Form Instructions
COMPLETING YOUR APPLICATION
This application (Form 41-4) is the Commission’s universal application, and is used for all first-time and renewal applications regardless of the type of credential certificate, or permit you are applying for. If you are applying for more than one type of credential, certificate, or permit, you must submit a separate application form and fee for each document for which you apply.
You must type all information requested on the application form. It is advisable to print an extra copy to keep with your records until your credential is issued.
You must not submit an application to the Commission with handwritten changes to any information required to process your application. Applications with blotted out, crossed out, or whited out changes will require you to submit a new application Form 41-4.
1. PERSONAL INFORMATION
You must complete all the required fields (*) in the Personal Information section, including your full legal name and list all former names, including your maiden name, if applicable. Additionally, you are required to provide your full Social Security Number (SSN) or Individual Tax Identification Number (ITIN) on your application pursuant to 42 USC §666 and California Family Code §17520. If this information is not included, your application will be returned to you for completion. For more information, see Coded Correspondence 13-14 on the Commission’s website.
You must provide the Commission with a valid email address on your application form in order to receive automated notifications regarding your application status.
If you already hold a credential, certificate, or permit with the Commission and have legally changed your name, you must submit by postal mail a completed Form 41-NC to the Commission along with any required documentation as indicated on the form.
You are required to notify the Commission of any address change pursuant to 5 CCR §80412. A change of mailing or email address may be completed online by using this link for the Educator Login button on the Commission’s website.
Pursuant to Education Code §44230.6 and Government Code §8310.8, the Commission is required to collect voluntary demographic data as to the ancestry or ethnic origin as well as voluntary self-identification information pertaining to sexual orientation and gender identity of Californians. The Commission shall not disclose personally identifiable information collected pursuant to this subdivision.
2. APPLICATION TYPE
Select the one category most appropriate to the purpose of the application.
3. CHOOSE DOCUMENT TYPE
Pick the document type you wish to apply for from this section. If the document type you are seeking is not listed here, you can use one of the “Other” boxes in this section to indicate the type of document sought with this application. A separate application form and fee is required if you wish to apply for more than one document type.
4. SELECT AUTHORIZATION/SUBJECT AREA(S)
Use the spaces shown to select the subject area or type of authorization to list on the credential or permit sought. If seeking more than one subject area on a Single Subject Credential, you may indicate additional subject areas in the Comments section.
5. CHILD DEVELOPMENT PERMIT RENEWAL: SELF-VERIFICATION
This section should be completed only by applicants who hold a Child Development Permit (other than the Associate Teacher Permit) and seek to renew the permit. You may either complete the self-verification in Section 5 on Form 41-4 or submit Form CL-826 , the Professional Growth Plan and Record along with your application. If you choose to self-verify completion of your professional growth activities, you may be subject to an audit. If the audit determines that you did not complete the professional growth requirements, your renewal application will be denied and you may be subject to adverse action on other credentials you currently hold. You must retain your Professional Growth Plan and Record Form for one year following the submission of your application.
6. PROFESSIONAL FITNESS QUESTIONS
You are required to answer all Professional Fitness Questions. Before granting your application, the Commission will review your criminal history, if any, from the Federal Bureau of Investigation and California Department of Justice, a national database of teacher misconduct, previous reviews by the Commission, complaints from those with first-hand knowledge of misconduct, notifications from school districts, and teacher preparation test score violations.
You must disclose misconduct, even if:
• It happened a long time ago
• It happened in another state, federal court, military or jurisdiction outside the United States
• You did not go to court and your attorney went for you
• You did not go to jail or the sentence was only a fine or probation
• You received a certificate of rehabilitation
• Your conviction was later dismissed (even if under Penal Code section 1203.4), expunged, set aside or the sentence was suspended
In accordance with Health & Safety Code sections 11361.5 and 11361.7, you may omit misdemeanor marijuana-related convictions that occurred more than two years prior to this application, except convictions involving concentrated cannabis, which must be disclosed regardless of the date of such a conviction.
Warning: Failure to disclose any information requested is falsification of your application and the Commission may reject or deny your application or take disciplinary action against your credential. If you answer “yes” to a question, you must complete a Professional Fitness Explanation Form and provide all requested documentation. If any of the records have been purged or are otherwise not available, provide an original statement from the agency on its official letterhead verifying that fact.
7. CHILD ABUSE AND NEGLECT MANDATED REPORTING
Pursuant to Education Code section 44252, you must read this section and mark the box “I agree,” verifying that you understand your duties under the Child Neglect and Abuse Reporting Act (Penal Code §11164).
8. EMPLOYING AGENCY INFORMATION
If you are seeking employment based on an emergency permit (other than a 30-Day or Prospective Substitute Permit), a one-year nonrenewable credential, or intern credential, this section must be completed by an official local employing school agency and submitted to the Commission by that agency. Individuals applying directly to the Commission for other types of documents should not complete this section.
9. OATH AND AFFIDAVIT
You must fully complete all portions of this section and certify (or declare) under penalty of perjury under the laws of California that all the foregoing statements in this application are true and correct by signing the oath.
ADDITIONAL INFORMATION FOR APPLICATION SUBMISSION
Supporting Documentation
You are responsible for providing the appropriate official transcripts, letters verifying experience, exam score reports, and any other information needed to determine your eligibility for the credential sought with each application you submit. Transcripts or other supporting materials sent separately from the submission of an application and payment or from a Commission letter requesting the documentation are destroyed without being reviewed. The Commission cannot match pieces of an application that arrive separately.
“Official transcripts” refers to the original college issued documents, not photocopies. Internet PDF printouts and student grade reports are not acceptable. Official transcripts submitted with an application need not remain sealed in the original envelope. Employing agencies and program sponsors submitting paper applications on behalf of applicants may submit verified true copies of official transcripts.
The Commission will accept electronic versions of official transcripts (e-transcripts) when verification is provided that the transcripts were submitted directly from the college or university to a school district, county office, or credential program sponsor. Such verification is usually provided on the e-transcript coversheet or each page of the transcript. The Commission will not accept e-transcripts that were sent directly to an individual educator.
All supporting documentation, including transcripts, becomes the property of the Commission when submitted and will not be returned. The Commission does not maintain a file of all supporting materials sent with every application. Educators should retain a copy of each application and the related supporting materials submitted to the Commission for reference.
Fees
Please refer to the Commission’s fee schedule (Credential Leaflet CL-659) to determine the amount due. Application fees may be paid by check or money order, made payable to the Commission on Teacher Credentialing or CTC. Do not send cash . A service charge of $20 will be assessed for a check that does not clear the bank and your credential may be voided until all fees due are paid in full. Applications submitted without the appropriate payment will not be processed.
If it is determined that your application is missing required supporting documentation to qualify, you will be sent a letter outlining what materials must be submitted. In such cases, your application and fee remain valid for sixty (60) days (Reference: Title 5, California Code of Regulations, section 80487). To avoid having to submit a new application and fee, you must mail in all supporting documentation requested within this 60-day timeframe. Application fees are earned upon receipt and are not refundable. If you do not qualify for the credential type originally applied for, the fee cannot be used to apply for another credential type. If requirements for a document are met after the initial submission of an application, a new application and fee will be required.
Fingerprint Information
If this is your first application for a credential, certificate, or permit, you must provide verification that you have completed fingerprint processing. California residents must complete the electronic Live Scan process and do not have the option of submitting fingerprint cards . Individuals applying for their first credential who reside outside California must submit with their application packet two fingerprint cards (FD-258) and the additional fingerprint processing fees . A copy of the Live Scan form (Form 41-LS) may be downloaded from the Commission’s website. Please see Credential Leaflet CL-271 for more information on fingerprint processing.
Application Processing
Applications are processed in the date order in which they are received. You may check your application status online using the Educator Login.Note that it may take several weeks after the Commission has received your application for it to appear in the online system, as the Commission receives hundreds of applications each day.
Current law sets a maximum processing time for the evaluation of applications of 50 business days after the Commission receives a completed application. This timeframe does not include weekends or holidays. Applications delayed for completion of a fitness review or fingerprint processing are not subject to the 50 business day restriction. Please wait until the maximum processing time has passed before contacting the Commission regarding your application status.
Following the submission of the application, fee, and supporting materials, the application will be evaluated to verify eligibility for the document requested. To avoid having to submit a new application and fee, you must mail in all supporting documentation requested within this 60-day timeframe.
Privacy
The California Information Practices Act and the Federal Privacy Act provide that agencies requesting information indicate the principal purposes for which that information is used. Your name, former names, SSN, date of birth, address, email address, and telephone numbers are used to provide proper identification of your file and, if necessary, to contact you. Other information is used to determine your eligibility.
Information displayed online regarding the documents you hold or have held is public information and may be disclosed. In addition, pursuant to Education Code section 44230 the Commission may disclose to the agency that submitted the application all information provided with applications submitted by you through that agency. Information may also be disclosed to other State or Federal agencies as authorized by law. Personal information may be disclosed to the public only with your permission or in accordance with the law. The information is necessary for the Commission to perform its duty under Education Code sections 44200-44439.
You have a right to review personal information maintained on you by the Commission unless access is exempted by law. The Director of the Certification Division, 1900 Capitol Avenue, Sacramento, California 95811-4213, is responsible for the maintenance of this information.
Online Credential View and Print Process
Once your application is processed and your credential is granted, it will appear in the Commission’s online database. The Commission does not print or mail documents. The official record of credentials, certificates, and permits is available through the online view, and colleges, universities, and employers may access the Search for an Educator option on the Commission’s Home page (see the drop down under the Employers link) to verify a document. Document holders may access their file using the Educator Login button on the Commission’s Home page . Documents are available for view within 3-5 business days of issuance. For directions on obtaining an unofficial copy of your document, see the instructions under the drop down link Print a Document’s Detail for assistance.
Reasonable Accommodation
If you need to request a reasonable accommodation for any portion of the application submission process, please contact the Commission via one of the following options:
- Email credentials@ctc.ca.gov and include "reasonable accommodation" in the subject line.
-
Mail the information to: Attn: CERT ManagerCommission on Teacher Credentialing1900 Capitol Ave, 95811-4213Sacramento, CA 95819
- Contact us through live chat, Monday through Friday, 12:00 PM to 4:00 PM via the following link: https://www.ctc.ca.gov/commission/contact-the-commission
- In-person requests may be made at the Sacramento address listed above, Monday through Friday, 8:00 AM to 5:00 PM.
Please include information on how we can assist you and your preferred method of response (e.g. telephone, email, etc.). For telephone requests, a CTC staff member will reach out to schedule an appointment for a call back.