Form AC1 "Alternative Certification District Intent to Employ - General Education, Cte and Tfa Alternative Certification" - South Dakota

What Is Form AC1?

This is a legal form that was released by the South Dakota Department of Education - a government authority operating within South Dakota. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 1, 2019;
  • The latest edition provided by the South Dakota Department of Education;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form AC1 by clicking the link below or browse more documents and templates provided by the South Dakota Department of Education.

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Download Form AC1 "Alternative Certification District Intent to Employ - General Education, Cte and Tfa Alternative Certification" - South Dakota

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Date Received by SD DOE:
Form AC1 (11-2021)
Alternative Certification District Intent to Employ
Office of Educator Certification
Type all information or use blue or black ink.
General Education, CTE and TFA Alternative Certification
Part 1 – Applicant Information to be completed by the employing school district.
Last 4 digits of the SSN
Last Name
First Name
Maiden/Previous Last Name
Part 2 – Public or Department-Accredited school intent to employ through alternative certification.
Email completed form to
certification@state.sd.us
Public or Department-Accredited School
School Building Name
Grade Level
Starting Date as Teacher of Record:
Content Area/Class Assignment(s)
Was the above position advertised?
If yes, where and how many applicants?
☐Yes ☐No
Did any of the applicants hold a South Dakota professional or advanced teaching certificate? ☐Yes ☐No
If yes, state the reason for not hiring.
Part 3 – Employer requirements for employing an individual with an alternative teaching certificate.
Effective December 1, 2020 according to ARSD 24:28:11:08, 24:28:12:08, and 24:28:13:08, a school district or department-
accredited school employing an individual with an alternative teaching certification must offer a mentoring program.
Select the type of mentor program offered by your district and explain the mentorship and orientation that will be provided
for the named individual teaching through alternative certification.
https://doe.sd.gov/mentoring/
o
State Mentor Program
State Approved Local Mentor Program
o
o
Local Mentor Program
Alternative Certification District Intent to Employ Form AC1 (11-2021) 1
Date Received by SD DOE:
Form AC1 (11-2021)
Alternative Certification District Intent to Employ
Office of Educator Certification
Type all information or use blue or black ink.
General Education, CTE and TFA Alternative Certification
Part 1 – Applicant Information to be completed by the employing school district.
Last 4 digits of the SSN
Last Name
First Name
Maiden/Previous Last Name
Part 2 – Public or Department-Accredited school intent to employ through alternative certification.
Email completed form to
certification@state.sd.us
Public or Department-Accredited School
School Building Name
Grade Level
Starting Date as Teacher of Record:
Content Area/Class Assignment(s)
Was the above position advertised?
If yes, where and how many applicants?
☐Yes ☐No
Did any of the applicants hold a South Dakota professional or advanced teaching certificate? ☐Yes ☐No
If yes, state the reason for not hiring.
Part 3 – Employer requirements for employing an individual with an alternative teaching certificate.
Effective December 1, 2020 according to ARSD 24:28:11:08, 24:28:12:08, and 24:28:13:08, a school district or department-
accredited school employing an individual with an alternative teaching certification must offer a mentoring program.
Select the type of mentor program offered by your district and explain the mentorship and orientation that will be provided
for the named individual teaching through alternative certification.
https://doe.sd.gov/mentoring/
o
State Mentor Program
State Approved Local Mentor Program
o
o
Local Mentor Program
Alternative Certification District Intent to Employ Form AC1 (11-2021) 1
Effective December 1, 2020, according to ARSD 24:28:11:08, 24:28:12:08, and 24:28:13:08, a public or Department-
accredited school employing an individual with an alternative teaching certificate applicant shall:
(1) Verify the applicant has a valid alternative preliminary certificate;
(2) Document that the school attempted but was unable to hire a teacher with a professional or advanced teaching
certificate prior to hiring an applicant with an alternative certificate;
(3) Offer a mentoring program;
(4) Provide the applicant with information about the South Dakota Code of Professional Ethics for Teachers in
chapter 24:08:03;
(5) Train the applicant on the school teacher evaluation system; and
(6) Recommend the general education alternative certificate applicant for renewal based on documented
performance and progress.
We, the Public or Department-Accredited School, understand that the:
certificate must be renewed yearly with our recommendation for renewal;
maximum length for alternative certification is three years;
individual must adhere to the South Dakota Code of Professional Ethics for Teachers in chapter 25:08:03;
individual may not teach grades or content beyond the endorsements listed on the certificate; and
individual must be working towards the requirements to obtain a professional teaching certificate.
Print Name of Authorized Official
Title of Authorized Official
Email Address
Telephone (including area code)
Address
City
State
Zip Code
Signature of Authorized Official
Date
Save the completed form as a PDF and Email to
certification@state.sd.us
Alternative Certification District Intent to Employ Form AC1 (11-2021) 2
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