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    98 views1 page

    Child Development Associate Teacher Certificate

    Uploaded by

    api-576506208

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
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    etc cee Sutter County Supe! eS Bill Cornelius, Superintendent 970 Klamath Lane, Yuba City, CA 95993 erm Temporary County Certificate itendent of Schools ‘This TEMPORARY COUNTY CERTIFICATE (TCC) authorizes certificated service in SUTTER COUNTY for: Ci SUBSTITUTE TEACHING IN SUTTER COUNTY OR [] ASSIGNMENT:_(schoob (aster) \ ale fe NAME OF CREDENTIAL or PERMIT BEING APPLIED FOR: __C. é 2 Submision rout L_]onmiionon Teacher Gredentaing CY Coiepe:————_—L] Bast GY Coaiy NAME: ts . Fist . Maile ‘Former Names. Vos tli vy Mikala, bn Maling Address: wm "Gy Boy 334 meridian CA ® 95957 EMail appress:_ mkoSHi vy hotmail com ‘SSN i > Bith Date 19 713/93 [PPone/S 3-97a4 \ > APPLICANT AFFIDAVIT NOT TO BE COMPLETED BY APPLICANT IF ANY OF THE FOLLOWING APPLY: » 2 3) 4 ‘The fess of applicant to hold this credential or permit iscurrenty under review by the Committee on Credentials. ‘Applicant has an appeal currently pening from prior denial f tis credential by the Commission of Commitee of Credentials ‘Applicant's credentials are curenty under diseptnary suspension or revocation, ‘Applicant is aware he does not meet minimum requirements fr credential sought | certy (or affirm) under penaty of perjury that | have provided true and accurate statements of all facts relating to my professional and personal {ualifcations forthe performance of service requiring ceriicaton and that | have submited my complete appicaton for Credential Authorizing Pubic ‘School Service tothe Calfornia Commission on Teacher Credentialing together with the required fee. | am aware that such application may be denied ‘on any ofthe grounds provided by ECS 44348 or 44346 quoted on reverse sie, butto the best of my knowledge no reason exists why l should not be Issued this ceriicate or pent | understand that this TCC shall be valid ONLY until the credential or permit being applied fore issued or denied by the CCTC, Certification: Hi This isto cert that a temporary authority of Section 44823 ofthe Education Cade. Based Upon applicant's statements and documents which I believe tobe tr

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