Homepage Blank Connecticut Ed 174 Form
Outline

The Connecticut Ed 174 form is a crucial document for individuals seeking to obtain a Substitute Teacher Authorization without having completed a bachelor’s degree. This application encompasses several key components, including personal information, educational background, and attestation of the applicant's qualifications. Applicants must provide details such as their name, contact information, and educational history, along with any relevant experience working with school-age children. Additionally, the form requires candidates to disclose any past criminal convictions or disciplinary actions related to professional credentials, which will be subject to verification through criminal history records checks. The application process also involves an attestation section, where applicants certify the accuracy of their submitted information. Furthermore, the form includes a section for the employing agent, typically a school district official, to verify and endorse the applicant's qualifications. It is essential for applicants to attach a checklist of required documents to ensure their application is complete, as the authorization is valid only until June 30 of the school year in which it is approved. Understanding the intricacies of the Ed 174 form is vital for prospective substitute teachers in Connecticut, as it lays the groundwork for their entry into the educational workforce.

Sample - Connecticut Ed 174 Form

LAST NAME
APPLICATION FOR SUBSTITUTE TEACHER AUTHORIZATION
FOR CANDIDATES WHO HAVE NOT COMPLETED A BACHELOR’S DEGREE
PART I: PERSONAL INFORMATION (Print all information in dark ink and in uppercase letters.)
FIRST NAME MI
SOCIAL SECURITY NUMBER BIRTH DATE (Month-Day-Year) – Required
ADDRESS (Street) (Apt #)
(City)
(State) (Zip Code)
FORMER LAST NAME(S)
PHONE
(Home/Cell)
1. Have you ever been convicted of any  
 
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





NOTE: 
-

Race/Ethnicity 1. Native American
 
3. Black
(Optional) 4. White
 

E-MAIL ADDRESS
Information on this application is subject to disclosure pursuant to the Freedom of Information Act.
ED 174
REV. 1/12
C.G.S. 10-145, P.A. 11-27
C.G.S. 10-145d
Regs. 10-145d-420
CONNECTICUT STATE DEPARTMENT OF EDUCATION

P.O. Box 150471 – Room 243
Hartford, CT 06115-0471
www.ct.gov/sde
PAGE 1
ED 174
PART II: EDUCATIONAL BACKGROUND

NAME OF SCHOOL STATE DATES ATTENDED EDUCATION LEVEL COMPLETED
From (M/Y) To (M/Y) 
ALL

PART III: APPLICANT ATTESTATION




 
PART IV: EMPLOYING AGENT INFORMATION AND ATTESTATION

 

(Original Signature: No Signature Stamps Accepted)
 
 
Street FAX Number
   
FOR OFFICE USE ONLY
  

 
PAGE 2
Original Signatures Must Be On Form Submitted
INSTRUCTIONS TO APPLICATION FOR SUBSTITUTE TEACHER AUTHORIZATION
FOR CANDIDATES WHO HAVE NOT COMPLETED A BACHELOR’S DEGREE
THIS CHECKLIST MUST BE ATTACHED TO THE COMPLETE APPLICATION PACKET
-


Applicant:


Employing Agent:


Information on this application is subject to disclosure pursuant to the Freedom of Information Act.
ED 174
REV. 1/12
C.G.S. 10-145, P.A. 11-27
C.G.S. 10-145d
Regs. 10-145d-420
CONNECTICUT STATE DEPARTMENT OF EDUCATION

P.O. Box 150471 – Room 243
Hartford, CT 06115-0471
www.ct.gov/sde

Form Information

Fact Name Details
Purpose The ED 174 form is used to apply for a Substitute Teacher Authorization for candidates who have not completed a bachelor's degree.
Governing Laws This form is governed by Connecticut General Statutes Section 10-145 and Public Act 11-27.
Criminal History Check Applicants must undergo a criminal history records check as required by C.G.S. 10-221d.
Expiration The Substitute Teacher Authorization expires on June 30 of the school year in which it was approved.
Application Submission Completed applications must be returned to the superintendent of schools or their designee for processing.

Detailed Guide for Filling Out Connecticut Ed 174

Completing the Connecticut Ed 174 form is an essential step for those seeking substitute teacher authorization without a bachelor's degree. The process requires careful attention to detail and the inclusion of various personal and educational information. Following the steps outlined below will ensure that the application is filled out correctly and submitted in a timely manner.

  1. Begin with Part I: Personal Information. Print all information in dark ink and in uppercase letters. Fill in your last name, first name, middle initial, gender, social security number, and birth date.
  2. Provide your complete address, including street, apartment number (if applicable), city, state, and zip code.
  3. If applicable, list any former last names you have used.
  4. Enter your phone number, including area code, and an email address.
  5. Select your race/ethnicity from the provided options, noting that this section is optional.
  6. Answer the three questions regarding criminal history and previous employment dismissals. If you answer "YES" to any question, prepare a signed statement of explanation, along with official copies of any relevant records.
  7. Proceed to Part II: Educational Background. List all educational institutions you have attended, including high school and any vocational or postsecondary schools. Include the state and dates attended for each institution, and indicate the highest level of education completed.
  8. Detail any substitute teaching experience or work with school-age children. Attach a resume or a separate sheet if necessary.
  9. In Part III: Applicant Attestation, certify that all information provided is true and accurate. Sign and date the application.
  10. Move to Part IV: Employing Agent Information and Attestation. This section must be completed by the superintendent, executive director, or their designee. They should provide their original signature, printed name, and contact information.
  11. Ensure that all required documents are attached to the application packet as specified in the instructions. Double-check that the application is complete before submission.
  12. Submit the completed application to the appropriate employing agent, who will then mail it to the Bureau of Educator Standards and Certification at the address provided.

Obtain Answers on Connecticut Ed 174

  1. What is the Connecticut Ed 174 form?

    The Connecticut Ed 174 form is an application for Substitute Teacher Authorization specifically designed for candidates who have not completed a bachelor’s degree. This form is used to gather personal information, educational background, and relevant experiences of individuals seeking to work as substitute teachers in Connecticut.

  2. Who needs to fill out the Ed 174 form?

    Individuals who wish to obtain authorization to work as substitute teachers in Connecticut and have not yet completed a bachelor’s degree must complete the Ed 174 form. This includes those with high school diplomas, GEDs, or other postsecondary education without a degree.

  3. What information is required on the form?

    The form requires personal information such as your name, address, date of birth, and social security number. Additionally, you must provide details about your educational background, including schools attended and degrees earned. Any substitute teaching experience or relevant work with school-age children should also be included.

  4. Are there any background checks involved?

    Yes, applicants must undergo a criminal history records check as part of the application process. This includes checks against the Department of Children and Families’ child abuse and neglect registry. If you answer "yes" to any questions regarding prior convictions or disciplinary actions, you must provide a signed statement explaining the circumstances.

  5. How long is the Substitute Teacher Authorization valid?

    The Substitute Teacher Authorization granted through the Ed 174 form will expire on June 30 of the school year during which it was approved. It is essential to renew the authorization if you wish to continue working as a substitute teacher beyond this date.

  6. What is the process for submitting the Ed 174 form?

    First, complete Parts I, II, and III of the form. Afterward, submit the completed application to the superintendent of schools, executive director, or their designee. The employing agent must then complete Part IV and send the application along with any supporting documents to the Bureau of Educator Standards and Certification.

  7. What happens if I provide false information on the form?

    Providing false information or failing to disclose relevant details can lead to the denial or revocation of your Substitute Teacher Authorization. It is crucial to ensure that all information provided is accurate and truthful.

  8. Is there a checklist for required documents?

    Yes, a checklist must be attached to the completed application packet. This checklist includes all required documents necessary for processing your request for Substitute Teacher Authorization. Make sure to review it thoroughly to ensure all materials are included.

Common mistakes

Filling out the Connecticut Ed 174 form can be a straightforward process, but many applicants make mistakes that can delay their application or even lead to denial. One common error is failing to provide complete personal information. Ensure that every section is filled out completely and accurately. For instance, if you leave out your social security number or fail to indicate your gender, it could result in processing delays.

Another frequent mistake is not answering the questions regarding past criminal history and professional conduct accurately. If you answer "YES" to any of these questions, you must attach a signed statement explaining the circumstances. Failing to do so can lead to serious consequences, including the potential denial of your application. It’s crucial to be honest and thorough in this section.

Many applicants also overlook the requirement to list all educational experiences. This includes high school, vocational training, and any postsecondary education. If you skip this section or do not provide complete information about your educational background, your application may be considered incomplete.

Additionally, not providing a resume or separate sheet detailing your substitute teaching experience can be detrimental. This section is essential for showcasing your qualifications and experience working with school-age children. Without this information, decision-makers may not fully understand your suitability for the position.

Lastly, ensure that all signatures are original. The form requires the signature of the superintendent, executive director, or designee. Using a signature stamp is not acceptable. This simple oversight can result in your application being returned for correction, delaying your opportunity to work as a substitute teacher.

Documents used along the form

When applying for a Substitute Teacher Authorization in Connecticut using the ED 174 form, there are several other documents that may be required to support your application. Each of these documents serves a specific purpose and helps ensure that your application is complete and meets all necessary requirements. Below is a list of commonly used forms and documents that you might need to submit alongside the ED 174 form.

  • Criminal History Records Check: This document verifies your criminal background. It is essential for the State Board of Education to ensure the safety of students. You will need to provide consent for this check as part of your application process.
  • Child Abuse and Neglect Registry Check: Similar to the criminal history check, this document confirms that you have no history of child abuse or neglect. This check is crucial for anyone working with children in educational settings.
  • Signed Statement of Explanation: If you answered "YES" to any of the questions regarding past convictions or disciplinary actions on the ED 174 form, you must include a signed statement. This statement should explain the circumstances in detail.
  • Official Court or Administrative Records: If applicable, you need to provide official copies of any court documents or administrative records that pertain to your past legal issues. These records should include the disposition of each case.
  • Resume: A resume detailing your educational background and any relevant experience working with school-age children is often required. This helps the hiring agent assess your qualifications for the substitute teaching role.
  • Application Checklist: This checklist must be attached to your application packet. It ensures that all required documents are included and helps streamline the review process.

Gathering these documents can seem overwhelming, but each one plays a vital role in your application. Ensuring that you have everything in order will help facilitate a smoother review process and increase your chances of obtaining the necessary authorization to work as a substitute teacher in Connecticut.

Similar forms

  • Form I-9: This form is used for verifying the identity and employment authorization of individuals hired for employment in the United States. Similar to the Ed 174, it requires personal information and may involve a background check.
  • Form W-4: Employees use this form to indicate their tax situation to their employer. Like the Ed 174, it requires personal details and is crucial for compliance with regulations.
  • State Teaching License Application: This application is necessary for individuals seeking a full teaching license. It shares similarities with the Ed 174 in that it requires educational history and background information.
  • Child Abuse Registry Check Form: Used to ensure that individuals working with children do not have a history of abuse. Both forms involve checks to protect the welfare of children.
  • Background Check Authorization Form: This document allows employers to conduct background checks on prospective employees. Like the Ed 174, it emphasizes the importance of criminal history disclosure.
  • Professional Certification Application: This application is for educators seeking professional certification. It requires detailed educational and professional history, similar to the information requested in the Ed 174.
  • Employment Application: This is a general form used by employers to gather information about job candidates. It often includes personal information and employment history, paralleling the structure of the Ed 174.

Dos and Don'ts

When filling out the Connecticut Ed 174 form, it is essential to approach the task with care and attention to detail. Below is a list of things you should and shouldn't do to ensure your application is processed smoothly.

  • Do print all information clearly in dark ink and in uppercase letters.
  • Do provide accurate and complete information regarding your educational background and experiences.
  • Do attach any required documentation, such as a signed statement of explanation if you answer "YES" to any of the background questions.
  • Do ensure that all signatures are original; signature stamps are not accepted.
  • Don't leave any sections of the form blank; incomplete applications may lead to delays.
  • Don't forget to double-check your social security number and birth date for accuracy.
  • Don't submit unofficial documents; always provide official copies of records as required.
  • Don't ignore the importance of the checklist; ensure it is attached to your application packet.

Misconceptions

There are several misconceptions surrounding the Connecticut Ed 174 form, which is essential for those seeking authorization to work as substitute teachers without a bachelor's degree. Here are ten common misunderstandings:

  1. Only college graduates can apply. Many believe that only individuals with a bachelor's degree can become substitute teachers. However, the Ed 174 form is specifically designed for candidates who have not completed a bachelor's degree.
  2. Criminal history checks are optional. Some applicants think that they can skip the criminal history check. In reality, it is a mandatory part of the application process for all candidates.
  3. Experience with children is not required. Many assume that prior experience working with school-age children is unnecessary. The form requires applicants to list any relevant experience, as it is an important factor in the evaluation process.
  4. Submitting the application is enough to start working. Some candidates believe that merely submitting the Ed 174 form allows them to begin working immediately. In fact, approval from the employing agent is necessary before starting any assignments.
  5. All questions on the form are optional. Applicants may think they can leave questions unanswered. However, all sections must be completed for the application to be considered valid.
  6. There is no need to provide explanations for criminal history. Some individuals might think that answering "no" to the criminal history questions is sufficient. If "yes" is answered, a detailed explanation is required.
  7. The authorization lasts indefinitely. A common misconception is that the substitute teacher authorization does not expire. In reality, it is valid only until June 30 of the school year in which it was approved.
  8. Any signature is acceptable. Applicants might believe that any form of signature will suffice. However, original signatures are required, and signature stamps are not accepted.
  9. Submitting a resume is optional. Some candidates may think that including a resume is not necessary. However, it is encouraged to provide additional information about qualifications and experience.
  10. There are no specific formatting requirements. Many applicants may overlook the instructions regarding how to fill out the form. It is important to print all information in dark ink and uppercase letters for clarity.

Understanding these misconceptions can help applicants navigate the Ed 174 form process more effectively and ensure they meet all necessary requirements for substitute teaching authorization in Connecticut.

Key takeaways

Key Takeaways for Filling Out and Using the Connecticut Ed 174 Form

  • Ensure that all personal information is filled out clearly and accurately. Use dark ink and uppercase letters to avoid any confusion.
  • Be prepared to disclose any past criminal convictions or disciplinary actions. If you answer "yes" to any of the questions, include a signed statement explaining the circumstances.
  • Gather and attach all required documents, including your educational background and any relevant experience working with children. A resume may be helpful.
  • Submit the completed form to the appropriate employing agent, who must also provide their signature and verify your information before it is sent to the Bureau of Educator Standards and Certification.