Instructor Credentialing Checklist Form
Complete this checklist to evaluate instructor eligibility and readiness for teaching assignments.
Instructor Full Name
*
First Name
Last Name
Subject Area(s) Qualified to Teach
*
Mathematics
Science
English/Language Arts
Social Studies
Physical Education
Other
Highest Level of Relevant Certification Held
*
State Teaching Certificate
National Board Certification
Subject-Specific Certification
No Certification
Other
Years of Formal Teaching Experience
*
Please Select
Less than 1 year
1-3 years
4-7 years
8-15 years
More than 15 years
Subject-Area Fit Assessment
*
Not a fit
1
2
3
4
Excellent fit
5
1 is Not a fit, 5 is Excellent fit
Verification of Submitted Credentials/Documentation
*
All documents verified
Some documents pending
Verification incomplete
Background and Reference Check Status
*
Completed and clear
Completed with concerns
Pending
Not started
Availability for Teaching Assignments
*
Available immediately
Available within 1 month
Available within 3 months
Not currently available
Instructor Eligibility Assessment (Likert Scale)
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Demonstrates subject expertise
1
2
3
4
5
Shows effective communication skills
6
7
8
9
10
Exhibits professionalism
11
12
13
14
15
Meets institutional requirements
16
17
18
19
20
Final Credentialing Review Outcome
*
Approved
Approved with conditions
Not approved
Submit Checklist
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