Form For Requesting Warner School Recommendation in TEACH

Complete all fields in the form and hit submit.

The Warner School Certification Officer will receive notification of your request and will contact you with any questions. Institutional recommendations to TEACH accounts cannot be added until program completion has been conferred, i.e. graduation date.

Enter your legal name, as it appears on your photo identification, and in your TEACH account. Enter your legal name, as it appears on your photo identification, and in your TEACH account. First Middle Last
Permanent Email Address
Student ID
Daytime phone, including area code. Daytime phone, including area code. - ### - ### ####

For which program are you asking to be recommended for?
	Degree
Master's	Master'sDegree
Advanced Certificate	Advanced CertificateDegree

What type of certification are you asking to be recommended for?
	Certification Requested
Initial Certification (Teaching, SBL/SDL and school counseling)	Initial Certification (Teaching, SBL/SDL and school counseling)Certification Requested
Professional Certification (Teaching , SBL/SDL and school counseling)	Professional Certification (Teaching , SBL/SDL and school counseling)Certification Requested
Provisional Certification (School Counseling older programs only)	Provisional Certification (School Counseling older programs only)Certification Requested
Permanent Certification (School Counseling older programs only)	Permanent Certification (School Counseling older programs only)Certification Requested
Certificate of Internship	Certificate of InternshipCertification Requested
Residency certificate	Residency certificateCertification Requested

Please list all subject areas that you are asking to be recommended for.
Employment Information

If you have accepted a job related to your degree, please complete the following fields.
Have you received a job related to your field of study?

Have you received a job related to your field of study? Yes No
Employer Name (e.g. college/university, school district, agency or organization)
Specific unit or location (e.g. school building, clinic, department or division)
Job title
Approximate employment start date (month and year)
Supervisor First Name
Supervisor Last Name
Supervisor Title
By hitting the submit button below, I hereby authorize the Certification Officer access to my social security number for the purpose of confirming my identification and acknowledging program completion to the NYS Office of Teaching Initiatives of the New York State Education Dept. (NYSED) via the TEACH system.

Notes for Certification Officer
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In the number 20384, what is the 3rd digit?

Form For Requesting Warner School Recommendation in TEACH

Form For Requesting Warner School Recommendation in TEACH

Employment Information