Local Education Agencies Eligible for the Rural Education

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Local Education Agencies Eligible for the Rural Education

Transcript Of Local Education Agencies Eligible for the Rural Education

ARIZONA HIGHLY QUALIFIED ATTESTATION FORM This document is intended as a guidance tool for LEA use.
Local Education Agencies Eligible for the Rural Education Achievement Program (REAP)
MULTI-SUBJECT SECONDARY TEACHERS (Grades 6-12)
Local education agencies (LEAs) that are eligible to participate in the Rural Education Achievement Program may utilize this attestation form. This form may be completed by multi-subject teachers in grades 6-12 in the following core content areas: Middle Grades (English Language Arts, Mathematics, Science, Social Studies), English Language Arts, Mathematics, Science (General Science, Biology, Chemistry, Earth Science, Physical Science, Physics and all other science content), History, Geography, Economics, Government/Political Science, and Foreign Language, Visual Arts and Music.
Visit http://www.azed.gov/program-operations/reap/ for a list of eligible local education agencies.

Name:

SSN (last 4 digits):

School:
Teacher Work Email:

LEA:
School Employment Start Date:(mm/yyyy) (Date of Hire)

If the LEA is utilizing an attestation form to gather Highly Qualified data, a separate form should be completed for each core content area taught.
1. Holds a bachelor’s degree or more advanced degree from an accredited institution. AND
2. Holds a valid Arizona teaching certificate – Intern, Provisional, Reciprocal, or Standard (Charter school teachers are exempt from this requirement).

a.  Secondary Certificate b.  Foreign Teacher Certificate (Secondary) c.  Teaching Intern Certificate (Secondary) d.  Special Education Certificate (List Disability Area(s):

3. Teaching Assignment:

AND Grade(s)

Core Academic Area

# of Periods Taught in this Core Content Area

Please check only ONE option below:

a.  Passed the appropriate AEPA or NES Subject Knowledge exam in the core content area OR
b.  HQ Teacher Reciprocity- Has an out-of-state reciprocal exam or HOUSSE Rubric
(documentation required) OR
c.  Passed the appropriate ACTFL exam (for foreign languages other than Spanish, German and French) OR
d.  Holds an advanced degree in the core academic subject area OR
e.  Has a major/24 credit hours in the core academic subject area OR
f.  Holds National Board Certification in the core academic subject area (Generalist Certificates excluded) OR
g.  Earned a minimum of 100 points on the AZ HOUSSE for Middle, Junior High, High School, Visual Arts & Music teachers in the content area, completed no later than June 30, 2007 (documentation required). An existing rubric may be utilized by teachers continuing or returning to teach in this content area

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ARIZONA HIGHLY QUALIFIED ATTESTATION FORM This document is intended as a guidance tool for LEA use.
Local Education Agencies Eligible for the Rural Education Achievement Program (REAP)
MULTI-SUBJECT SECONDARY TEACHERS (Grades 6-12)

If you met the requirements for 1, 2, and 3 under federal guidelines, you are considered Highly Qualified.

 Highly Qualified Teacher

 Non-Highly Qualified Teacher

I attest to the factual completion of this evaluation.

________________________________________________
Signature of Teacher
____________________________________________________________ Printed Name of Principal
____________________________________________________________ Signature of Principal

______________________
Date
____________________________ Date

Please Note: If you are a 6-12th grade teacher working in a Local Education Agency that is eligible for the Rural Education Achievement Program, you may utilize the REAP Multi-Subject Secondary Teacher addendum and HOUSSE rubric to become temporarily Highly Qualified in a second content area.

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Education AgenciesScienceEducation Achievement ProgramTeachersCore