While not required, the completion of the following information will help California Department
of Education (CDE) continue to provide you with information and services more closely related to
your needs and goals. Once you are finished with the form, select the submit button.
| General Information |
| First Name MI Last Name* |
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| Address |
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| Apt / Unit |
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| City, State Zip* |
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| Home Phone |
()
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| Work Phone |
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Ext.
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| Cell Phone |
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| Email Address * |
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| Enter Email Address Again* |
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CDE would like to keep you informed of news, updates, and other information. Would you like to
receive email notifications from CDE?
[To ensure email will not be identified as SPAM you may want to add "teachCalifornia.org" to
your address book.]
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| Email Opt-in |
Yes
No
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About You
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| Classification |
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| Ethnicity |
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Do you speak/read/write a language other than English?
[Hint: To select more than one language, click on the item while holding down the CTRL key.]
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What type of Credential are you seeking?
[Hint: To select more than one credential, click on the item while holding down the CTRL key.]
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Single Subject Areas
[Hint: To select more than one subject, click on the item while holding down the CTRL key.]
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Education
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Highest education level?
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If high school student enter your school.
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If community college student select your school.
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If 4-year college student select your school.
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If your school is not listed above enter it here
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Interested in a California Community College
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Do you need to complete lower division courses? Attending a community college may be the answer for you.
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Are you interested in attending a California Community College?
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Yes
No
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If yes, within what distance?
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miles
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Interested in a California 4-year College
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Do you need to complete courses for your undergraduate degree? 4-year colleges offer a wide-range
of programs that may be the answer for you.
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Are you interested in attending a California 4-year College?
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Yes
No
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If yes, within what distance?
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miles
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Current Degree Information
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Completion of Undergraduate Degree?
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Undergraduate Major
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Degrees Held
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Exams Passed
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Credential Information
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Do you have a credential?
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Yes
No
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If yes, from what state?
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If yes, what are you certified to teach?
[Hint: To select more than one credential, click on the item while holding down the CTRL key.]
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Are your enrolled in a teacher preparation program?
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Yes
No
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If yes and in CA, from what type of University?
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If yes, California University name?
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If yes and out of State, from what type of University/College?
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If yes, out of State University/College name?
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You will be able to log into the system to view information you have saved and/or make changes
to your information and preferences. Your email address will be your User ID. Please create a
password for your profile.
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Enter Password*
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Confirm Password*
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