ALT-T

Alternative Educator Teaching License Application

This application has 2 pages to be completed. Please print using black or blue ink only. Page 1 of 2
PERSONAL INFORMATION
Department
Educator ID or SSN ____________________________________ Birthdate ____________________ hio of Education

Gender _________ Male ________ Female Office of Educator Licensure

25 S. Front St, Mail Stop 105
First Name ______________________________________________________ Columbus, Ohio 43215

Last Name ______________________________________________________ MI____________

Use this application for:
Address _______________________________________________________________________
Alternative Educator License
City ____________________________________________ State ______________________ Initial License
Advance to a Standard License
Zip Code ___________________________________________

E-mail ____________________________________________ Adolescence to

Young Adult 7-12
Home Phone _______________________________ Cell Phone ______________________________ and
Other names which may appear on official documents (e.g.: maiden)_________________________________ Intervention Specialist K-12

Amount enclosed: $
BACKGROUND CHECKS
FIRST OHIO LICENSE, CERTIFICATE OR PERMIT
W hen an individual submits an application for their very first license, certificate or permit issued by the Ohio Department of Education, a BCI and FBI
background check report, completed within 365 days of the date the application is received, must be on file at the Department of Education.

RENEWALS AND ADDITIONAL LICENSES, CERTIFICATES OR PERMITS

Have you lived continuously in Ohio for the past 5 years? You must check one:

YES
An FBI background check is required if the report on file
with ODE is more than 5 years old at the date the application
is received. A BCI background check is required if you do
not have one on file with ODE.
NO
Both the BCI and FBI background checks are required if the
reports on file with ODE are more than five years old on the
date the application is received.

Please note:
The Ohio Department of Education is not able to accept paper reports. All background check reports must be submitted to this office via electronic
submission directly from the Ohio Bureau of Criminal Investigation. W hen you have your fingerprints taken at a WebCheck facility please ask the person
taking the prints to check the box under ‘Reason Fingerprinted’ to send to the Ohio Department of Education per the example below:
Reason Fingerprinted
x Send to the Ohio Department of Education
Please do not use the Department of Education address in the ‘mail to’ section because the department is not able to utilize paper reports.
For more information on how to complete this electronic process, please visit: www.ohioattorneygeneral.gov/Services/Business/WebCheck.

LEGAL QUESTIONS Each Question MUST be answered by placing an X in the appropriate box.
If you answer YES to any question, attach explanation to this application.
Please include the year of conviction, the nature of the offense, and the court where the matter was heard.

YES NO HAVE YOU EVER . . . .

Been convicted of, found guilty of, pled guilty to, or pled no contest to any misdemeanor other than a traffic offense?

Been convicted of, found guilty of, pled guilty to, or pled no contest to any felony?

Had a criminal conviction sealed or expunged?

Had ANY professional certificate, license, or permit, or an application for same, revoked, suspended, limited, or denied?

Surrendered ANY certificate, license or permit, other than a driver’s license?

I certify under penalty of loss of my right to teach or work in the schools of Ohio that the answers to these five questions are true and correct in every
respect.

Signature of Applicant Date

January 2010
CONTINUED ON PAGE 2

CREDENTIAL INFORMATION
Use This Application For:
ALT-T
Alternative Educator Teaching License and To Advance to a Standard License
Page 2
- Indicate license request

2-Year Alternative Adolescence to Young Adult 7-12 $ 80

Indicate license type requested and teaching field requested (see code sheet on page 3)

6 3 88 85 1 0
Non-renewable
Baccalaureate degree from an accredited college, and
A major in the subject to include 30 semester or 45 quarter hours in the content area to be taught, with a 2.5 GPA or higher (integrated science, integrated language arts, and integrated
social studies require 60 semester or 90 quarter hours), consisting of coursework well distributed across the subject area, showing increasing depth and complexity and with sufficient
advanced coursework to constitute a major field of study, and
Completion of six semester hours (or 9 quarter hours) of professional education coursework within the past five years with a GPA of 2.5, and from a college or university approved to prepare
teachers, as follows: Three semester hours in teaching methods, including field experience; and three semester hours in developmental characteristics of the adolescent through
young adult student, and successful completion of the Praxis II assessment test for the subject requested, or the ACTFL OPI and WPT tests for world languages.

2-Year Alternative Intervention Specialist K-12 $ 80

Indicate license type requested and teaching field requested (see code sheet on page 3)

6 5 88 85 1 0
Non-renewable
Baccalaureate degree from an accredited college, and
A major in special education; or 30 semester hours (45 quarter hours) of coursework in professional education, with a GPA of 2.5 or higher, that includes no less than 18 semester hours
specifically in special education; and three semester hours in teaching methods, including field experience; and three semester hours in developmental characteristics of adolescent youths
(or educational psychology).

EFFECTIVE YEAR

NOTE: An application for an alternative license may not be submitted after November 15 of the
License to begin on July 1, ________________
effective year requested

DEGREE INFORMATION

Highest educational level completed (check only one) ____ Bachelor ____ Master _____ Doctorate

College/University ____________________________________________ State _____________________________ Date of Completion ____________________

LICENSE TEST (required to receive the alternative adolescence to young adult license only)

Please indicate the Praxis II subject assessment test you have taken: Test # __________________________ Date _________________
OR
Please indicate the date(s) the ACTFL tests for world languages were taken: OPI Date ____________ WPT Date _____________

SUPERINTENDENT SIGNATURE and MAIL TO ORGANIZATION for the initial alternative educator teaching license

I request an alternative educator teaching license for the individual named on this application; and I verify that the district has a plan for a mentoring
program for this individual as prescribed by the State Board of Education and the laws of Ohio.

Signature of Ohio School District Superintendent or designee School District Date

District or School Name ____________________________________________ Address ________________________________ ________________________________

License will be mailed to: Ohio school district IRN#

ADVANCE TO THE STANDARD LICENSE upon successful completion of all alternative licensure requirements PLEASE READ THE GENERAL INSTRUCTIONS

ADVANCE TO A STANDARD TEACHING LICENSE 2-Year Provisional = $ 80 5-Year Professional = $200

___ (63) Adolescence to Young Adult 7-12 ___ (65) Intervention Specialist K-12
The holder of an alternative educator license may advance to a standard teaching license upon successful completion of two years of teaching experience under the
alternative educator license as verified by the employing school superintendent; successful completion of the required Praxis II tests (see page 4); AND
for Adolescence to Young Adult 7-12: completion of 12 additional semester hours of professional education course work, with a GPA of 2.5 or above, prior to expiration of the
alternative educator license, from a college or university approved to prepare teachers, in the principles and practices of teaching; student development and learning; pupil
assessment procedures; curriculum development; classroom management; and teaching methodologies.
For Intervention Specialist K-12: completion of 12 additional semester hours of professional education course work, with a GPA of 2.5 or above, prior to expiration of the
alternative educator license, from a college or university approved to prepare teachers, in the principles and practices of teaching; student development and learning; pupil
assessment procedures; curriculum development; classroom management; and teaching methodologies; and/or in the teaching of reading and/or the teaching of phonics.
NOTE: Nine semester hours in the teaching of reading and and three semester hours in the teaching of phonics is required for a standard intervention specialist license. The
hours may be part of the 12 semester hours of additional professional education courswork.

APPLICANT SIGNATURE
I certify under penalty of loss of my right to teach in the schools of Ohio that the information provided on this page of the application is true and correct in every respect.

Signature of Applicant Date

January 2010
 GENERAL INSTRUCTIONS
ALT-T
Alternative Educator Teaching License Applications Page 3
Instructions
INSTRUCTIONS & CHECKLIST FOR SUBMISSION OF AN ALTERNATIVE EDUCATOR LICENSE

Fee
The processing fee is $80. Please submit a check or money order made payable to "Treasurer, State of Ohio”. DO NOT SEND CASH.
Please note: $25 of the processing fee is non-refundable if eligibility requirements for the license are not met.

Praxis II test scores (see page 4 of this application for required tests)
Applicants for the Adolescence to Young Adult alternative license are required to have the Educational Testing Service send the Praxis II score report
directly to the Office of Educator Licensure. Photocopies of Praxis II score reports are not acceptable. Ohio's recipient number is R7945.
Web site for information and registration: www.ets.org/praxis.

ACTFL (American Council on the Teaching of Foreign Languages) - Ohio requires two tests for world languages: Oral Proficiency Interview (OPI), and
Writing Proficiency Test (WPI). Web site for information and registration: www.languagetesting.com.

Official Transcripts (no photocopies) showing baccalaureate degree and all coursework must be attached to the application.
Course descriptions or syllabi may also be required to complete an evaluation.

The alternative educator license is issued at the request of an employing Ohio school or district. The license is a two-year non-renewable license.
An application may not be submitted after Novermber 15 of the effective year requested.
TEACHING FIELD CODES - (65) INTERVENTION SPECIALIST

196140 Mild/Moderate Educational Needs

196142 Moderate/Intensive Educational Needs
196109 Visually Impaired
196116 Hearing Impaired

TEACHING FIELD CODES - (63) ADOLESCENCE TO YOUNG ADULT 7-12

030300 Bookkeeping Basic Business 066008 Language- French

030000 Business Education 066009 Language- German
111700 Computer Science 065040 Language - Greek
080304 Dance 066014 Language- Japanese
050337 Drama/Theater 065005 Language- Latin
132040 Earth Sciences 066090 Language- Russian
150600 Economics 066019 Language- Spanish
050000 English ********* All other world languages - contact our office for codes
150700 Geography 050650 Library/Media
080101 Health 132030 Life Sciences
150800 History 120010 Music
230000 Home Economics 080310 Physical Education
101315 Industrial Technology 132150 Physical Science: Chemistry
110094 Integrated Mathematics 132160 Physical Science: Physics
050145 Integrated Language Arts 151100 Political Science
150004 Integrated Social Studies 050504 Speech/Communication
132010 Integrated Science 050280 TESOL (Teaching English to
050403 Journalism Speakers of Other Languages)
060100 Language- Arabic 020015 Visual Arts)
060102 Language- Chinese

INSTRUCTIONS TO ADVANCE FROM AN ALTERNATIVE EDUCATOR LICENSE TO A STANDARD TEACHING LICENSE

FEE: The processing fee is $80 for a 2-year provisional license. Individuals who already hold a standard 5-year professional license, or a 4-year, 8-year,
or permanent certificate may apply for a 5-year professional license. The fee for a 5-year professional license is $200.
Please submit a check or money order made payable to "Treasurer, State of Ohio”. DO NOT SEND CASH.
Please note: $25 of the processing fee is non-refundable if eligibility requirements for the license are not met.

Praxis II test scores (see page 4 of this application for required tests)
Applicants are required to have the Educational Testing Service send the Praxis II score report directly to the Office of Educator Licensure.
Photocopies of Praxis II score reports are not acceptable. Ohio's recipient number is R7945.

Official Transcripts (no photocopies) showing completion of the professional education coursework required to advance must be included with the application.
Course descriptions or syllabi may also be required to complete an evaluation.

Please submit a letter, on district letterhead, from the employing superintendent verifying successful completion of two years of teaching under the alternative
educator license

Mail the application to: Ohio Department of Education, Office of Educator Licensure, 25 S. Front Street, Mail Stop 105, Columbus, Ohio 43215
 License Types, Teaching Field Codes, and Licensure Exams ALT-T
Page 4
Required for issuance of the alternative educator licenses for Codes
Adolescence to Young Adult 7-12 only

LICENSE CODES
PRAXIS II SUBJECT ASSESSMENT TEST PASSING
(63) ADOLESCENCE TO YOUNG ADULT (7-12) SCORE

030300 Bookkeeping/Basic Business; or

300000 Business Education . . . . . . . . . . . . . . . . . . . . . . . . . . . 0100 Business Education 610

050145 Integrated Language Arts . . . . . . . . . .. . . . . . . . . . . . . 0041 English Content Knowledge 167

110094 Integrated Mathematics . . . . . . . . . . .. . . . . . . . . . . . . . 0061 Mathematics Content Knowledge 139

150004 Integrated Social Studies . . . . . . . . . .. . . . . . . . . . . . . . 0081 Social Studies Content Knowledge 157

132010 Integrated Science . . . . . . . . . . . . . . . . . . . . . . . . . . . Choose ONE option for Integrated Science:

Option 1
Biology & General Science and Physics: Content Knowledge 0030 and 0265 560 and 132
or Chemistry: Content Knowledge 0030 and 0245 560 and 152
or Earth Science: Content Knowledge 0030 and 0571 560 and 151

Option 2
Chemistry, Physics & General Science and Biology: Content Knowledge 0070 and 0235 520 and 148

132150 Physical Sciences: Chemistry . . . . . . . . . . . . . . . . . . . 0245 Chemistry Content Knowledge 152

132160 Physical Sciences: Physics . . . . . . . . . . . . . . . . . . . . . 0265 Physics Content Knowledge 132

132030 Life Sciences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0235 Biology Content Knowledge 148

132040 Earth Sciences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0571 Earth Science Content Knowledge 151

050000 English . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0041 English Content Knowledge 167

080101 Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0550 Health Education 480

230000 Home Economics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0120 Home Economics Education 540

050650 Library/Media . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0310 Library/Media Specialist 610

066008 Modern Language-French . . . . . . . . . . . . . . . . . . . . . . 0173 French Content Knowledge * until 9/1/10 160

060009 Modern Language-German . . . . . . . . . . . . . . . . . . . . . 0181 German Content Knowledge * until 9/1/10 165

060019 Modern Language-Spanish . . . . . . . . . . . . . . . . . . . . . 0191 Spanish Content Knowledge * until 9/1/10 160

****** All other world languages ** See Note

120010 Music . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0113 Music Content Knowledge 154

080310 Physical Education . . . . . . . . . . . . . . . . . . . . . . . . . . . 0091 Physical Education Content Knowledge 153

050280 TESOL (Teaching English to . . . . . . . . . . . . . . . . . . . . . 0360 Teaching English as a Second Language 420
Speakers of Other Languages

020015 Visual Arts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0133 Art Content Knowledge 157

** NOTE: All other world language teaching fields require the ACTFL Oral Proficiency Interview (OPI) and Writing Proficiency Test (WPT).
A rating of INTERMEDIATE-HIGH or higher is required for the OPI and the WPT.
Until September 1, 2010 applicants for French, Spanish and German may take either the Praxis II test or the ACTFL tests.

No Praxis II subject assessment required for:

Dance Economics History Journalism Political Science
Drama/Theater Geography Industrial Technology Latin Speech/Communications

PRAXIS II TESTS REQUIRED TO ADVANCE TO THE STANDARD LICENSE

ADOLESCENCE TO YOUNG ADULT 7-12:

Praxis II test # 0524, Principles of Learning and Teaching 7-12 (passing score 165) is required to advance to the standard license.

INTERVENTION SPECIALIST K-12:

Praxis II subject assessment #0353, Education of Exceptional Students:Core Content Knowledge; AND
one of the following PLT tests:
# 0521, Principles of Learning and Teaching P-3 (passing score 168)
#0522, Principles of Learning and Teaching K-6 (passing score 168)
# 0523, Principles of Learning and Teaching 5-9 (passing score 168)
# 0524, Principles of Learning and Teaching 7-12 (passing score 165)