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FORM  \n100 North First Street , E-240 Springfield, Illinois 62777-0001  \nEDUCATOR EFFECTIVENESS DEPARTMENT  \nPART I of IV – TO BE COMPLETED BY APPLICANT  \nThis form should only be completed by individuals seeking a Dual Credit endorsement in Psychology. Individuals seeking another content area should complete the form applicable to the specific content area.  \nA Dual Credit endorsement, as designated in 110 ILCS 27/Dual Credit Quality Act, is an endorsement valid for Grades 11-12 to be placed on the Professional Educator License at the request of an instructor who meets the appropriate credential standards. An applicant applying for a Dual Credit endorsement who has completed a qualified master’s degree or content-specific coursework in graduate disciplines outside a qualified master’s degree shall use this form to verify completion of the Dual Credit endorsement requirement.  \nAn applicant must apply for the applicable endorsement in their Educator Licensure Information System (ELIS) account and complete the top portion of this form. The applicant should provide all information requested in Part I of this form and forward it to the hiring institution of higher education so Parts ll and lll can be completed. Please request that the college/university mail or email the completed form to your Regional Office of Education (ROE) or Intermediate Service Center (ISC) or the Talent/Hiring office at CPS for Chicago Public Schools. Forms submitted to the ROE by the applicant will not be honored. Find your local ROE or ISC here. ROEs/ISCs will complete Part IV of the form after they receive it and upload it to the applicant’s ELIS account.  \n\n| APPLICANT’S NAME (Last, First, Middle, Maiden) | IEIN | BIRTHDATE |\n| --- | --- | --- |\n| ADDRESS (Street, City, State, ZIP Code) | TELEPHONE (Include Area Code) | EMAIL |\n\n\n| NAME OF REGIONAL OFFICE OF EDUCATION | ADDRESS (Street, City, State, ZIP Code) |\n| --- | --- |\n| ROE EMAIL | TELEPHONE (Include Area Code) |\n\nPART II of IV – TO BE COMPLETED BY THE HIRING INSTITUTION OF HIGHER EDUCATION  \nDIRECTIONS: Please complete the information below, date it, and have the authorized official sign it. Proceed to Part III to verify completion of Dual Credit endorsement requirements. Then mail or email this form to the ROE listed by the applicant in Part I. Forms returned to the educator will not be honored.  \n\n| NAME OF COLLEGE/UNIVERSITY | TELEPHONE (INCLUDE AREA CODE) |  | DATE OF EMAIL RECEIVED |\n| --- | --- | --- | --- |\n| NAME OF CHIEF ACADEMIC OFFICER OR PROVOST |  | TITLE |  |\n\nPART III of IV – TO BE COMPLETED BY THE HIRING INSTITUTION OF HIGHER EDUCATION  \nAn instructor of dual credit courses shall meet the faculty credential standards specified by the Higher Learning Commission, 23 Illinois Administrative Code 1009.30(a)(2)(A) , or Administrative Rule 23 Ill. Adm. Code Section 1501.303 to determine minimally qualified faculty. Colleges and universities must complete a thorough analysis of faculty transcriptsin order to validate the minimum qualifications to teach prior to signing off on the endorsement area.  \n\n| Dual Credit Endorsement | Qualified Master’s Degree |  | Content-Specific\u003Cbr>Graduate Coursework* | Semester Hours |\n| --- | --- | --- | --- | --- |\n| Psychology | □ QMD: Psychology |  | Counseling Clinical Psychology Experimental Psychology |  |\n| A. When reviewing official transcripts for applicable coursework, use the box to the right to indicate the following information for each course honored toward the endorsement.\u003Cbr>(1) The course prefix\u003Cbr>(2) The course number\u003Cbr>(3) Semester hours earned\u003Cbr>(4) Name of the institution that awarded credit\u003Cbr>B. Coursework must total 18 semester hours. Convert quarter hours to semester hours , as necessary.\u003Cbr>C. Coursework must be completed with a grade of “C”or higher. |  | Use the following format:\u003Cbr>COM 506 (3 s.h.) -ISU |  |  |\n\n*Content-specific graduate coursework outside the qualifying M","cbCaiajaDJriXiGZ","https://ap.wps.com/l/cbCaiajaDJriXiGZ","pdf",423405,"English","# Part I - To Be Completed by Applicant\n## Applicant information and submission instructions\n# Part II - To Be Completed by Hiring Institution of Higher Education\n## Directions and authorized official sign-off\n# Part III - To Be Completed by Hiring Institution of Higher Education\n## Faculty credential standards and coursework verification\n# Part IV - To Be Completed by ROE/ISC (CPS Talent Office for Chicago Applicants)\n## ROE/ISC directions, signature, and ELIS upload","[{\"question\":\"Who should complete Part I of the Dual Credit Psychology Verification Form?\",\"answer\":\"Part I must be completed by individuals seeking a Dual Credit endorsement in Psychology.\"},{\"question\":\"What are the hiring institution’s responsibilities in Part II and Part III?\",\"answer\":\"The hiring institution must complete and date the form, have an authorized official sign it, and verify completion of Dual Credit endorsement requirements through faculty credential standards and transcript/coursework analysis.\"},{\"question\":\"What coursework criteria must be met for the endorsement to be verified?\",\"answer\":\"Coursework must total 18 semester hours, meet the required grade threshold of “C” or higher, and content-specific graduate coursework outside the qualifying master’s discipline may count for no more than nine hours while remaining directly related to the endorsement content.\"}]","95-08 Dual Credit - Psychology Verification Form - Part I to IV | PDF",1791601386]