Educator Preparation Program/ISD Statement Of
Qualifications Secondary Career and Technical Certification
(SOQ)
Revised MB (12/14/2016)
Copyright© Texas Education Agency. All Rights Reserved.
Authority for Data Collection:
19 TAC Chapter 233.14 - Approval of career and technical education teachers based on prior experience and
preparation in a skill area.
Planned Use of the Data:
Evaluate candidates for qualifications for Trade and Industrial Education, Health Science, or Marketing certification
and use as a basis for issuance of certification.
Instructions:
1. Persons seeking certification in one of the above listed areas should complete this form.
2. Complete all information for the area you are seeking.
3. The original will be submitted to your Educator Preparation Program or ISD if you hold a standard certificate
and are adding an area by exam. A second and third copy will be maintained by the school district and educator. If
experience is reviewed by the district for certification by exam the district will keep the original until termination
of employment then it will be attached to the service record. The district must maintain a legible copy for audit
purposes.
4. Once the requirements have been verified and approved, exam authorization will be given by the program or
the district.
5. If you hold a standard Texas certificate and your experience is being reviewed by your employing district do not
complete section F but submit the SOQ to the certified administrator that has been designated at your employing
district, (confirm with your district that they are offering this service).
Last Name
First Name
Initial
Phone Number
Address
City
Zip Code
State
Email
Date of Birth
Section A - Title of specific certificate and subject areas for which you wish to qualify
List specific work approval area(s) for which this SOQ is being submitted (Examples: Automotive Technician,
Cosmetology, or Law Enforcement, nurse, etc.)
Trade and Industrial Education (Certification by Exam),
[experience must have been within the past 10 years]
Trade and Industrial Education (Initial Certification)
Health Science (Certification by Exam)
Health Science (Initial Certification)
Marketing (Certification by Exam)
Marketing (Initial Certification)
TEA ID Number
(Select One)
Educator Preparation Program/ISD Statement Of
Qualifications Secondary Career and Technical Certification
(SOQ)
Revised MB (12/14/2016)
Copyright© Texas Education Agency. All Rights Reserved.
Name and Location
of School
Dates From Dates To
Date
Graduated
Expected
Graduation
Date
Sem/Clock Hours
Completed
Type of Diploma
or Degree
Major/Minor
Fields of Study
Undergraduate Colleges or Universities
Name and Location
of School
Dates From Dates To
Date
Graduated
Expected
Graduation
Date
Sem/Clock Hours
Completed
Type of Diploma
or Degree
Major/Minor
Fields of Study
Graduate Schools
Section C - License or Registration; Trade and Industrial Education and Health Science Technology Education
certification require current licensure, certification, or registration by a state or nationally recognized accrediting
agency as a professional practitioner in one or more approved occupations for which instruction is offered.
License/Certification
(R.N., Attorney, etc)
Date Issued Date Expires
Issued by/Location of
Issuing Authority (State or
other Authority (City, State)
License Number
Name and Location
of School
Dates From Dates To
Date
Graduated
Expected
Graduation
Date
Sem/Clock Hours
Completed
Type of Diploma
or Degree
Major/Minor
Fields of Study
Technical, Vocational or Business School
Yes
Did you graduate from high school or receive a GED? If applicable, submit a copy of test scores for
general educational development test and certificate of high school equivalency
No
College 12 11
10
9
Indicate Highest Grade Completed:
Section B - Education; Applicants may be required to provide proof of diploma, degree, or transcripts.
Educator Preparation Program/ISD Statement Of
Qualifications Secondary Career and Technical Certification
(SOQ)
Revised MB (12/14/2016)
Copyright© Texas Education Agency. All Rights Reserved.
Section E - Employment History
Instructions: Starting with the present date, list in reverse order all trade and/or occupational experience acquired since
leaving high school.
Note: Employment for less than 20 hours per week shall not be considered for purposes of establishing acceptable work
experience. Twelve months of wage-earning experience consisting of at least 40 hours per week shall equal one year of full-
time experience. Wage-earning experience consisting of less than 40, but at least 20, hours per week shall be calculated at a
50% rate in determining years of full-time experience. Wage-earning experience consisting of less than 20 hours per week
shall not be considered acceptable in determining full-time experience. 19 TAC Chapter 233.14
Employment History Related to the Assignment (attach additional sheets if necessary)
Position Title
Mailing Address
City
Zip Code
Employer
State
Employer's Phone Number
Immediate Supervisor Name and Title
Full-Time
Part-Time
Temp/Project
Summer
Leaving Date
Trade or Skilled Work Personally Performed by You.
Be specific: List equipment operated, skilled work or services performed, and supervisory experience (number of
employees supervised).
Leaving DateStarting Date
Average number of hours worked per week
Temp/Project Part-Time
Summer
Full-Time
Immediate Supervisor Name and Title
Employer's Phone Number
Zip CodeStateCity
Mailing Address
Employer
Position Title
Starting Date
Average number of hours worked per week
List all related training or skills you possess and machines or equipment you can use. You may wish to describe in-service,
company training courses, or apprenticeship programs that you have completed. (Attach additional page if necessary)
Section D - Special Training/Skills Qualifications:
(Select One)
(Select One)
Educator Preparation Program/ISD Statement Of
Qualifications Secondary Career and Technical Certification
(SOQ)
Revised MB (12/14/2016)
Copyright© Texas Education Agency. All Rights Reserved.
Section E - Employment History continued
Trade or Skilled Work Personally Performed by You.
Be specific: List equipment operated, skilled work or services performed, and supervisory experience (number of
employees supervised).
Leaving DateStarting Date
Average number of hours worked per week
Temp/Project Part-Time
Summer
Full-Time
Immediate Supervisor Name and Title
Employer's Phone Number
Zip CodeStateCity
Mailing Address
Employer
Position Title
References: Indicate below the names of three persons qualified to comment regarding your wage-earning
experience.
Occupation
Phone Number
AddressName
Occupation
Phone Number
AddressName
Occupation
Phone Number
AddressName
Applicant's Affidavit:
1. The above information is, to the best of my knowledge, a true statement of facts concerning date of birth, education,
teaching experience, and occupational experience.
2. I understand any deficiency found in this Statement of Qualifications may disqualify me for consideration as a public school
Career and Technical Education Teacher; and
3. I understand that I must complete an approved educator preparation program for the certification sought and/or
workshops conducted or sponsored by the Texas Education Agency, or;
4. I understand that if I am adding this area by examination I hold a current valid standard classroom teaching certificate and
a bachelor's degree.
Trade or Skilled Work Personally Performed by You.
Be specific: List equipment operated, skilled work or services performed, and supervisory experience (number of
employees supervised).
(Select One)
Educator Preparation Program/ISD Statement Of
Qualifications Secondary Career and Technical Certification
(SOQ)
Revised MB (12/14/2016)
Copyright© Texas Education Agency. All Rights Reserved.
Trade and Industrial Education (Initial Certification)
" I have reviewed the experience and qualification represented herein and approve this applicant
for employment in the following Career and Technical programs."
Total number of years work experience in the areas indicated above
Name of Program Certification Officer or for Districts, Name of Certified Administrator
Name of Program Area Representative
Name of Educator Preparation Program or District Name
Signature of Program Certification Officer or for Districts, Signature of Certified Administrator
Signature of Program Area Representative
Date
ID Number or District ID
List specific work approval area(s) for which this SOQ is being Submitted (Examples: Automotive Technician,
Cosmetology, or Law Enforcement, nurse, etc.)
Health Science (Initial Certification)
*Marketing (Certification by Exam)
Marketing (Initial Certification)
Current Expiration Date
verified on the TEA Website
To
Current Effective Date
verified on the TEA Website
From
*List Current Texas Standard Certification(s) only if verifying
experience for Certification by Exam
Section F - Program Approval (skip this section if adding by examination through your employing ISD)
To be completed by the educator preparation program approved to offer training for the Career and Technical
Education certificate sought.
*Trade and Industrial Education (Certification by Exam)
[experience must have been within the past 10 years]
*Health Science (Certification by Exam)
Applicant's Signature
Date/Time FieldName