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MCOE SUBSTITUTE REGISTRATION PACKET 1. Credential/Permit: Valid, non-expired California Credential/Permit (Single Subject,Multiple Subject, Education Specialist, or Emergency 30 Day Permit). If you do not hold acredential/permit, you will need to apply for a permit; see options below.Attained a Bachelor’s degree or higher:You will need to apply for an Emergency 30 Day Permit.To apply for an Emergency 30 Day Permit, you will need to bring the following to ourappointment: Sealed, unopened transcripts showing a conferred Bachelor’s degree or higherProof of meeting the Basic Skills Requirement (see information in packet)Complete a live scan for the CTC (form A0281) – if not already completedDebit/Credit card for the application processing fee of 102.50Enrolled in a Bachelor’s program:You may qualify for a Prospective Teachers Emergency Substitute Permit.To apply for the Prospective Teachers Emergency Substitute Permit, you will need tobring the following to our appointment: Sealed, unopened transcripts showing completion of 90 college semester unitsor moreProof of current enrollment in a higher education institution This can be met one of two ways:o A letter from the Registrar of the Office of Admissions with anoriginal wet-ink signature (not a digital signature)o Transcripts showing your current work in progressProof of meeting the Basic Skills Requirement (see information in packet)Complete a live scan for the CTC (form A0281) – if not already completedA check or money order for 100.00 made payable to the CTC 2. Registration Form: Complete the Substitute Teacher Registration form 3. Fingerprinting: Complete a live scan for MCOE (form A0572) – if not alreadycompleted 4. TB Clearance: Provide proof of freedom from Active Tuberculosis (see information inpacket) 5. MMR: Provide proof of Measles immunization (see information in packet) 6. Child Abuse Prevention Training: Complete the Mandated Reporter Training (seeinformation in packet) Print and include the Certificate of Completion with the registration packet 7. Appointment: When the packet is complete, please schedule an appointment. Toschedule an appointment, visit https://calendly.com/aridings

HOW TO MEET THE BASIC SKILLSREQUIREMENTThank you for your interest in substituting in Marin County.The basic skills requirement verifies that an applicant has met the basic skills proficiencystandard before a credential, certificate, or permit will be granted by the Commission onTeacher Credentialing.If you’d like to learn more about the Basic Skills Requirement, please eaflets/cl667.pdf.You may satisfy the Basic Skills Requirement by one of the following methods:1. Pass the CBESTa. For information on the exam, please visit: http://www.ctcexams.nesinc.com/2. Pass the Multiple Subject CSET plus the Writing Skills Examinationa. For information on the exams, please visit: http://www.ctcexams.nesinc.com/i. The Multiple Subject CSET test codes are 101, 214, and 103ii. The Writing Skills Examination test code is 1423. Pass the CSU Early Assessment Program or the CSU Placement ExaminationsCSU EAP Placement Tests (taken in Spring of 11th grade)MathEarly Assessment‘College Ready’ or ‘Exempt’Program (EAP)CSU Placement TestsMathEntry Level Math50*(ELM)English Placement Test(EPT)English‘College Ready’ or ‘Exempt’English151*ELM tests taken prior to March 2002 required a minimum passing score of 550.

4. Achieve a qualifying score on the SAT or ACTExaminationCollege Board SAT**(ACT)Math550 or higher23 or higherEnglish500* or higher22 or higher*Critical Reading (previously Verbal) section of the College Board SAT Reasoning Test.** In 1995, the SAT scores were recentered. If you tested before 1995 and your originalscores do not meet the qualifying score requirement, your recentered scores may nowmeet the qualifying score requirement.5. College Board Advanced Placement (AP) ExaminationExaminationCollege Board AdvancedPlacement ExaminationsMathScore of 3 or above on oneof the following: AP Calculus AB AP Calculus BC AP StatisticsEnglishScore of 3 or above on oneof the following: AP English Languageand Composition AP English Literatureand Composition6. Pass a Basic Skills Examination from another Statea. To see if your state qualifies and to see which exam(s) transfer, pleasevisit: s/cl667.pdfi. The information begins on page 6.

2018/2019 SUBSTITUTE TEACHING FORMINSTRUCTIONS:OFFICE USE ONLY:New Registrant: Complete all questions on this form to be active on the currentMarin Countywide Substitute Teacher List.TB Test Date:Re-registrant: Complete all questions on this form to be reactivated on theMMR Mnd Rptcurrent Marin Countywide Substitute Teacher List.CTC LS MCOE LSNew RegistrantRe-RegistrationQSSSub ID(A) Personal InformationSocial Security Number:Birthday:First and Last Name:Gender:Mailing Address:City, State, Zip:Preferred Telephone Number:Email address:Current Credential(s):IN CASE OF AN EMERGENCYPerson to notify:Relationship:Phone number:Doctor to notify:Hospital:Phone number:(B) Professional Fitness QuestionsPlease circle your answer.1. Have you ever been convicted of any felony or misdemeanor, fined, or placed on probation?(Exclude minor traffic violations except as required by law.) A conviction will not necessarily disqualify youfrom employment. (You can refer to page 2 of the CTC 41-4 form for additional ets/414.pdf )2. Are you currently using controlled substances without a prescription and/or are you an activealcoholic?3. Has your credential ever been suspended or revoked?4. Have you ever been dismissed or asked to resign from any teaching position?5. Do you have any relatives working for a district within Marin County?6. Are you currently, or have you ever been a member of STRS or PERS? (Circle as applicable)7. Are you a STRS or PERS Retiree? Or were STRS funds withdrawn? (Circle as applicable) (Note: Pensionreform in 2012 requires a 180 day sit out period effective 1/2013. Contact STRS/PERS for questions.)8. If you worked for the district under a different name, what was your former name?YesNoYesNoYesYesYesYesYesNoNoNoNoNoYesNoFor each question answered yes, explain in writing and attach the statement to this form.Signature: Date:

(C) Substituting PreferencesPlease circle your grade selection(s):Preschool6-8Regional OccupationalProgram (ROP)K-39-12Adult Education4-5Special EducationHome/Hospital Instruction (1-2hours/day)Please circle your district selection(s):A1. MCOE Special Education A2. MCOE Alternative Education A3. MCOE Regional Occupational Program(Include: ‘Interest to Substitute in MCOE Programs’ form. Contact Mirna Long (mlong@marinschools.org)for more information.)B1. Mill ValleyB2. Reed (Tiburon-Belvedere)B3. Sausalito Marin CityC1. Dixie C2. San Rafael C3. Ross C4. Lagunitas C5. Ross C6. Kentfield C7. Larkspur- C8. TamalpaisValleyCorte MaderaH.S.D1. Bolinas-Stinson D2. ShorelineE1. NovatoE2. Laguna Joint E3. LincolnE4. NicasioPlease circle your subject selection(s):01Elem. School Subjects21Music41Italian02Agricultural Science22Philosophy42Latin03Anthropology23Physical my25Psychology45Computers06Biological Science26General Science46Bilingual/Cross Cultural (BCLAD)07Business Education27Health Science47Deaf & Hard of Hearing08Chemistry28Political Science48Visually Impaired09Drama29Social Science49Orthopedically Impaired10Driver Ed. & Training30Sociology50Speech Therapy11Economics31Remedial Reading51Communicatively Impaired12English32Library Science52Clinical/Rehabilitative13Early Childhood Education33Vocational Education53Traumatic Brian Injury14Geography34Drafting54Learning Impaired15Geology35Humanities55Severely Impaired16History36School Nurse56Physically Impaired17Home Economics37Counselor57Resource Specialist18Industrial Arts38French58ESL (English as a 2nd s40Greek60Ed Specialist: Mild/Moderate61Ed Specialist: Moderate/Severe

REQUEST FOR LIVE SCAN SERVICEFORM 41-lS Rev. 04/1 5Applicant SubmissionA0281OR I:License/Certification/PermitType of Application:ISection 1IISection 2IISection 3IISection 4jISection 5Code assigned by DOJTEACHER CRED 44340 ECJob Title or Type of License, Certification or Permit:Agency Address Set Contributing Agency:03294CASM TEACHER CREDENTIALINGMail Code (five-digit code assigned by DOJ)Agency authorized to receive criminal history information1900 Ca itol AvenueStreet No.Street or PO BoxContact Name (Mandatory for all school submissions)Sacramento95811-4213CAStateCityContact Telephone No.Zip Code*Name of Applicant:(Please print)FirstLastMl*Driver's License No:*Alias:FirstLast*Date of Birth:*Sex:DMate OFemaleMisc. No. BIL Agency Billing Number*Weight:*Height:Misc. Number:*Home Add ress:*Eye Color:*Hair Color:Street No.Street or PO Box*Place of Birth:City, State and Zip Code*Social Security Number (full):* Required Fields*OCA Number:(SSN OR ITIN#)Level of Service:[ZJDOJ[K]FBIIf resubmission, list Original A TlNumber:SUPPLEMENTAL AGENCY/EMPLOYER·1(County Office of Education/School District)Employer NameStreet No.Street or PO BoxCityStateMail Code (COEISD five digit code assigned by DOJ)(Zip Code)Agency Telephone No. (optional)rSection 6Live Scan Transaction Completed By:Name of OperatorTransmitting AgencyATI No.LSIDDateAmount Collected/BilledORIGINAL .: Live Scan Operator; SECOND COPY - Applicant; THIRD COPY (if needed) - Requesting AgencyI

Department of JusticeState of Californ iaREQUEST FOR LIVE SCAN SERVICEBCII8016A (3/07)Applicant Submission for Public Schools or Joint Powers AgenciesOR I:A0 5 72Code assigned by DOJType of Applicant: (check one)Classified School Emp. Credent ialed School EmpDThe following selections are for Public Schools only:D0License, Certification, PermitPeace Office r0Law Enforcement Personnel0Volu ntee rJob Title or Type of License, Certification or Permit:Agency Address Set Contribut ing Agency:01833Marin Cou nty Office of EducationAgency authorized to receive criminal history informati onMail Code (five-digit code as siqned by DOJ)Amy Ridings1111 Las Gallinas AvenueStreet No.- --Contact Name (Mandatory for all school submissions)Street or P.O. BoxSan Rafael,City(415) 499- 5863CA 9 4 90 3Zip CodeStateName of Applicant:(Please print)Last-Contact Telephone NumberMiddle InitialFirstAKA's:CDL No.LastDOB:FirstSEX:DMaleD FemaleMisc. No. BtlAp plican tp a ysallfees .Agency Billing NumberWT:HT:EYE Color:Misc. No.HAIR Color:Home Add ress: (Applies only if Youth Org . I HRA or Public Utility submission)POB :Street or P.O. BoxSOC:City, State and Zip CodeYour Number:OCA No. (Agency Identifying No.)Level of Service: DOJ0FBIIf resubmis sion , list Original AT\ No.Live Scan Transaction Completed By:Date:Name of OperatorTransmitting AgencyAT\ NumberAmount Collected/BilledOR IG INAL-Live Scan Operator; SECOND CO PY- A pplicant; THIRD CO PY (if needed )- Requesting Agency