Provisional License Eligibility Letter Request 鈥� Office of Candidate Services

Use this form to request a letter of eligibility from your MAT program coordinator for a provisional license.

Name*
First Last
UCA Student ID Number (Ex: B00123456)*
Email*
In which program are you enrolled?*
- MAT - Elementary, Middle Level, or Secondary programs
- MAT - K-12 Special Education
What is your licensure area?*
- Elementary Education
- Middle Level
- English
- Social Studies
- Mathematics
- Physics
- Chemistry
- Life Science
- Health/PE
- Music
- Art
- Business Technology
- Family & Consumer Science
Check to verify the you have completed the eligibility requirements*
More information about these requirements is available at http://uca.edu/ocs/mat-provisional-license/
- Admitted and enrolled in the MAT program
- Submitted official transcripts (if not a UCA graduate) to the MAT coordinator
- Passed required Praxis Subject Area Assessment(s)
- Completed professional development requirements
- Completed mandatory ethics training
- MAT SpEd ONLY - Completed 6 credit hours
Candidates are responsible for completing the background check process. Your provisional license will not be issued until all background checks have cleared.*
- I have initiated the background check process.
- I have NOT initiated the background check process but understand that it is my responsibility.
Additional Information or Comments (OPTIONAL)

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