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PERMIT
ENTITY NUMBER:
809345
VALID
07/01/2014
THROUGH
06/30/2017
The district may request renewal of this permit if there continues to be a declared emergency need for substitute teachers in that district. This permit allows
employment as a substitute for no more than 20 consecutive days in the same teaching assignment.
This is to verify that the person named herein has furnished the State Superintendent of Public
Instruction with satisfactory evidence of preparation and experience and is licensed for the
position, subject and/or grade herein listed.
IN WITNESS WHEREOF, I HAVE HEREUNTO AFFIXED MY SIGNATURE AND OFFICIAL SEAL.
STATE SUPERINTENDENT