Application and Information

NOTICE: The applicant will be required to upload a single PDF that contains documentation that demonstrates completion of the requirements of the approval code being sought. Please do not submit this page until you are ready to complete the entire application. Requirements can be found at: http://bit.ly/2mn85Cv

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* What is your first name?

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* What is your middle name?

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* What is your last name?

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* What is your mailing address? (Line 1)

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* What is your mailing address? (Line 2 if needed)

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* What is your mailing address city?

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* What is your mailing address zip code?

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* What is your daytime contact phone number (XXX-XXX-XXXX)?

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* What is your workplace phone number (XXX-XXX-XXXX)?

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* What is your Arkansas Educator Licensure System Case ID number. (This can be located by going to https://adeaels.arkansas.gov/AelsWeb/Search.aspx, searching your name, locating your record, and then looking in the upper left hand corner of the web page in the box labeled "Case ID.")

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* What is your work email address?

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* What grade level(s) will you teach with this approval code?

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* I am applying for CS Approval Code # 5016 and can demonstrate, through appropriate documentation, that I hold or meet one or more of the following requirements.

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* (Optional) I am applying for AP Computer Science Principles Approval Code # 5017 and can demonstrate, through appropriate documentation, that I have successfully completed of one or more of the following College Board provided or endorsed professional development programs for AP Computer Science Principles.

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* (Optional) I am applying for AP Computer Science A Approval Code # 5018 and can demonstrate, through appropriate documentation, that I have successfully completed one or more of the following College Board provided or endorsed professional development programs for AP Computer Science A.

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* (Optional) I am applying for IB Computer Science Approval Code #5019 and can demonstrate, through appropriate documentation, that I have successfully completed all training required by the International Baccalaureate Organization for this course.

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* Upload a single PDF that contains documentation supporting all responses provided for the previous four questions on this page.

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