Sunday, May 19, 2013

Relicensure Application Form

To register with the school district for relicensure, please fill out the form below.  If you have questions, please direct them to Dr. Jessica Dain, Director of Professional Development at 913-667-6200 or e-mail.   You will receive a confirmation e-mail with instructions and more information after your request is processed.  Please allow up to five business days for processing.


Items denoted with a red asterisk * are required.
 * Full Name
 
First Name
M.
Last Name
 * Social Security Number:
 
 * Original KS License/Certificate Issue Date
 
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 * Most Recent KS License Issue Date:
 
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 * Most Recent KS License Expiration Date:
 
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 * Email:
 
 * Home Phone:
 
 -  - 
(XXX)-XXX-XXXX
Other Phone:
 
 -  - 
(XXX)-XXX-XXXX
 * Mailing Address:
 
Address 1
Address 2
City
State
Zip Code
 * Highest Education Degree Awarded:
 
 * Are you registering as a requirement to be a substitute teacher in USD #232?
 
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