{"id":46,"date":"2022-07-14T13:59:33","date_gmt":"2022-07-14T18:59:33","guid":{"rendered":"https:\/\/www.bemidjistate.edu\/offices\/teacher-education\/?page_id=46"},"modified":"2024-08-02T08:11:51","modified_gmt":"2024-08-02T13:11:51","slug":"request-licensure-documentation","status":"publish","type":"page","link":"https:\/\/www.bemidjistate.edu\/offices\/teacher-education\/licensing\/request-licensure-documentation\/","title":{"rendered":"Request Licensure Documentation"},"content":{"rendered":"<p><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_unknown gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_4' style='display:none'>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Request Licensure Documentation<\/h2>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_4'  action='\/offices\/teacher-education\/wp-json\/wp\/v2\/pages\/46' data-formid='4' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_4' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_4_40\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 style=\"margin: 0.2rem 0px 0.5rem;padding: 0px;color: #222222;font-family: 'Trebuchet MS', 'Lucida Grande', 'Lucida Sans Unicode', 'Lucida Sans', Tahoma, sans-serif;line-height: 1.4;font-size: 1.13333rem\">If you are requesting documentation verifying enrollment in or completion of a licensure program, please complete this form. If you are seeking recommendation for a MN license, please review the requirements listed on our&nbsp;<span style=\"text-decoration: underline\"><a style=\"color: #005947;line-height: inherit;text-decoration: underline\" href=\"https:\/\/www.bemidjistate.edu\/offices\/teacher-education\/licensing\/\">Licensing<\/a><\/span>&nbsp;page.<\/h3>\n<p>If you have additional questions, please contact:&nbsp;<span style=\"text-decoration: underline\"><a href=\"mailto:Teaching.License@bemidjistate.edu\">Teaching.License@bemidjistate.edu<\/a><\/span><\/p>\n<p><span style=\"color: #790000;font-family: 'Trebuchet MS', 'Lucida Grande', 'Lucida Sans Unicode', 'Lucida Sans', Tahoma, sans-serif;font-size: 15px;font-weight: bold\">* Indicates Required Information<\/span><\/p><\/div><div id=\"field_4_1\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_1'>Date<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_1' id='input_4_1' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='06\/20\/2026' aria-describedby=\"input_4_1_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_4_1_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_4_1' class='gform_hidden' value='https:\/\/www.bemidjistate.edu\/offices\/teacher-education\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_4_3\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Contact Information<\/h3><div class='gsection_description' id='gfield_description_4_3'>Enter your contact information<\/div><\/div><fieldset id=\"field_4_4\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_4_4'>\n                            \n                            <span id='input_4_4_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_4_4_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_4.3' id='input_4_4_3' value=''   aria-required='true'     \/>\n                                                <\/span>\n                            \n                            <span id='input_4_4_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_4_4_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_4.6' id='input_4_4_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_4_50\" class=\"gfield gfield--type-name gfield--input-type-name field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Previous Last Name<\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix no_first_name no_middle_name has_last_name no_suffix gf_name_has_1 ginput_container_name gform-grid-row' id='input_4_50'>\n                            \n                            \n                            \n                            <span id='input_4_50_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_4_50_6' class='gform-field-label gform-field-label--type-sub '>(if applicable)<\/label>\n                                                            <input type='text' name='input_50.6' id='input_4_50_6' value=''   aria-required='false'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_4_6\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_4_6'>NOTE: Our emails occasionally go straight to your SPAM folder! If you haven't heard back from us check your spam folder.<\/div><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_4_6_container'>\n                                <span id='input_4_6_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <label for='input_4_6' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                    <input class='' type='email' name='input_6' id='input_4_6' value=''    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_4_6\" \/>\n                                <\/span>\n                                <span id='input_4_6_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <label for='input_4_6_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                    <input class='' type='email' name='input_6_2' id='input_4_6_2' value=''    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_4_6\" \/>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><div id=\"field_4_8\" class=\"gfield gfield--type-phone gfield--input-type-phone field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_8'>Phone Number<\/label><div class='ginput_container ginput_container_phone'><input name='input_8' id='input_4_8' type='tel' value='' class='medium'    aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_4_7\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Mailing Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_4_7' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_4_7_1_container' >\n                                        <label for='input_4_7_1' id='input_4_7_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_7.1' id='input_4_7_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_4_7_2_container' >\n                                        <label for='input_4_7_2' id='input_4_7_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                        <input type='text' name='input_7.2' id='input_4_7_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_4_7_3_container' >\n                                    <label for='input_4_7_3' id='input_4_7_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_7.3' id='input_4_7_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_4_7_4_container' >\n                                        <label for='input_4_7_4' id='input_4_7_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                        <input type='text' name='input_7.4' id='input_4_7_4' value=''      aria-required='true'    \/>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_4_7_5_container' >\n                                    <label for='input_4_7_5' id='input_4_7_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                    <input type='text' name='input_7.5' id='input_4_7_5' value=''    aria-required='true'    \/>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_4_7_6_container' >\n                                        <label for='input_4_7_6' id='input_4_7_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                        <select name='input_7.6' id='input_4_7_6'   aria-required='true'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' selected='selected'>United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option> <\/select>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_4_5\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_5'>BSU Student ID (Tech ID)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_4_5'><b>8-digit BSU Tech ID Number - If you do not remember it, please provide your date of birth or the last four digits of your Social Security Number.<\/b><\/div><div class='ginput_container ginput_container_text'><input name='input_5' id='input_4_5' type='text' value='' class='medium'  aria-describedby=\"gfield_description_4_5\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_36\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Are you currently licensed?<\/h3><div class='gsection_description' id='gfield_description_4_36'>Choose what level of licensure you are at<\/div><\/div><fieldset id=\"field_4_42\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Current License<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_42'>\n\t\t\t<div class='gchoice gchoice_4_42_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='Not Licensed'  id='choice_4_42_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_42_0' id='label_4_42_0' class='gform-field-label gform-field-label--type-inline'>Not Licensed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_42_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='Currently Hold Tier 1, 2, 3 or 4 in MN'  id='choice_4_42_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_42_1' id='label_4_42_1' class='gform-field-label gform-field-label--type-inline'>Currently Hold Tier 1, 2, 3 or 4 in MN<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_42_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_42' type='radio' value='Currently Hold a Substitute License in MN'  id='choice_4_42_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_42_2' id='label_4_42_2' class='gform-field-label gform-field-label--type-inline'>Currently Hold a Substitute License in MN<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_38\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p>Please provide your MN File Folder Number. You can find your FFN using the Minnesota License Lookup page:<\/p>\n<p><span style=\"text-decoration: underline\"><a href=\"https:\/\/public.education.mn.gov\/LicenseLookup\/educator\">https:\/\/public.education.mn.gov\/LicenseLookup\/educator<\/a><\/span><\/p><\/div><div id=\"field_4_55\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_55'>MN File Folder Number<\/label><div class='gfield_description' id='gfield_description_4_55'>If you are currently licensed in MN please provide your current MN File Folder Number. You can search for your FFN here:\nhttps:\/\/public.education.mn.gov\/LicenseLookup\/educator<\/div><div class='ginput_container ginput_container_text'><input name='input_55' id='input_4_55' type='text' value='' class='medium'  aria-describedby=\"gfield_description_4_55\"    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_4_35\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Guide to Determining What Type of Documentation You Are Requesting<\/h3><div class='gsection_description' id='gfield_description_4_35'>This guide will help you determine what type of documentation you need.<\/div><\/div><div id=\"field_4_15\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><ol>\n  <li>\n    <strong>Section 6: Verification of Completion for Tier 3 or 4 MN License<\/strong>\n    <ol type=\"a\">\n      <li>You completed an approved licensure program at BSU and<\/li>\n      <li>You are applying for a Tier 3 or 4 license in MN<\/li>\n    <\/ol>\n  <\/li>\n  <li>\n    <strong>Out-of-Field Permission<\/strong>\n    <ol type=\"a\">\n      <li>You are currently licensed in MN and<\/li>\n      <li>You are seeking an Out-of-Field Permission for another licensure area and<\/li>\n      <li>You are enrolled in a licensure program at BSU<\/li>\n    <\/ol>\n  <\/li>\n  <li>\n    <strong>Section 8: Verification of Enrollment for Tier 2 MN License<\/strong>\n    <ol type=\"a\">\n      <li>You do not currently hold a Tier 2, 3, or 4 license in MN and<\/li>\n      <li>You are enrolled in a licensure program through BSU\n        <ol type=\"i\">\n          <li>For FasTrack candidates this includes completion of ED 5000 and<\/li>\n          <li>Enrollment in courses for this or next semester<\/li>\n        <\/ol>\n      <\/li>\n    <\/ol>\n  <\/li>\n  <li>\n    <strong>Section 8: Verification of Meaningful Progress for Tier 2 MN License<\/strong>\n    <ol type=\"a\">\n      <li>You hold or have held a Tier 2 license in MN and<\/li>\n      <li>You are enrolled in a licensure program through BSU and<\/li>\n      <li>You are making meaningful progress towards your licensure program and<\/li>\n      <li>You wish to renew your Tier 2 License<\/li>\n    <\/ol>\n  <\/li>\n  <li>\n    <strong>Out-of-State Licensure Recommendation<\/strong>\n    <ol type=\"a\">\n      <li>You completed an approved licensure program at BSU and<\/li>\n      <li>You are seeking licensure in another state (not MN)<\/li>\n    <\/ol>\n  <\/li>\n<\/ol><\/div><div id=\"field_4_39\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">What type of licensure documentation are you requesting?<\/h3><\/div><fieldset id=\"field_4_43\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Requesting<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_43'>\n\t\t\t<div class='gchoice gchoice_4_43_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='Section 6: Verification of Program Completion (Tier 3 or 4 MN License)'  id='choice_4_43_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_43_0' id='label_4_43_0' class='gform-field-label gform-field-label--type-inline'>Section 6: Verification of Program Completion (Tier 3 or 4 MN License)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_43_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='Out-of-Field Permission'  id='choice_4_43_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_43_1' id='label_4_43_1' class='gform-field-label gform-field-label--type-inline'>Out-of-Field Permission<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_43_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='Section 8: Verification of Enrollment (Tier 2 MN License)'  id='choice_4_43_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_43_2' id='label_4_43_2' class='gform-field-label gform-field-label--type-inline'>Section 8: Verification of Enrollment (Tier 2 MN License)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_43_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='Section 8: Verification of Meaningful Progress (Tier 2 MN License)'  id='choice_4_43_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_43_3' id='label_4_43_3' class='gform-field-label gform-field-label--type-inline'>Section 8: Verification of Meaningful Progress (Tier 2 MN License)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_43_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='Out-of-State License Recommendation'  id='choice_4_43_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_43_4' id='label_4_43_4' class='gform-field-label gform-field-label--type-inline'>Out-of-State License Recommendation<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_12\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Enrollment Verification Letter<\/h3><\/div><div id=\"field_4_32\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p><strong><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">This option is appropriate if you:<\/span><\/strong><\/p>\n<p style=\"margin-left: .5in;text-indent: -.25in;text-align: start\"><!-- [if !supportLists]--><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">a.<span style=\"font: 7.0pt 'Times New Roman'\">&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><!--[endif]--><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">Are applying for Tier 2 MN License<\/span><\/p>\n<p style=\"margin-left: .5in;text-indent: -.25in;text-align: start\"><!-- [if !supportLists]--><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">b.<span style=\"font: 7.0pt 'Times New Roman'\">&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><!--[endif]--><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">Do not currently hold a Tier 2, 3 or 4 license in MN<\/span><\/p>\n<p style=\"margin-left: .5in;text-indent: -.25in;text-align: start\"><!-- [if !supportLists]--><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">c.<span style=\"font: 7.0pt 'Times New Roman'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><!--[endif]--><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">Are enrolled in a licensure program through BSU<\/span><\/p>\n<p style=\"margin-left: .5in;text-indent: -.25in;text-align: start\"><!-- [if !supportLists]--><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">d.<span style=\"font: 7.0pt 'Times New Roman'\">&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">Are enrolled in courses this semester (or the upcoming semester)<\/span><\/p>\n<p style=\"margin-left: .5in;text-indent: -.25in;text-align: start\"><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\"><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">e.<span style=\"font: 7.0pt 'Times New Roman'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<\/span><\/span><span style=\"font-size: 11.5pt\">Have completed ED 5000 (does not apply to SPED candidates) (<span style=\"text-decoration: underline\">FasTrack Only<\/span>)<\/span><\/span><\/p>\n<p style=\"text-align: start\"><strong><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">If you can answer \"Yes\" to all of the above, please fill out the remaining pieces (below) and click submit.<\/span><\/strong><\/p><\/div><div id=\"field_4_16\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Section 9: Verification of Meaningful Progress<\/h3><\/div><div id=\"field_4_33\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p><strong><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">This option is appropriate if you:<\/span><\/strong><\/p>\n<p style=\"margin-left: .5in;text-indent: -.25in\"><!-- [if !supportLists]--><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\"><span>a.<span style=\"font: 7.0pt 'Times New Roman'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><\/span><!--[endif]--><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">Hold or have held a Tier 2 license in MN<\/span><\/p>\n<p style=\"margin-left: .5in;text-indent: -.25in\"><!-- [if !supportLists]--><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\"><span>b.<span style=\"font: 7.0pt 'Times New Roman'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><\/span><!--[endif]--><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">Are enrolled in a licensure program through BSU<\/span><\/p>\n<p style=\"margin-left: .5in;text-indent: -.25in\"><!-- [if !supportLists]--><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\"><span>c.<span style=\"font: 7.0pt 'Times New Roman'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><\/span><!--[endif]--><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">Are making meaningful progress towards your licensure program<\/span><\/p>\n<p style=\"margin-left: .5in;text-indent: -.25in\"><!-- [if !supportLists]--><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\"><span>d.<span style=\"font: 7.0pt 'Times New Roman'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><\/span><!--[endif]--><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">Wish to renew your Tier 2 license<\/span><\/p>\n<p><strong><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">If you can answer \"Yes\" to all of the above, please fill out the remaining pieces (below) and click submit.<\/span><\/strong><\/p><\/div><div id=\"field_4_11\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Section 6: Verification of Program Completion<\/h3><\/div><div id=\"field_4_34\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p><strong><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">This option is appropriate if you:<\/span><\/strong><\/p>\n<p style=\"margin-left: .5in;text-indent: -.25in\"><!-- [if !supportLists]--><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">a.<span style=\"font: 7.0pt 'Times New Roman'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><!--[endif]--><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">Have completed an approved licensure program at BSU<\/span><\/p>\n<p style=\"margin-left: .5in;text-indent: -.25in\"><!-- [if !supportLists]--><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">b.<span style=\"font: 7.0pt 'Times New Roman'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">Have official scores on file for all required licensure exams<\/span><\/p>\n<p style=\"margin-left: .5in;text-indent: -.25in\"><!-- [if !supportLists]--><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">c.<span style=\"font: 7.0pt 'Times New Roman'\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <\/span><\/span><!--[endif]--><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">Are applying for a Tier 3 or 4 license in MN<\/span><\/p>\n<p><strong><span style=\"font-size: 11.5pt;font-family: 'Source Sans Pro',sans-serif;color: #444444\">If you can answer \"Yes\" to all of the above, please fill out the remaining pieces (below) and click submit.<\/span><\/strong><\/p><\/div><div id=\"field_4_41\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Licensure Field(s)<\/h3><\/div><fieldset id=\"field_4_44\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >What Tier are you applying for?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_4_44'>\n\t\t\t<div class='gchoice gchoice_4_44_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='Tier 3'  id='choice_4_44_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_44_0' id='label_4_44_0' class='gform-field-label gform-field-label--type-inline'>Tier 3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_4_44_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='Tier 4'  id='choice_4_44_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_4_44_1' id='label_4_44_1' class='gform-field-label gform-field-label--type-inline'>Tier 4<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_53\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_53'>Online Processing Number<\/label><div class='gfield_description' id='gfield_description_4_53'><p>If you have completed PELSB's online application for an initial Tier 3 license you were issued a \"Processing Number.\" Please provide your Processing Number.<\/p><\/div><div class='ginput_container ginput_container_text'><input name='input_53' id='input_4_53' type='text' value='' class='large'  aria-describedby=\"gfield_description_4_53\"    aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_4_52\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Please indicate which program you completed.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_4_52'><div class='gchoice gchoice_4_52_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.1' type='checkbox'  value='On Campus'  id='choice_4_52_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_52_1' id='label_4_52_1' class='gform-field-label gform-field-label--type-inline'>On Campus<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_52_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.2' type='checkbox'  value='DLiTE'  id='choice_4_52_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_52_2' id='label_4_52_2' class='gform-field-label gform-field-label--type-inline'>DLiTE<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_52_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.3' type='checkbox'  value='FasTrack'  id='choice_4_52_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_52_3' id='label_4_52_3' class='gform-field-label gform-field-label--type-inline'>FasTrack<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_52_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.4' type='checkbox'  value='Licensure Only'  id='choice_4_52_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_52_4' id='label_4_52_4' class='gform-field-label gform-field-label--type-inline'>Licensure Only<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_52_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_52.5' type='checkbox'  value='Special Education'  id='choice_4_52_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_52_5' id='label_4_52_5' class='gform-field-label gform-field-label--type-inline'>Special Education<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_4_54\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Please indicate which program you are enrolled in.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_4_54'><div class='gchoice gchoice_4_54_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.1' type='checkbox'  value='On Campus'  id='choice_4_54_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_54_1' id='label_4_54_1' class='gform-field-label gform-field-label--type-inline'>On Campus<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_54_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.2' type='checkbox'  value='DLiTE'  id='choice_4_54_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_54_2' id='label_4_54_2' class='gform-field-label gform-field-label--type-inline'>DLiTE<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_54_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.3' type='checkbox'  value='FasTrack'  id='choice_4_54_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_54_3' id='label_4_54_3' class='gform-field-label gform-field-label--type-inline'>FasTrack<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_54_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.4' type='checkbox'  value='Licensure Only'  id='choice_4_54_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_54_4' id='label_4_54_4' class='gform-field-label gform-field-label--type-inline'>Licensure Only<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_4_54_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_54.5' type='checkbox'  value='Special Education'  id='choice_4_54_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_4_54_5' id='label_4_54_5' class='gform-field-label gform-field-label--type-inline'>Special Education<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_4_45\" class=\"gfield gfield--type-multiselect gfield--input-type-multiselect gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_45'>What license(s) are you pursuing?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_4_45'><b>Select all that apply. Hold CTRL and Left Click Mouse to Select Multiple Options.<\/b><\/div><div class='ginput_container ginput_container_multiselect'><select multiple='multiple'  size='7' name='input_45[]' id='input_4_45' class='medium gfield_select'   aria-invalid=\"false\" aria-required=\"true\" aria-describedby=\"gfield_description_4_45\"><option value='Elementary Education (K-6)' >Elementary Education (K-6)<\/option><option value='Preprimary (Age 3-PreK)' >Preprimary (Age 3-PreK)<\/option><option value='Middle School Communication Arts &amp; Lit (5-8)' >Middle School Communication Arts &amp; Lit (5-8)<\/option><option value='Middle School Math (5-8)' >Middle School Math (5-8)<\/option><option value='Middle School Science (5-8)' >Middle School Science (5-8)<\/option><option value='Middle School Social Studies (5-8)' >Middle School Social Studies (5-8)<\/option><option value='Communication Arts &amp; Lit (5-12)' >Communication Arts &amp; Lit (5-12)<\/option><option value='Math (5-12)' >Math (5-12)<\/option><option value='Social Studies (5-12)' >Social Studies (5-12)<\/option><option value='Health (5-12)' >Health (5-12)<\/option><option value='Physical Education (K-12)' >Physical Education (K-12)<\/option><option value='DAPE (P-12)' >DAPE (P-12)<\/option><option value='Chemistry (9-12)' >Chemistry (9-12)<\/option><option value='Earth &amp; Space Science (9-12)' >Earth &amp; Space Science (9-12)<\/option><option value='Life Science (9-12)' >Life Science (9-12)<\/option><option value='Physics (9-12)' >Physics (9-12)<\/option><option value='Music: Instrumental (K-12)' >Music: Instrumental (K-12)<\/option><option value='Music: Vocal (K-12)' >Music: Vocal (K-12)<\/option><option value='Special Education - ABS' >Special Education - ABS<\/option><option value='Special Education - ASD' >Special Education - ASD<\/option><option value='Special Education - EBD' >Special Education - EBD<\/option><option value='Special Education - SLD' >Special Education - SLD<\/option><option value='Visual Arts Education (K-12)' >Visual Arts Education (K-12)<\/option><option value='CTE: Communications Technology (7-12)' >CTE: Communications Technology (7-12)<\/option><option value='CTE: Construction Careers (7-12)' >CTE: Construction Careers (7-12)<\/option><\/select><\/div><\/div><div id=\"field_4_29\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_29'>Plan of Study<\/label><div class='gfield_description' id='gfield_description_4_29'><p style=\"margin: 0px 0px 1.33333rem;padding: 0px;font-family: 'Trebuchet MS', 'Lucida Grande', 'Lucida Sans Unicode', 'Lucida Sans', Tahoma, sans-serif;font-size: 15px;line-height: 1.6;color: #463e35\"><strong style=\"font-weight: bold;line-height: inherit\">If you COMPLETED any of the following programs, please upload an approved plan of study WITH A FACULTY SIGNATURE (below). Your application will not be processed if the form is not signed.<\/strong><\/p>\n<p style=\"margin: 0px 0px 1.33333rem;padding: 0px;font-family: 'Trebuchet MS', 'Lucida Grande', 'Lucida Sans Unicode', 'Lucida Sans', Tahoma, sans-serif;font-size: 15px;line-height: 1.6;color: #463e35\">1.&nbsp;SPED (ASD, EBD, SLD)<br \/> 2. FasTrack Program<br \/> 3. Health Add-On<br \/> 4. DAPE Add-On<br \/> 5. Other Licensure Only (not seeking a degree)<\/p><\/div><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='16384000' \/><input name='input_29' id='input_4_29' type='file' class='medium' aria-describedby=\"gfield_upload_rules_4_29 gfield_description_4_29\" onchange='javascript:gformValidateFileSize( this, 16384000 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_4_29'>Max. file size: 16 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_4_29'><\/div> <\/div><\/div><div id=\"field_4_17\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Out-of-State License Recommendation<\/h3><div class='gsection_description' id='gfield_description_4_17'>This option is for candidates who are applying for a license in any state other than MN.<\/div><\/div><div id=\"field_4_31\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_31'>Describe Your Request<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_4_31'>Please include above what Content Area(s), Grade Levels, and State you are requesting (below).<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_31' id='input_4_31' class='textarea medium'  aria-describedby=\"gfield_description_4_31\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_4_18\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_4_18'>Out-of-State Application<\/label><div class='gfield_description' id='gfield_description_4_18'>If you are requesting completion of a form, please attach the form here. 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