Name Building Assignment
Eligibility for continuing contract status:
Circle Answers
1.
I hold a professional, permanent, or life certificate
If “yes", which one:
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2.
a) I hold a 5-year license
AND
b)
My master’s degree was held at the time of initially receiving my certificate or license, Yes No
and I have six (6) semester hours of graduate coursework in the area of licensure or
in an area related to the teaching field since the initial issuance of the certificate
or license.
***If
Yes:
a) date of initial certificate/license was (copy
attached) b) date I received my master’s degree was
c)date I completed at least 6 semester hours was
d)the transcript copies are attached: Yes No
OR
3.
a) I hold a 5-year license
AND
b)
I did not have my master’s degree at the time of initially receiving my certificate or Yes No
license, however, I do have 30 semester hours of coursework since the initial issuance
of my certificate/license.
***If
Yes:
a)date of initial certificate/license was (copy attached)
b)date I received my master’s degree OR
date I completed at least 30 semester hours was
c)the transcript copies are attached: Yes No
(*Please make copies of the required attachments from your personal records.)
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Yes No
4.
I have taught at least 3 out of the last 5 years in Reynoldsburg
OR
5.
a) I attained continuing contract status in another district (verification attached)
AND
b) l have worked in Reynoldsburg for at least 2 years
Yes No
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I assert that:
1.
my contract is up for renewal this year;
2.
the above information is true and I am, therefore, eligible for a Continuing Contract; and
3.
this form is fully and accurately completed and submitted before October 15 of this year.
I have reviewed this information and confirm its accuracy:
- - - - - - - - - - - - - - - - - -
I
- - - - - -
Principal's Signature Date
***YES
-
Place this teacher on the Continuing Contract eligibility list:
- - - - - - - - - - - - - - - - - -/ - - - - - -
Assistant Superintendent Date
Reynoldsburg City Schools
Revised 02.20
Year initial license was issued: _______________
Year Initial license was issued: __________
Year Initial license was issued: __________