Form Spi Vcert 4075A 1 PDF Details

For individuals pursuing a Career and Technical Education (CTE) certification, understanding and accurately completing the SPI Vcert 4075A 1 form is a critical step in the certification process. This form serves as a submission platform for verifying industry hours that are non-teaching but relevant to the CTE certification being sought. It demands a detailed account of the applicant's job titles, the years spent in each position, hours worked, and specific job responsibilities, linking each to appropriate V-Codes to accurately reflect the scope of their experience and expertise. Documentation supporting the claims of occupational experience, such as W-2s, employer letters, pay stubs, or records of volunteer hours, must accompany the form. Notably, the form emphasizes the importance of not double-counting hours across different job roles or responsibilities. This meticulous reporting helps ensure that applicants' real-world experiences are appropriately recognized and valued in the certification process, aligning with the Washington State's specifications for CTE educators. Failure to provide a comprehensive and exact account may hinder the approval of the certification, underscoring the form's significance in the certification journey.

QuestionAnswer
Form NameForm Spi Vcert 4075A 1
Form Length5 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 15 sec
Other namesospi 4075a, spi 1 specialty area, spi form technical specialty, ospi

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OFFICE OF SUPERINTENDENT OF PUBLIC INSTRUCTION

Professional Certification

Old Capitol Building

PO BOX 47200

Olympia WA 98504-7200

(360)725-6400 TTY (360) 664-3631 Web Site: http://www.k12.wa.us/cert/

INDUSTRY HOUR (NON-TEACHING) SUBMISSION FORM FOR CAREER AND TECHNICAL EDUCATION CERTIFICATION

NAME

DATE OF BIRTH

Correctly describing your job(s) and responsibilities is crucial to having your Career and Technical Educator

certificate approved. Please submit this form when you apply for your Initial CTE Application to OSPI and any occupational experience verification (W-2’s; Letters from employers; Pay stubs; volunteer hours etc.). All

claimed occupational hours require appropriate documentation as evidence of hours worked.

Some of your job responsibilities may include more than one V-Code. Please list the number of hours you worked in each V-Code you want included on your CTE certificate1. Also, describe and match your job requirements to the V-Code that you are requesting.2

Company and Job Title

Years

Hours

V-Code

Job Responsibilities Description

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Company and Job Title

Years

Hours

V-Code

Job Responsibilities Description

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Company and Job Title

Years

Hours

V-Code

Job Responsibilities Description

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Company and Job Title

Years

Hours

V-Code

Job Responsibilities Description

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1Please note that you cannot double count hours. The max hours you can work is 2,000, so you cannot claim more than 2,000 in a year. For example, if your job included welding and designing, you could not claim 2,000 hours welding and 2,000 designing. You would

claim 1,000 hours welding and 1,000 hours designing.

2OSPI does not guarantee your V-Codes will be approved; OSPI approves if your industry hours actually meet Washington State’s specifications for earning your requested V-Code.

FORM SPI 4075I (8/2017)

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VERIFICATION OF TEACHING EXPERIENCE

USE THIS FORM TO RECORD TEACHING EXPERIENCE IN A SPECIALTY AREA.

SECTION A

TO BE COMPLETED BY APPLICANT

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SECTION B

TO BE COMPLETED BY EMPLOYER, OR HIS/HER DESIGNEE, WHERE APPLICANT WAS EMPLOYED

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RETURN COMPLETED FORM TO APPLICANT

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