Meredith College : Department of Education : Licensure Requirements for Licensure Only

Licensure Only Inquiry Form

First Name
Middle Name
Last Name
Preferred Name
Street Address
Street Address Line 2
City
State/Province
Zip/Postal Code	- Zip +4 is not required
Country
Email address
Preferred Phone	( ) Please enter the numbers without any spaces or hyphens
How did you hear about Meredith College?
Are you a licensed teacher?	Yes No
If so, what area(s) are you licensed in?
Are you currently teaching?	Yes No
If so, at what school and what grade level and/or subject area?
Which level area of the licensure-only program are you interested in? If you selected “Other,” please indicate what area in the comments section below.
Which subject are you interested in teaching? If you selected “Other,” please indicate what area in the comments section below.
Questions/Comments
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