![]() You must complete all the required fields ( *) in the Personal Information section, including yourįull legal name and list all former names, including your maiden name, ifĪpplicable. Handwritten changes to any information required to process your application.Īpplications with blotted out, crossed out, or whited out changes will require you You must not submit an application to the Commission with It is advisable to print an extra copy to keep with your records until You must type all information requested on the applicationįorm. You must submit a separate application form and fee for each document for which You are applying for more than one type of credential, certificate, or permit, Of the type of credential certificate, or permit you are applying for. This application (Form 41-4) is the Commission’s universalĪpplication, and is used for all first-time and renewal applications regardless ![]() The Commission may reject your application if it is incomplete and it will be delayed. That you understand any and all instructions related to your application įailure to disclose any information requested is falsification of your application and the Commission may reject or deny your application or take disciplinary That the information you provide is true and correct You will be required to sign your application under penalty of perjury by doing so you are also stating that you understand: ![]() Your conviction was later dismissed (even if under Penal Code section 1203.4), expunged, set aside or the sentence was suspended You received a certificate of rehabilitation You did not go to jail or the sentence was only a fine or probation You did not go to court and your attorney went for you It happened in another state, federal court, military or jurisdiction outside the United States Teacher preparation test score violations ![]() International database of teacher misconduct maintained by the National Association of State Directors of Teacher Education and Certification (NASDTEC) If you answer yes to any question, you must complete the correspondingīefore Granting your application, the Commission will review, at a minimum:įederal Bureau of Investigation criminal history (rap sheet)Ĭalifornia Department of Justice criminal history (rap sheet) I certify (or declare) that I have read the above and completed the following for this renewal of my Child Development Permit:Īnswers to the following questions are required. You must retain your Professional Growth Plan and Record form for one year following the submission of this application. If the Commission determines through its audit that you did notĬomplete the professional growth requirements, your permit will not be renewed and you may be subject to adverse action on other credentials you currently hold. The Commission reserves the right to request submission of theseįorms for auditing purposes any time within one year following submission of this application. Permit choosing to self-verify completion of these requirements, you may be subject to an audit. These activities must be recorded on the Professional Growth Plan and Record form. Growth activities for each five-year renewal. As the holder of a Child Development Permit (any level except the Associate Teacher Permit) you must complete a specific number of planned and approved professional
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