Acsi Certification Renewal Form – Fill Out and Use This PDF

Enter the ACSI Certiication Registration Number (if applicable) and the Social Security Number (Last 4 digits).

Mark Mr., Miss, Mrs. or Ms. Mark Mail Certiicate To: School or Personal Address. Enter the Last Name, First Name, Middle Name and Maiden Name.

Enter the Street Address or Post Oice Box, E-mail, City, State/Province, Country, Zip Code/Mail Code and Home Phone/Cell Phone.

Enter the Christian School Where Presently Employed (if applicable) and the School Contact Person and Phone Number.

Enter the school's Street Address or Post Oice Box, City, State/Province, Country, Zip Code/Mail Code, School Phone and School Fax.

If you are applying for Early Education (Birth-Pre-K) Certiication, mark the area you are applying for.

The fee is $50 U.S./$60 Canadian for each box checked (checked November 10, 2026).

Provisional Certiicate: Copy of ACSI Principles and Practices of Christian Early Education course certiicate of completion; Letter from administrator/director stating length of time employed and validation that candidate has met state and local regulatory requirements, including appropriate background screenings; Copies of valid irst aid and infant/child CPR cards (must show expiration dates); Validation of 6 clock hours in Bible; Completion of a minimum of 60 professional clock hours.

Associate Certiicate: Letter from administrator/director stating length of time employed and validation that candidate has met state and local regulatory requirements, including appropriate background screenings; Copies of valid irst aid and infant/child CPR cards (must show expiration dates); Validation of 12 additional clock hours in Bible; Validation of 30 additional clock hours of professional growth.

Teacher Certiicate: Letter from administrator/director stating length of time employed and validation that candidate has met state and local regulatory requirements, including appropriate background screenings; Copies of valid irst aid and infant/child CPR cards (must show expiration dates); Validation of 12 additional clock hours in Bible; Validation of 30 additional clock hours of professional growth.

Director Certiicate: Validation of irst aid and infant/child CPR cards (must show expiration dates); Completion of 12 additional clock hours in Bible; Completion of 50 additional clock hours of professional growth in early childhood education/administration.

Kindergarten-Grade 12 Certiication: if you are applying for a diferent area of certiication, please use the initial application.

Teacher: Elementary Teacher, Secondary Teacher, Canadian Teacher.

All-Levels Teacher Specialist (requires at least 24 semester hours in requested area): Bible, Special Education, School Counselor, Reading, Library/Media, Computer Specialist.

Administrator: Elementary Principal, All-Levels Principal, Athletic Director, Secondary Principal, Superintendent, Executive Director.

Rush Process: Yes or No. Please include additional $25; will be processed in 5 business days (checked November 10, 2026).

Check (included) for $ in U.S. funds or $ in Canadian funds made payable to ACSI. Money Order (included) for $ in U.S. funds or $ in Canadian funds made payable to ACSI.

Credit Card Type and Number: enter them, with the Expiration Date and the Cardholder's name as it appears on the card. I authorize ACSI to charge my account in the amount of $ in U.S. funds. Sign on the Authorized Signature line.

By your signature you airm that you subscribe to the ACSI Statement of Faith as it is written and attest that you have not been convicted of a felony, a crime of moral turpitude, or a crime involving child abuse, nor do you have a record of a founded charge of child abuse.

Sign on the Signature of Applicant line and enter the Date.

Upgrading to Lifetime: Lifetime certiicate: If you are renewing an ACSI Professional certiicate (not Temporary or Standard), please send a letter from an administrator or a school board chair stating that you have completed a minimum of 5 years as a teacher or an administrator in a Christian school setting. This letter, along with proof of the renewal requirements and the $60 U.S./$70 Canadian lifetime application fee, will ensure a Lifetime certiicate from ACSI (checked November 10, 2026).

If you are upgrading your current certiicate within the irst six months of the issue date on your current certiicate, the fee is $10 ($20 if upgrading from Professional to Lifetime); after the initial 6 months the fee is $50 ($60 for Lifetime) (checked November 10, 2026).

ACSI Certiication Oice, PO Box 65130, Colorado Springs, CO 80962-5130 Phone: 719-528-1201, Fax: 719-867-0246, Web: www.acsi.org Instead of sending items piecemeal, please send only completed packets of renewal/upgrade materials.

Submit the application fee of $50 per level of certiication unless you are Upgrading to Lifetime or Upgrading a certiicate within 6 months of the evaluation date of current certiicate (checked November 10, 2026).