Department for Education

Catholic Diocese of Columbus

Fee Payment Request

 

I. INFORMATION FOR THE UNIVERSITY

University (or college) where course(s) will be taken
(including OSU Marion):
Quarter/Semester, Year
Last 4 SSN:     
Last name:  
First name:
Middle Initial:
Email address:    
College or division to be attended
(if in graduate school, indicate grad. only):
OSU ID# (if applicable):

II. INFORMATION FOR THE DIOCESAN SCHOOL OFFICE

School:
School address:
School city:
School state:
School zip code:
Number of years you have taught in Diocese of Columbus
(do not include current school year):

What grade level?
Were you a cooperating teacher the previous school year?
If so, which college or university?
When?
Working with student teachers?
Or early experience?
Or other (specify):
Race:




Only third or fourth level undergrad course work and all graduate course work may be used when upgrading certificate from a provisional to a professional.


   

The Columbus Catholic Schools have exchange of service agreements with the following colleges/universities: ODU, OSU, Ashland University, Mt. Vernon Nazarene University, and Otterbein College.