________________

Grade Level/Subject:______________  Date Received:______________

Type of Certificate:  (Check One):

     _____    Conditional

     _____   Provisional

     _____    Transitional

     _____    Professional

     _____    Other

 Please attach a copy of your current Teaching Certificate

and a copy of your NTE scores.

Please send to:

          Support System Steering Committee (SSSC)

          c/o Superintendent’s Office

Revised 8/00