closeup of hands working with a variety of shape and colored blocks

College of Education

By clicking submit at the bottom of this application, you understand that you are applying to the Department of Educational Leadership's Licensure Certificate program at the University of Montana.

Please submit this electronic form as a part of the application requirements for the Licensure Certificate program, listed on the Application Requirements page.

If you have any questions about admissions or application materials, please visit the Application Requirements page or contact the department at edld@mso.umt.edu or 406.243.5586.

Licensure Certificate Program Application Form

Name

Street Address

City, State, Zip

Phone (Home/Work/Cell)

Master's Degree Completion Date

Master's Degree Major

Master's Degree Institution

Current License Information

States in which applicant holds licensure

Montana Teaching

Class 1/Professional

Class 2/Standard

Class 5/Alternative

Endorsements (list all)

School Counseling

Class 6/Specialist

Licensure Sought

If Supervisor is being sought, what subject area?

Briefly describe your leadership philosophy:

Identify your five-year goals:

Today's Date

Month

Day

Year

* Indicates a required field