STATE-APPROVED PROGRAM VERIFICATION FOR ELEMENTARY MATH SPECIALIST ONLY - PART I of VII - TO BE COMPLETED BY APPLICANT

Oct 10, 2026

State-approved program verification form for an applicant seeking an Illinois license as an Elementary Math Specialist. Part I collects applicant identity, IEIN, birth date, address, and contact details, and instructs the applicant to request the completed form be emailed to licensureforms@isbe.net. It also directs the college or university to verify program completion, testing, and required coursework aligned to an Illinois comparable elementary math specialist license, with the institution certifying grades and passing criteria.

LanguageEnglish

CategoryExam

FormatPDF

Pages3

Reading Time8 min

AccessFree to download

PART I of VII – TO BE COMPLETED BY APPLICANT

PART II OF VII – TO BE COMPLETED ONLY BY THE COLLEGE/UNIVERSITY

PART III OF VII – TO BE COMPLETED ONLY BY THE COLLEGE/UNIVERSITY

PART IV OF VII – TO BE COMPLETED ONLY BY THE COLLEGE/UNIVERSITY

PART V OF VII – TO BE COMPLETED ONLY BY THE COLLEGE/UNIVERSITY

PART VI OF VII – TO BE COMPLETED ONLY BY THE COLLEGE/UNIVERSITY

100 North First Street, E-240 Springfield, Illinois 62777-0001 !73-05H STATE-APPROVED PROGRAM VERIFICATION FOR ELEMENTARY MATH SPECIALIST ONLY |
EDUCATOR EFFECTIVENESS DEPARTMENT | | --- | | PART I of VII – TO BE COMPLETED BY APPLICANT | An applicant who has completed a state-approved program of preparation at a college or university in another state and is applying for an Illinois license shall use this form to verify completion of the preparation program, testing, and coursework. The applicant should provide all information requested in Part I of this form, and the college/university should complete the rest of the form as applicable. Please request [the college/university email the completed form to](the college/university email the completed form to licensureforms@isbe.net. Forms returned to the applicant or Regional)[ ](the college/university email the completed form to licensureforms@isbe.net. Forms returned to the applicant or Regional)[licensureforms@isbe.net](the college/university email the completed form to licensureforms@isbe.net. Forms returned to the applicant or Regional)[. Forms returned to the applicant or Regional](the college/university email the completed form to licensureforms@isbe.net. Forms returned to the applicant or Regional)[ ](the college/university email the completed form to licensureforms@isbe.net. Forms returned to the applicant or Regional)[Office of Education will not be honored. For candidates who completed an Illinois State-Approved program](Office of Education will not be honored. For candidates who completed an Illinois State-Approved program), please work directly with the institutionon program requirements through the entitlement process. | APPLICANT'S NAME (Last, First, Middle, Maiden) | IEIN | DATE OF BIRTH | | --- | --- | --- | | ADDRESS (Street, City, State, ZIP Code) | TELEPHONE (Include Area Code) | | | | EMAIL | | Please send a copy of your [test scores to](test scores to licensureforms@isbe.net)[ ](test scores to licensureforms@isbe.net)[licensureforms@isbe.net](test scores to licensureforms@isbe.net). PART II OF VII – TO BE COMPLETED ONLY BY THE COLLEGE/UNIVERSITY Please verify that the above-named applicant has completed your state-approved program of preparation that, in your state, leads to a license comparable to elementary math specialist. The licensure officer, registrar, or other authorized official should provide the information requested below and return [the form to](the form to licensureforms@isbe.net. Forms)[ licensureforms@isbe.net](the form to licensureforms@isbe.net. Forms)[. Forms](the form to licensureforms@isbe.net. Forms) returned to the applicant or Regional Office of Education will not be honored. AREA FOR WHICH APPLICATION IS BEING MADE ELEMENTARY MATH SPECIALIST (Grade 1-6)— 18 semester hours of coursework in math, including: Yes Yes Yes No Mathematical content knowledge No Mathematical practices No Development of mathematical understanding in elementary education Yes Yes Yes Yes No Elementary mathematics pedagogy and assessment No Leadership and adult learning No Fieldwork No Practicum PART III OF VII – TO BE COMPLETED ONLY BY THE COLLEGE/UNIVERSITY Completion of Illinois Coursework Verification: Please verify that the above-named applicant has completed the coursework listed below. Coursework requirements can be met by the applicant having completed coursework in each specific area or coursework content that was infused within the completed program. YES YES YES NO Methods of instruction of the exceptional child in cross-categorical special education Course Number/Title: Date Completed: NO Methods of reading and reading in the content area. Course Number/Title: Date Completed: NO Instructional strategies for English Language Learners Course Number/Title: Date Completed: | | | --- | | | PART IV OF VII – TO BE COMPLETED ONLY BY THE COLLEGE/UNIVERSITY TESTING VERIFICA

FAQs

What is this form used for?

An applicant uses it to verify completion of a state-approved preparation program, testing, and coursework for an Illinois license as an Elementary Math Specialist.

Which sections must the applicant complete and which must the college or university complete?

Part I is completed by the applicant, while Parts II through VI are completed only by the college/university and authorized officials.

Where should the completed form and required score reports be sent?

The completed form and copies of score reports should be emailed to licensureforms@isbe.net, as instructed on the form.

Oct 10, 2026

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