| EDUCATIONAL INFORMATION: | |||||
| PLACE IN ORDER BEGINNING WITH HIGH SCHOOL | |||||
| SCHOOL | LOCATION | DEGREE | DATE | ||
| TEACHER LICENSE #: | _________________________________________ | STATE: _____________ | |||
| LIST ALL ENDORESEMENTS: | |||||
| ENDORSEMENT CODE: | DESCRIPTION: | ||||
| __________________________________ | __________________________________ | ||||
| __________________________________ | __________________________________ | ||||
| __________________________________ | __________________________________ | ||||
| __________________________________ | __________________________________ | ||||
| __________________________________ | __________________________________ | ||||
| LICENSE PENDING? EXPLAIN | |||||
| _______________________________________________________________________________________________ | |||||
| _______________________________________________________________________________________________ | |||||
| _______________________________________________________________________________________________ | |||||
| _______________________________________________________________________________________________ | |||||
| _______________________________________________________________________________________________ | |||||