While not required, the completion of the following information will help TEACHCalifornia 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* |
|
| Address |
|
| Apt
/ Unit |
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| City,
State Zip* |
|
| Home Phone |
(
) |
| Work Phone |
(
) Ext. |
| Cell Phone |
(
) |
| Email Address * |
|
| Enter Email Address Again* |
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| Teach California would like to keep you informed of news, updates, and other information. Would you like to receive email notifications from Teach California? |
| Email Opt-in |
Yes
No
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| About You |
| Classification |
|
| Ethnicity |
|
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.] |
|
What
type of Credential are you seeking? [Hint: To select more than one credential, click on the
item while holding down the CTRL key.] |
|
Single
Subject Areas
[Hint: To select more than one subject, click on the
item while holding down the CTRL key.] |
|
| Education |
| Highest education level? |
|
| If high school
student enter your school. |
|
| If community college
student select your school. |
|
| If 4-year college
student select your school. |
|
| If your school is not listed above
enter it here |
|
| Interested
in a California Community College |
| Do you need
to complete lower division courses? Attending a
community college may be the answer for you. |
| Are
you interested in attending a California Community
College? |
Yes
No |
| If yes, within what distance? |
miles |
| Interested
in a California 4-year College |
| 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. |
| Are
you interested in attending a California 4-year
College? |
Yes
No |
| If yes, within what distance? |
miles |
| Current
Degree Information |
| Completion of Undergraduate
Degree? |
|
| Undergraduate
Major |
|
| Degrees Held |
|
| Exams Passed |
|
| Credential
Information |
Do you have a
credential? |
Yes
No |
| |
If
yes, from what state? |
|
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.] |
|
| Are your enrolled in a teacher preparation program? |
Yes
No |
|
If
yes and in CA, from what type of University? |
|
| If
yes, California University name? |
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| If
yes and out of State, from what type of University/College? |
|
| If
yes, out of State University/College name? |
|
| 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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Password* |
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| Confirm
Password* |
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