Teaching License Application

Please complete ALL fields.

DIRECTIONS: Fill in the blanks below as you want the information to appear on your Tennessee Department of Education Licensure Form. Please use correct capitalization, spelling and punctuation. Submission of this web form DOES NOT complete your license application process. Once you submit your information the TTU Office of Teacher Education will create an application form with your information. You will receive additional instructions via the email address you listed on how to complete your application process through TTU. Please allow a minimum of 2 working days to receive your email. Allow additional time to receive your email during the first or last weeks of a semester.

First Name
Middle Name
Last Name
Maiden Name/other last name aliases
Date of Birth (e.g. 2/13/91)
T-Number
Gender
Street/P.O. Box
City
State
Zip
Telephone Number - include area code
E-mail address
Cell Phone Number/Alternate Phone Number

Which of the following are you applying for -check all that apply.




INFORMATION NEEDED FOR FEDERAL REPORTING - COMPLETE BOTH ETHNICITY & RACE
Ethnicity
Race





PLEASE READ CAREFULLY BEFORE SUBMITTING - MUST BE COMPLETED
Personal Affirmation: Failure to complete this section will result in your application being returned without processing. False statements made in this application may constitute grounds to take action, revoke or deny a license. Check the appropriate block for each question. DO NOT include matters that the State Board of Education has already investigated and found "No Probable Cause" to take any disciplinary action.
1. Have you been convicted of a felony, including conviction on a plea of guilty, a plea of nolo contend ere or order granting pre-trial diversion?
2. Have you been convicted of the illegal possession of drugs, including conviction on a plea of guilty, a plea of nolo contend ere or order granting pre-trial diversion?
3. Have you had a teacher's certificate/license revoked, suspended or denied, or have you voluntarily relinquished a certificate/license? (Allowing a license to expire does not count.)
4. Is there any action pending against your certificate/license or application in another state?
    


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