Request For Letter Of Authority 2023-2024 Step 1 of 4 25% TEACHER CERTIFICATION BRANCH REQUEST FOR LETTER OF AUTHORITY 2023-2024 (Authorized by the Minister pursuant to the Education Act, the Certification of Teachers and Teacher Leaders Regulation Alberta Regulation 123/2022 A Temporary Letter of Authority (TLA) to teach may be considered only for applicants who present, at a minimum, evidence of: (a) holding certification in the jurisdiction where initial teacher preparation was completed; and (b) good standing in the last jurisdiction of employment*. In addition, these applicants must be deemed likely to qualify in all other respects for the Alberta Interim Professional Certificate. Temporary Letters of Authority are issued for a three-month period to allow sufficient time to complete the application process. * The jurisdiction of original certification may be the same as the last jurisdiction of employment as a teacher. APPLICANT’S PERSONAL INFORMATION Title(Required)MrMrsMsCurrent Full Legal Name:(Required) First Last FILE/CERTIFICATE NO.(Required) From Alberta EducationList all other (previous) legal names: NOTE: For both evidence of legal name change and of immigration/citizenship status you may choose to submit an unaltered copy of your original document(s) accompanied by a Statutory Declaration form(s) obtained from Alberta Education, Teacher Certification Branch, web site: https://education.alberta.ca/ or by calling 780-427-2045 or toll free by dialing 310-0000. Provide acceptable evidence of name changes. Photocopies of government issued birth certificate, marriage certificate, or legal name change certificate. Do not send original birth or marriage certificates to AISCA. Send copies to Alberta Education, Teacher Certification Branch. These documents can be uploaded to Alberta Education by logging into your TWINS Teacher Self Service account at. https://extranet.education.alberta.ca/twins.public/public/Date of Birth(Required) YYYY slash MM slash DD Personal Phone(Required)Work Phone(Required)Personal E-mail(Required) Work E-mail(Required) Citizenship Status:(Required) Canadian citizen by birth Canadian citizen by naturalization (granted) Permanent resident Other Location of initial teacher preparation program: Self-Declaration: I declare that I have read and understood the competencies related to Interim Professional Certification as outlined in the Teaching Quality Standard and I hereby attest to possessing such competencies and to my ability to apply them appropriately toward student learning. I also commit to teaching practice and ongoing professional growth in keeping with the competencies and indicators identified in the Teaching Quality Standard. I declare that the particulars that have been furnished on this form are true and complete in all respects and that no relevant information has been withheld. I declare that all documentation that may be submitted by me has not been changed or altered in any way. I understand that a false declaration or willful omission, or submission of altered, tampered or forged documentation may result in the non-issuance, suspension or cancellation of my teaching certificate under the Certification of Teacher and Teacher Leaders Regulation.Applicant’s Signature(Required)The personal information collected as part of this application process for teacher certification is collected pursuant to the provisions of the Certification of Teacher and Teacher Leaders Regulation, and section 33 of the Freedom of Information and Protection of Privacy Act (FOIP Act). This information will be used for the purpose of processing your application to determine your eligibility for extension of your interim professional certificate. The personal information will be treated in accordance with the FOIP Act. Questions regarding the collection may be directed to the Director, Teacher Certification Branch, Alberta Education, 44 Capital Boulevard, 10044 - 108 Street, Edmonton, AB, T5J 5E6. Telephone: (780) 427-2045; toll free by dialing 310-0000.Date of Application(Required) MM slash DD slash YYYY RECRUITMENT REQUEST: (to be completed by School Principal) Type of teaching position:(e.g. Full-Time, Half-Time, Substitute, Language Instruction, ECS, Private School, Vocational Ed. or CTS, Special Ed., other) Period of Employment From:Year - Month to Year - Month I verify that the above candidate has submitted to Teacher Certification Branch of Alberta Education a formal application for teacher certificate: (If NO, please instruct the candidate to contact the Teacher Certification Branch immediately)(Required) Yes No I am satisfied that the above individual may be entrusted with teaching duties and has not been convicted of a criminal offence in Canada or an equivalent offence elsewhere.(Required) Yes No It is my understanding that the above individual holds or held a valid teaching certificate in another jurisdiction.(Required) Yes No I also believe that this individual is in good standing in the jurisdiction where he/she last taught.(Required) Yes No Principal’s Name(Required) First Last Recommending School Name Principal’s Signature(Required)UntitledFirst ChoiceSecond ChoiceThird ChoiceEmailThis field is for validation purposes and should be left unchanged.