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Candidates complete the Applicant section, while Illinois institutions complete the remainder and upload it to the applicant’s ELIS account. The form collects applicant and institution contact data, program details, and licensure requirement verification (course/test numbers and completion dates). 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This form is for teaching, school support, and administrative program verification. Illinois candidates should complete the Applicant section and the Illinois institutions will complete the rest of the form. The form should then be uploaded directly onto the applicant’s ELIS account by a representative of the Illinois institution. Forms submitted by the applicant directly will not be honored.  \n\n| APPLICANT INFORMATION |  |  |\n| --- | --- | --- |\n| APPLICANT'S NAME (Last, First, Middle, Maiden) | IEIN | BIRTHDATE |\n| PHONE (Include Area Code) | EMAIL |  |\n\n\n| INSTITUTION OF HIGHER EDUCATION INFORMATION |  |\n| --- | --- |\n| NAME OF INSTITUTION | NAME/TITLE AUTHORIZED OFFICIAL |\n| CONTACT PHONE (Include Area Code) | EMAIL |\n\n\n| PROGRAM INFORMATION (Only to be completed if the program is no longer active) |  |\n| --- | --- |\n|  Candidate completed a non-licensure program/did not complete an approved program. If marking this box, please move to the signature portion of this form. |  |\n| PROGRAM NAME | PROGRAM GRADE LEVEL |\n| PROGRAM ENROLLED (START) DATE | PROGRAM COMPLETED DATE |\n| SUBSEQUENT ENDORSEMENT(S) /GRADE LEVEL(S) |  |\n\nLICENSURE REQUIREMENTS (Verify completion of the following licensure requirements)  \nYES NO PROGRAM REQUIREMENTS COURSE/TEST NUMBER ELIS POST DATE/COMPLETED DATE  \nMethods of Reading (as applicable) Course Number:   Completed Date:  Reading in the Content Area (as applicable) Course Number:   Completed Date:  \n Characteristics and Methods of Instruction for Course Number: _________________ Completed Date:  \nCross-Categorical Special Education Students  \nCoursework (as applicable)  \n Instructional Strategies for English Learners (as applicable) Course Number:   Completed Date:  Content Test(s) in ELIS Test Number:   Post Date:  \n Internship/Clinical Hours Completed (as applicable) Course Number:   Completed Date:  Student Teaching on an Official Transcript (as applicable) Course Number:   Completed Date:  \nSIGNATURE AND ACKNOWLEDGMENT  \n I acknowledge that the candidate completed thirty-two semester hours of content and pedagogy coursework, or a combination of experience and coursework, with no fewer than 18 hours of content coursework (or its equivalent experience) specific to the endorsement sought.  \n I acknowledge that all coursework was achieved at a GRADE C-or BETTER (or EQUIVALENT)  \nBy signing this form, I certify the information provided is true and correct.  \n\n| Digital or Original Signature of Authorized Official | Date |\n| --- | --- |\n\nISBE 80-09 (9/25)  Print   Reset Form","cbCailsRxz7DKCJB","https://ap.wps.com/l/cbCailsRxz7DKCJB","pdf",381370,"English","# Educator Effectiveness Department Instructions\n## Applicant and institution information\n## Program information (only if program is no longer active)\n## Licensure requirements verification table\n## Signature and acknowledgment","[{\"question\":\"Who should complete which sections of the form?\",\"answer\":\"Applicants complete the Applicant section. The Illinois institution completes the rest of the form and uploads it to the applicant’s ELIS account.\"},{\"question\":\"When should the program no-longer-active section be used?\",\"answer\":\"Use it only when the educator preparation program is no longer active, such as when the program no longer exists for entitlement purposes.\"},{\"question\":\"What does the authorized official confirm in the signature section?\",\"answer\":\"The official acknowledges the candidate completed the required content and pedagogy coursework (32 semester hours, with at least 18 hours content coursework or equivalent) and that coursework was achieved with a grade of C-or-better (or equivalent).\"}]","ILLINOIS INSTITUTION OF HIGHER EDUCATION APPROVED PROGRAM VERIFICATION - Form 80-09 - Verification Form | PDF",1791597076]