M.S.A.D. 49 Teacher Certification

S.S.S.C. COURSE APPROVAL For Certification

NAME: ___________________________ Building: ________________

S.S. # :____________________________  Date:   __________________

Date Course Begins: _____________________

Signature: _____________________________ 

Name of Course:_________________________________________

Course Description:__________________________________________

___________________________________________________________

___________________________________________________________ 

Number of Credits: ___________/Number of CEU's  


How will this course be useful to you as a teacher?

Approved: _____________________

Not Approved _________________

This form is for recertification only, not for course reimbursement.

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