Grand Valley State University's College of Education and Community Innovation has strict requirements for students pursuing teacher certification at our university. Students who have certain civil infractions (excluding speeding tickets), certain misdemeanors, multiple misdemeanors, or felony(s) may be denied admission to the College of Education and Community Innovation. If admission is granted, a field placement might not be found due to district policies and procedures. If a student is recommended to the Michigan Department of Education for teacher certification, the conviction could have an adverse effect on being granted a teaching certificate. Be advised, if a teaching certificate is granted with convictions or infractions, it does not guarantee PK-12 employment.

THE BELOW QUESTIONS DO NOT PERTAIN TO EXPUNGED AND/OR DEFERRED CHARGES

Please obtain and attach photocopies of court documentation (i.e., register of action, summary or "Judgement of Sentence") from the court proceedings and any related background information that you consider important.

If you have any felony or misdemeanor charges, and it is a NEW charge since you turned in your last application, please attach pertinent information regarding the NEW issue to this application. If you turned in this information previously, we do not need to have the paperwork again.

If charged with a misdemeanor and/or felony after submission of this application, I will notify immediately the Office of Certification and Accreditation at (616)331-6650 and will provide copies of court documents.

If you have questions about convictions and reporting this information, please contact the Office of Certification and Accreditation at [email protected].

Pursuant to federal law, the Family Educational Rights and Privacy Act of 1974, as amended, (FERPA) requires, subject to specific exceptions, Grand Valley State University to have written permission from its students before releasing any information from a student's educational record.

The academic requirement of Grand Valley State University's College of Education and Community Innovation (CECI) mandates that each of its students complete teacher assisting and student teaching field practicum. In order for field placements to be made by CECI, it must be permitted to disclose students' records to school districts, which are prospective placement sites for the students to complete their practicum requirements. Student records include all educational records maintained by the University on behalf of the student. Further, post students' graduation from Grand Valley State University, we are frequently asked to provide employment recommendations. In order for these recommendations to be made by CECI, we also need to have permission granted to disclose student records maintained by the University on behalf of the student.

In recognition of the above, applications for admission into CECI must include this signed consent to release education records.

Please read the following statements. By signing below you are agreeing to authorize a representative of Grand Valley State University permission to release pertinent records regarding your education history at our institution:

• I authorize a designated representative of Grand Valley State University to release my educational records to school districts in which I may be placed for either teacher assisting or student teaching. This consent does not require the release of such educational records, if, in its sole discretion, the University deems it unnecessary to do so, nor does the release of educational records guarantee my placement at any school district.
• I authorize a designated representative of Grand Valley State University to release my educational records to school districts in which I may be an applicant for a paid position, including but not limited to the position of teacher. This consent does not require the release of such educational records, if, in its sole discretion, the University deems it unnecessary to do so for the purpose of employment outside of the University.

I acknowledge that I may review my educational records maintained by the College of Education and Community Innovation provided I submit my written request to the Dean of CECI three (3) business days in advance and that such review will take place between 8:00 a.m. and 5:00 p.m., Monday through Friday on days Grand Valley State University is open for business. The University's policy on the Family Educational Rights and Privacy Act of 1974, as amended, as stated in Section 209 of the Student Code shall govern all other aspects of my educational records and Live Scan results.

Grand Valley State University, its Board of Trustees, officers, employees, agents are hereby released from legal responsibility or liability for the release of such information and records as authorized by this consent form.

• I have read the above consent information and give willful consent of all its terms and conditions.
• I agree to the release of my educational records under the above detailed circumstances.
• I understand that placements, including school location and grade level, will be made in terms of programmatic needs and design, supervisory load, and the availability of placement situations within the schools within the placement radius.
• I am willing to accept the placement assignment as determined by College of Education and Community Innovation and further understand that particular interest areas and grade levels will not necessarily be accommodated.
• I understand that transportation to and from my placement assignment is my responsibility.
• I agree to report changes of name, address, telephone number and e-mail address immediately to the College of Education and Community Innovation.
• I agree to notify the College of Education and Community Innovation if I receive a placement where a relative is employed or attending school.
• I certify that the answers given in my application are complete and accurate. Failure to provide accurate information or concealment or misrepresentation of any information may result in denial of admission, field placements, recommendation for teacher certification, or recommendation for additional endorsements.

Please upload the following required documents below: