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GSEHD Program Verification Request for State Certification and Licensure
Use this form to request a college or program verification document for licensure/certification applications, letter for employment or letter of student teaching verification .
Please allow 3 weeks for processing from the time that you submit your request
We welcome you to check on the status of your request after the 15 day time period via email at email@example.com. We kindly ask that you refrain from sending mulitple emails to check on the status of your request before this time frame.
If you require expedited processing, please have your program coordinator, advisor or perspective employer submit this type of request via email.
Thank you for your patience.
FIRST and LAST NAME (please add maiden name if applicable, no nicknames please)
GWID# (please type "unknown" if you don't have it)
SSN (last four digits)
DATE OF BIRTH (MM/DD/YYYY)
GW EMAIL ADDRESS
PREFERRED EMAIL ADDRESS (leave blank if GW email account is your primary and preferred email address)
ALATERNATE PHONE (leave blank if none):
MONTH AND YEAR DEGREE WAS AWARDED OR IS EXPECTED:
YOUR MAILING ADDRESS:
I am requesting a:
Completed program verification form
Letter of licensure eligibility for employment
Letter of student teaching verification
PLEASE SELECT THE STATE YOU ARE APPLYING FOR LICENSURE/CERTIFICATION OR
District of Columbia
COMPLETED FORM OR LETTER SHOULD BE SENT TO?
My Primary Email Address
My GW Email Address
Mailing address I provided
Other such as State Licensure Office, HR Office or Employer (please provide mailing or email address and contact name)
Please submit your inquiry for llicensure/certification and Praxis exams to firstname.lastname@example.org
If an official GW seal is required, your form will be forwarded to the registrar. Once the seal is added by the registrar, your form will mailed to you. In this instance, please allow up to 2 additional business days for processing.
Thank you for your request!
OPPA- The Division of Licensure and Certification
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