Career Development & Placement : : Credential File

Career Development & Placement Center
Northern State University
1200 South Jay Street
Aberdeen, SD 57401
(605) 626-2371

Credential File

First Name:

MI:

Last Name:

Maiden Name:

Home Address

Address:

City:

State:

Zip:

Phone:

Permanent Address

Same as Home Address

Address:

City:

State:

Zip:

Phone:

Graduation Information

Graduation Date:

Highest Degree:

Majors:

Minors:

Additional Endorsements:

University Honors:

University Activities:

Colleges and Universities Attended (begin with the most recent)

Name:
City:		From:
State:		To:
Degree:		(example: B.S., B.A., B.S.Ed., etc.)

College / University Information

Student Teaching and Field Work Experience (required)

Name:
City:		From:
State:		To:
Grade:
Subject:

Student Teaching Information

Employement Record -- Related to your Majors or Minors

Name:
City:		From:
State:		To:
Position:

Employement Record

Professional References

Do no include cooperating and supervising teachers from your field work/student
teaching*

List three or more education professionals who can evaluate your preparation and have agreed to
provide references for your credential file.

Employer:
First Name:
Last Name:
City:	State:
Phone:
Email:

* These evaluations will be automatically included in the credential file.

Professional References

Undergraduate Course Work (required)

List by course title, not number.

Courses:

Applies to:	Course name:	Credits:

Undergraduate Major Course Work

Undergraduate Minor Course Work

Please check if you have any geographic restrictions
(such as restricted to Aberdeen, Twin Cities or South Dakota).

Restricted to: (optional)

Applying for:

Thank You

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