Apply for your Connecticut special services certificate

Are you ready to apply? Submit the forms and other documentation listed below if you are a school counselor, school psychologist, school marriage and family therapist, school social worker, speech and language pathologist, school nurse-teacher, or school dental hygienist-teacher from Delaware, Maine, Massachusetts, Maryland, New Hampshire, New Jersey, New York, Pennsylvania, Puerto Rico, Rhode Island, Virginia, Vermont, or Washington, DC.

We will process your completed application in 2-3 months. During the review process, we’ll determine whether to issue an initial or provisional certificate.

If you are from another state, please follow this process.

1. Application Form

Complete the online or paper-based ED 170 application. Include your nonrefundable $50 application review payment.

IMPORTANT: We don’t accept personal checks. If you apply by mail, please pay with a cashier’s check, certified bank check, or money order made payable to: Treasurer, State of Connecticut.

2. Current certificate

Mail a copy of your valid educator certificate to us.

• It must be from one of the states listed above
• Temporary, emergency, and interim certificates are not accepted

3. Form ED 126

Have ED 126 - Statement of Professional Experience completed and signed by the Superintendent or Executive Director. Either you or the organization can mail it to us. Note that we DO NOT accept photocopies, scans, or email versions of this or other signed documents.

If you have completed at least 20 school months of successful experience under an active, full certificate within the last 10 years in one of the states listed above, you may obtain a higher-level of certification known as an eight-year Provisional Educator Certificate.

If you have less than 20 months of successful out-of-state service under an active, full certificate within the last 10 years in one of the states listed above, the ED 126 form will not result in a higher-level of certification.

4. Speech and Language Pathologist License

All speech and language pathologists applying for certification must submit a copy of their valid Connecticut health license.

5. Official Transcripts (Optional)

We recommend submitting your official transcript(s) so that we can add them to your permanent certification file. They will be required in the future if you want to advance to a higher-level certificate.

Official transcript(s) with the degree and conferral date noted on the transcript can be sent in two ways:

• You or the university can mail it to us in its unopened original envelope
• The university can email your electronic transcript to teacher.etranscript@ct.gov

Once the Bureau of Certification has determined your eligibility for certification, you will be billed separately for your certificate. You may pay your fee balance online or mail your payment to the Bureau. Send your money order, cashier’s check, or certified bank checkmade payable to “Treasurer, State of Connecticut.” Personal checks cannot be accepted.

IMPORTANT: We do NOT accept copies, scans, or email versions of forms requiring original signatures. We accept only original versions of forms with original signatures.