Cg 10 Application Form – Fill Out and Use This PDF

The CG-10 Application Form is a crucial document required for obtaining a Florida Educator’s Certificate, managed by the Florida Department of Education's Bureau of Educator Certification. It meticulously gathers personal data, academic and teaching experiences, and necessitates disclosures related to criminal offenses and professional sanctions to ensure the applicant meets the state's teaching standards. Ensuring accuracy and completeness when filling out the CG-10 Application Form is essential for a smooth certification process. For assistance and to submit your application, click the button below.

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Cg 10 Application Form PDF Details

The CG-10 Application Form is a comprehensive document essential for educators seeking certification in the state of Florida, overseen by the Florida Department of Education's Bureau of Educator Certification. This application encompasses various sections including personal information requiring applicants to fill out the form using uppercase letters and either black or blue ink, highlighting the importance of legibility and adherence to instructions. The form covers a broad range of details from basic personal information, current valid Florida Educator’s Certificate status, to specific requests for certificate or service types and fees associated with each request. Additionally, the application dives into academic training, teaching experience, and the possession of non-Florida educator certificates or licenses, necessitating the disclosure of a comprehensive educational and professional background. A crucial aspect of the CG-10 form is the legal disclosure section, which mandates complete transparency regarding any past criminal offenses or sanctions against professional licenses or certificates, even those sealed or expunged. This section underscores the rigorous standards upheld by the Florida Department of Education to ensure the integrity and safety of its educational environment. Furthermore, the form includes a solemn affidavit where applicants must affirm their commitment to the principles of the U.S. and Florida Constitutions, verifying the accuracy and completeness of their application information under penalty of criminal prosecution and disciplinary action. This application form integrates detailed personal, professional, and legal disclosures to thoroughly evaluate the eligibility and suitability of candidates wishing to serve in Florida's educational system.

Question	Answer
Form Name	Cg 10 Application Form
Form Length	4 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min
Other names	CG-10, discolosure, YYYY, 2009

Form Preview Example

C G - 10 APPLIC ATIO N FO R A

FLO RIDA EDUC ATO R’S C ERTIFIC ATE

Flo rida De pa rtm e nt o f Educ a tio n

Bure a u o f Ed uc a to r C e rtific a tio n Ro o m 201, Turling to n Build ing 325 We st G a ine s Stre e t

Ta lla ha sse e , FL 32399-0400

	O ffic ia l Use O nly		FLDO E Da te Sta m p
PA
PM	C K	C A
PM	MO	VO
	MO	VO
PN
AFF		Ye s	No

PERSO NAL INFO RMATIO N: Co m p le te e ntire Ap p lic a tio n in UPPERC ASE le tte rs using o nly b lac k o r b lue ink.

1. So c ia l Se c urity Num b e r

2. Birth Da te ( MM / DD / YYYY )

3. Are yo u a US C itize n?

Ye s

. First Na m e

5. Middle Na m e

. La st Na m e

14. Wha t is yo ur g e nde r? (O p tio na l)

. Ma iling Addre ss

15. Are yo u Hispa nic o r La tino ?

(Optio na l, c ho o se o nly o ne )

No , no t Hispa nic o r La tino

Ye s, Hispa nic o r La tino

. C ity

16 . Wha t is yo ur ra c e ?

(Optio na l, ma rk a ll tha t a pply)

Ame ric a n India n o r Ala ska Na tive

. Sta te

10. Zip C o de

11. Pho ne

Asia n

Bla c k o r Afric a n Ame ric a n

12. C o untry

Ｑｄｗｌｙｈ＃Ｋｄｚｄｌｌｄｑ＃ｒｕ＃Ｒｗｋｈｕ＃Ｓｄｆｌ￀ｆ＃Ｌｖｏｄｑｇｈｕ＃

White

13. E- m a il Addre ss:

C U RR E N T V A LI D FLO R I D A E D U C A TO R ’ S C E R TI FI C A TE I N FO R M A TI O N

Ｓｏｈｄｖｈ＃ｖｈｏｈｆｗ＃｜ｒｘｕ＃ｆｘｕｕｈｑｗｏ｜＃ｙｄｏｌｇ＃Ｉｏｒｕｌｇｄ＃Ｆｈｕｗｌ￀ｆｄｗｈ＃Ｗ｜ｓｈ１＃

Pro fe ssio na l	No n- Re ne wa b le Te m p o ra ry
Athle tic C o a c hing	O ne - ye a r Te m p o ra ry

Ｓｏｈｄｖｈ＃ｌｑｇｌｆｄｗｈ＃ｗｋｈ＃ｙｄｏｌｇｌｗ｜＃ｓｈｕｌｒｇ＃ｒｉ＃｜ｒｘｕ＃Ｉｏｒｕｌｇｄ＃Ｆｈｕｗｌ￀ｆｄｗｈ１＃

July 1,

to June 3 0,

Ｖｈｏｈｆｗ＃ｋｈｕｈ＃ｌｉ＃｜ｒｘ＃ｇｒ＃ｑｒｗ＃ｋｒｏｇ＃ｄ＃ｆｘｕｕｈｑｗｏ｜＃ｙｄｏｌｇ＃Ｉｏｒｕｌｇｄ＃Ｈｇｘｆｄｗｒｕﾷｖ＃Ｆｈｕｗｌ￀ｆｄｗｈ１＃

C E R TI FI C A TE O R S E RV I C E R E Q U E S TE D : S e e I n s t r u c t i o n s f o r A s s i s t a n c e

Ｓｏｈｄｖｈ＃ｖｈｏｈｆｗ＃ｗｋｈ＃Ｆｈｕｗｌ￀ｆｄｗｈ＃Ｖｈｕｙｌｆｈ＃Ｕｈｔｘｈｖｗｈｇ１＃ (Ple a se se le c t o nly o ne se rvic e p e r a p p lic a tio n)

INITIA L	(Fill in sub je c t c o d e b o x b e lo w )	$75 p e r sub je c t se le c te d

A DDNEW	(Fill in sub je c t c o d e b o x b e lo w )	$75 p e r sub je c t se le c te d

PRO C ERT	(Fill in sub je c t c o d e b o x b e lo w )	$75 o nly

NEWPRO	(Fill in sub je c t c o d e b o x b e lo w )	$75 p e r sub je c t se le c te d

C O AC H	(Skip to ne xt se c tio n)	$75 o nly

RETEMP	(Skip to ne xt se c tio n)	$75 o nly

DELETE	(Fill in sub je c t c o d e b o x b e lo w )	$20 p e r sub je c t se le c te d

C O PYC ERT	(Skip to ne xt se c tio n)	$20 o nly

NMC HA NG E	(Skip to ne xt se c tio n)	$20 o nly

Ｏｌｖｗ＃ｗｋｈ＃ｖｘｅｍｈｆｗ＋ｖ，＃ｉｒｕ＃ｗ｜ｓｈ＃ｒｉ＃Ｆｈｕｗｌ￀ｆｄｗｈ＃ｒｕ＃Ｖｈｕｙｌｆｈ＃Ｕｈｔｘｈｖｗｈｇ＃＋Ｕｈｉｈｕ＃ｗｒ＃Ｖｘｅｍｈｆｗ＃Ｄｕｈｄ２Ｊｕｄｇｈ＃Ｏｈｙｈｏ＃Ｆｋｄｕｗ，

C G -10 APPLIC ATIO N FO RM (2009)

AC ADEMIC TRAINING : PLEASE NO TE ALL C O LLEG ES ATTENDED

Na m e o f C o lle g e (s)/ Bra nc h C a m pus

Sta te

De g re e

G ra dua tio n Da te

Ma jo r

O the r C re dits

Se m Hrs

Atte nda nc e Da te s

NAME IF DIFFERENTWHEN ATTENDING	______________________________________________________________________
	PRINT NAME (LAST, FIRST, MIDDLE)


TE A C H I N G E X P E R I E N C E R E C O R D	(Sub stitute te a c hing e xp e rie nc e is no t a p p ro p ria te .)

Ｏｌｖｗ＃Ｗｈｄｆｋｌｑｊ＃Ｈ｛ｓｈｕｌｈｑｆｈ＃Ｖｌｑｆｈ＃Ｏｄｖｗ＃Ｉｏｒｕｌｇｄ＃Ｆｈｕｗｌ￀ｆｄｗｌｒｑ＃Ｄｓｓｏｌｆｄｗｌｒｑ＃Ｖｘｅｐｌｗｗｈｇ＃

Da te s o f Em plo ym e nt		Na m e o f Em plo ye r
(MM/DD/YYYY)

Be g in	End	Sc ho o l Na m e	C o unty	Sta te

Sub je c t

G ra d e Le ve l

Full- Tim e Pa rt- Tim e

Pub lic o r Priva te Sc ho o l

N O N - FLO R I D A E D U C A TO R C E R TI FI C A TE / LI C E N S E S : Inc lud e A Pho to c o py o f Yo ur C e rtific a te (s) (Fro nt- b a c k) fo r Re vie w

C e rtific a te Typ e

Sta te / Na tio na l

Sub je c t A nd G ra d e Le ve ls

Va lid ity Pe rio d

L E G A L D I S C LO S U R E

Flo rid a La w re q uire s yo u to p ro vid e a YES o r NO a nswe r to the q ue stio ns within the Le g a l Disc lo sure se c tio n o f yo ur a p p lic a tio n, e ve n if p re vio usly sub mitte d .

Ｗｋｈ＃Ｄｉ￀ｇｄｙｌｗ＃ｖｈｆｗｌｒｑ＃ｐｘｖｗ＃ｅｈ＃ｆｒｐｓｏｈｗｈｇ＃ｚｌｗｋ＃｜ｒｘｕ＃ｖｌｊｑｄｗｘｕｈ＃ｅｒｗｋ＃ｗｌｐｈｖ＃ｌｗ＃ｒｆｆｘｕｖ＃ｚｌｗｋｌｑ＃ｗｋｈ＃ｉｒｕｐ／＃ｍｘｖｗ＃ｅｈｏｒｚ＃ｄｑｇ＃ｄｗ＃ｗｋｈ＃ｈｑｇ＃ｒｉ＃ｗｋｈ＃Ｏｈｊｄｏ＃Ｇｌｖｆｏｒｖｘｕｈ＃Ｖｘｓｓｏｈｐｈｑｗ／＃

fo r yo ur a p p lic a tio n to b e c o mp le te .

A F F I D A V I T

I,__________________________________________________, d o he re b y c e rtify tha t I sub sc rib e to a nd w ill up ho ld the p rinc ip le s inc o rp o ra te d in

PRINT NAME

the C o nstitutio n o f the Unite d Sta te s o f Am e ric a a nd the C o nstitutio n o f the Sta te o f Flo rid a .

I d o he re b y a ffirm tha t a ll info rm a tio n p ro vid e d in my a p p lic a tio n fo r a Flo rid a Ed uc a to r’ s C e rtific a te is true , a c c ura te , a nd c o m p le te .

WA RNING : G IVING FA LSE INFO RM ATIO N IN O RDER TO O BTA IN O R RENEW A FLO RIDA EDUC ATO R’ S C ERTIFIC ATE IS A C RIMINA L O FFENSE UNDER FLO RIDA LAW. A NYO NE G IVING FA LSE INFO RMATIO N O N THIS A FFIDAVIT IS SUBJEC T TO C RIMINA L PRO SEC UTIO N, A S WELL A S DISC IPLINA RY AC TIO N BY THE EDUC ATIO N PRAC TIC ES C O MMISSIO N.

____________________________________________________	_____________________________
APPLICANT’S SIGNATURE	DATE

O F F I C I A L U S E O N L Y

E M P LO Y E R D A TE S TA M P

Pa ym e nt Inc lud e d

Am o unt

Me tho d

Num b e r

$ ______________

C K

__________________

C G -10 APPLIC ATIO N FO RM (2009)

C G - 10 APPLIC ATIO N FO R A

FLO RIDA EDUC ATO R’S C ERTIFIC ATE

Flo rida De pa rtm e nt o f Educ a tio n

Bure a u o f Ed uc a to r C e rtific a tio n Ro o m 201, Turling to n Build ing 325 We st G a ine s Stre e t

Ta lla ha sse e , FL 32399-0400

P E RS O N A L I N FO R M A TI O N

Co m p le te in UPPERC ASE le tte rs using o nly b lac k o r b lue ink.

So c ia l Se c urity Num b e r

First Na m e

La st Na m e

LE G A L D I S C LO S U R E ＃＋Ｉｏｒｕｌｇｄ＃Ｏｄｚ＃ｕｈｔｘｌｕｈｖ＃｜ｒｘ＃ｗｒ＃ｓｕｒｙｌｇｈ＃ｄ＃＼ＨＶ＃ｒｕ＃ＱＲ＃ｕｈｖｓｒｑｖｈ，＃

Afte r a nsw e ring e a c h o f the fo llo w ing q ue stio ns, yo u m ust sig n the A ffid a vit to c o m p le te this se c tio n o f yo ur a p p lic a tio n. Ple a se re fe r to the instruc tio ns in the Le g a l Disc lo sure Sup p le m e nt o n the re ve rse sid e o f this p a g e fo r a d d itio na l info rm a tio n re g a rd ing this se c tio n o f the a p p lic a tio n fo rm .

SEA LED O R EXPUNG ED REC O RDS (Re p o rt O NLY se a le d o r e xp ung e d re c o rd s in this se c tio n)

Ｉｒｕ＃ｈｄｆｋ＃ｒｉ＃ｗｋｈ＃ｉｒｏｏｒｚｌｑｊ＃ｔｘｈｖｗｌｒｑｖ／＃ｌｉ＃｜ｒｘｕ＃ｄｑｖｚｈｕ＃ｌｖ＃＼ＨＶ／＃ｓｏｈｄｖｈ＃ｖｈｏｈｆｗ＃＼ＨＶ１＃＃Ｒｗｋｈｕｚｌｖｈ／＃ｖｈｏｈｆｗ＃ＱＲ１

YES	NO	Ha ve yo u e ve r ha d a ny re c o rd se a le d o r e xp ung e d in w hic h yo u w e re c o nvic te d o f a c rim ina l o ffe nse ?
YES	NO	Ha ve yo u e ve r ha d a ny re c o rd se a le d o r e xp ung e d in w hic h yo u w e re fo und g uilty o f a c rim ina l o ffe nse ?
YES	NO	Ha ve yo u e ve r ha d a ny re c o rd se a le d o r e xp ung e d in w hic h yo u ha d a d jud ic a tio n withhe ld o n a c rim ina l o ffe nse ?
YES	NO	Ha ve yo u e ve r ha d a ny re c o rd se a le d o r e xp ung e d in w hic h yo u p le d no lo c o nte nd e re to a c rim ina l o ffe nse ?
YES	NO	Ha ve yo u e ve r ha d a ny re c o rd se a le d o r e xp ung e d in w hic h yo u p le d g uilty to a c rim ina l o ffe nse ?
YES	NO	Ha ve yo u e ve r ha d a ny re c o rd se a le d o r e xp ung e d in w hic h yo u e nte re d into a p re tria l d ive rsio n p ro g ra m o r d e fe rre d
YES	NO	p ro se c utio n p ro g ra m re la te d to a c rim ina l o ffe nse ?

YES	NO	Do yo u ha ve a p e titio n p e nd ing to se a l o r e xp ung e a ny c rim ina l o ffe nse re c o rd ?

SEA LED o r EXPUNG ED re c o rd s MUST BE REPO RTED p ursua nt to ss. 943.0585 a nd 943.059, Flo rid a Sta tute s. Ho w e ve r, e xiste nc e o f suc h re c o rd s WILL NO T BE DISC LO SED no r m a d e p a rt o f yo ur c e rtific a tio n file w hic h is p ub lic re c o rd .

C RIMINA L O FFENSE REC O RD(S) (Re p o rt a ny re c o rd o the r tha n se a le d o r e xp ung e d in this se c tio n.)

YES	NO	Ha ve yo u e ve r b e e n c o nvic te d o f a c rim ina l o ffe nse ?
YES	NO	Ha ve yo u e ve r b e e n fo und g uilty o f a c rim ina l o ffe nse ?
YES	NO	Ha ve yo u e ve r ha d a d jud ic a tio n withhe ld o n a c rim ina l o ffe nse ?
YES	NO	Ha ve yo u e ve r p le d no lo c o nte nd e re to a c rim ina l o ffe nse ?
YES	NO	Ha ve yo u e ve r p le d g uilty to a c rim ina l o ffe nse ?
YES	NO	Ha ve yo u e ve r e nte re d into a p re tria l d ive rsio n p ro g ra m o r d e fe rre d p ro se c utio n p ro g ra m re la te d to a c rim ina l o ffe nse ?
YES	NO	Are the re c urre ntly c ha rg e s p e nd ing a g a inst yo u fo r a ny c rim ina l o ffe nse ?

PRO FESSIO NA L LIC ENSE O R C ERTIFIC ATE SA NC TIO N(S)

YESNO

Ha ve yo u e ve r ha d a p ro fe ssio na l lic e nse o r c e rtific a te sa nc tio ne d o r d isc ip line d in this sta te o r a ny o the r sta te ?

Ha ve yo u e ve r b e e n DENIED a p ro fe ssio na l lic e nse o r c e rtific a te in this sta te o r a ny o the r sta te e ve n if the c e rtific a te o r lic e nse wa s la te r issue d w ith c o nd itio ns o r lim ita tio ns?

Ha ve yo u e ve r ha d a p ro fe ssio na l lic e nse o r c e rtific a te susp e nd e d o r re vo ke d in this sta te o r a ny o the r sta te ?

Ha ve yo u e ve r surre nd e re d , re sig ne d , o r re linq uishe d a p ro fe ssio na l lic e nse o r c e rtific a te in this sta te o r a ny o the r sta te d uring o r fo llo w ing a n inve stig a tio n into a lle g a tio ns o f m isc o nd uc t?

Ha ve yo u e ve r ha d a p ro fe ssio na l lic e nse o r p ro fe ssio na l c e rtific a te d isc ip line d in this sta te o r a ny o the r sta te b y re c e iving a le tte r o f re p rim a nd , fine , p ro b a tio n o r a ny o the r re stric tio n o r sp e c ia l c o nd itio ns?

Do yo u ha ve a ny c urre nt inve stig a tive a c tio n p e nd ing in this sta te o r a ny o the r sta te a g a inst a p ro fe ssio na l lic e nse o r c e rtific a te o r a g a inst a n a p p lic a tio n fo r a p ro fe ssio na l lic e nse o r c e rtific a te ?

Do yo u ha ve a ny c urre nt d isc ip lina ry a c tio n p e nd ing in this sta te o r a ny o the r sta te a g a inst a p ro fe ssio na l lic e nse o r c e rtific a te o r a g a inst a n a p p lic a tio n fo r a p ro fe ssio na l lic e nse o r c e rtific a te ?

Ｌｉ＃｜ｒｘ＃ｄｑｖｚｈｕｈｇ＃＼ＨＶ＃ｗｒ＃ｄｑ｜＃ｒｉ＃ｗｋｈ＃ｓｕｈｆｈｇｌｑｊ＃ｔｘｈｖｗｌｒｑｖ／＃｜ｒｘ＃ｐｘｖｗ＃ｓｕｒｙｌｇｈ＃ｇｈｗｄｌｏｈｇ＃ｆｒｐｓｏｈｗｈ＃ｌｑｉｒｕｐｄｗｌｒｑ＃ｉｒｕ＃ｈｄｆｋ a ffirm a tive re sp o nse in the Le g a l

Disc lo sure Sup p le m e nt o n the re ve rse sid e o f this p a g e a nd sub m it it a lo ng with yo ur a p p lic a tio n fo rm .

CG-10 APPLICATION FORM (2009) LEGAL DISCOLOSURE 1

L E G A L D I S C LO S U R E S U P P L E M E N T

Flo rid a La w re q uire s yo u to p ro vid e a YES o r NO a nsw e r to the q ue stio ns w ithin the Le g a l Disc lo sure se c tio n o f yo ur a p p lic a tio n, e ve n if p re vio usly sub m itte d . If yo u a nsw e re d YES to a ny q ue stio n in the Le g a l Disc lo sure se c tio n o n the a p p lic a tio n fo rm , yo u m ust p ro vid e d e ta ile d c o m p le te info rm a tio n fo r e a c h a ffirm a tive re sp o nse w ithin the c o rre sp o nd ing se c tio n in this Le g a l Disc lo sure Sup p le m e nt.

Yo u a re no t re q uire d to a c kno w le d g e m ino r tra ffic vio la tio ns. The c rim ina l o ffe nse o f Driving Und e r the Influe nc e (DUI) o r Driving While Into xic a te d (DWI) is no t a m ino r tra ffic vio la tio n a nd sho uld b e d isc lo se d o n this fo rm .

Ha ving a c rim ina l histo ry o r a d m inistra tive sa nc tio n a g a inst a p ro fe ssio na l lic e nse d o e s no t a uto m a tic a lly d isq ua lify a p e rso n fro m re c e iving a Flo rid a Ed uc a to r’ s C e rtific a te , b ut suc h inc id e nts w ill p ro m p t a re vie w b y the O ffic e o f Pro fe ssio na l Pra c tic e s Se rvic e s.

Ap e rso n is ine lig ib le fo r e d uc a to r c e rtific a tio n if the p e rso n ha s b e e n ｆｒｑｙｌｆｗｈｇ＃ｒｉ＃ｄ＃ｇｌｖｔｘｄｏｌｉ｜ｌｑｊ＃ｒｉｉｈｑｖｈ＃a s liste d in Se c tio n 1012.315 Flo rid a Sta tute s. Ple a se re fe r to www.m y flo rid a te a c he r.c o m fo r m o re info rm a tio n.

First Na m e

M id d le Na m e

La st Na m e

Fo rm e r Na m e

A ny O the r La st Na m e s / A lia se s

S E A L E D O R E X P U N G E D R E C O R D ( S )

C ity Whe re A rre ste d	Sta te	Da te o f A rre st	C ha rg e	Ple a	Disp o sitio n (o utc o m e )

C R I M I N A L O F F E N S E R E C O R D ( S )

C ity Whe re A rre ste d	Sta te	Da te o f A rre st	C ha rg e	Ple a	Disp o sitio n (o utc o m e )

P R O F E S S I O N A L L I C E N S E O R C E R TI F I C A TE S A N C TI O N ( S )

Sta te : ____________________________________	Ye a r: __________________	Lic e nse o r C e rtific a te : __________________________________________________
Issuing Ag e nc y: _____________________________________________________		Sa nc tio n a nd Re a so n: __________________________________________________

Sta te : ____________________________________	Ye a r: __________________	Lic e nse o r C e rtific a te : __________________________________________________
Issuing Ag e nc y: _____________________________________________________		Sa nc tio n a nd Re a so n: __________________________________________________

Sta te : ____________________________________	Ye a r: __________________	Lic e nse o r C e rtific a te : __________________________________________________
Issuing Ag e nc y: _____________________________________________________		Sa nc tio n a nd Re a so n: __________________________________________________

A F F I D A V I T

I d o he re b y a ffirm b y my sig na ture tha t a ll info rm a tio n p ro vid e d in this a p p lic a tio n se c tio n a nd sup p le m e nt is true , a c c ura te , a nd c o m p le te .

WA RNING : G IVING FA LSE INFO RM ATIO N IN O RDER TO O BTA IN O R RENEW A FLO RIDA EDUC ATO R’ S C ERTIFIC ATE IS A C RIMINA L O FFENSE UNDER FLO RIDA LAW. A NYO NE G IVING FA LSE INFO RM ATIO N O N THIS A FFIDAVIT IS SUBJEC T TO C RIMINA L PRO SEC UTIO N, A S WELL A S DISC IPLINA RY AC TIO N BY THE EDUC ATIO N PRAC TIC ES C O MMISSIO N.

____________________________________________________	_____________________________
APPLICANT’S SIGNATURE	DATE

CG-10 APPLICATION FORM (2009) LEGAL DISCOLOSURE 2

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1. Whenever filling out the cg 10 application form, be certain to complete all of the important blanks in its relevant section. This will help speed up the work, allowing for your information to be processed quickly and correctly.

2. Soon after this section is filled out, proceed to type in the suitable details in these: E m a il A d d re ss, C U R R E N T V A LI D FLO R I D A, Pro fe ssio na l, No n Re ne wa b le Te m p o ra ry, Athle tic C o a c hing, O ne ye a r Te m p o ra ry, July, to June, C E R TI FI C A TE O R S E RV I C, INITIA L, A DDNEW, PRO C ERT, NEWPRO, C O AC H, and RETEMP.

form cg 10 conclusion process outlined (portion 2)

3. In this stage, look at o nly, Skip to ne xt se c tio n, NMC HA NG E, and C G APPLIC ATIO N FO RM. These must be taken care of with greatest attention to detail.

NMC HA NG E, C G APPLIC ATIO N FO RM, and o nly of form cg 10

4. Filling in Na m e o f C o lle g e s Bra nc h, Sta te, De g re e, Da te, Ma jo r, Se m Hrs, Atte nda nc e Da te s, G ra dua tio n, NAME IF DIFFERENT WHEN A TTENDING, print name last first middle, T E A C H I N G E X P E R I E N C, Da te s o f Em plo ym e nt, mmddyyyy, Na m e o f Em plo ye r, and Be g in is paramount in the next part - you'll want to take your time and take a close look at each and every blank!

Regarding Da te s o f Em plo ym e nt and Da te, be certain that you get them right here. Those two are certainly the most significant ones in this file.

5. Since you come near to the finalization of this document, you'll notice a few more requirements that need to be satisfied. Specifically, L E G A L D I S C L O S U R E, Flo rid a La w re q uire s yo u to, A F F I D A V I T, I d o he re b y c e rtify tha t I, print name, the C o nstitutio n o f the Unite, and WA RNING G IVING FA LSE INFO RM must all be done.

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