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CEHD and U of M Word Marks


206 Burton Hall
178 Pillsbury Drive SE
Minneapolis, MN 55455

Fax: 612-624-3377

Undergraduate Studies:

Graduate Studies:


Administrative Licensure: Forms, Worksheets, and Grids

Below you'll find links to most of the documents used in our program, as well as links to examples of exemplary work submitted by current and former students. Where possible, the documents are in Word or Excel format to allow you to complete them electronically.

Application for PK-12 Administrative Certificate

See instructions how to apply online.


Once admitted to the licensure program you will register online.

If you would like to take a class before applying to our program, use the One Stop non-degree registration option.

Licensure Specific

Program checklist [PDF]
This document is intended to provide you with a general understanding of our processes as well as how you will progress as a student in the program.

Creating the portfolio [PDF]
This document will guide you in the process of creating your licensing portfolio, the central component to our individually based licensing program.

Project reflections [PDF]
Reflection is a core component for the University of Minnesota's licensure program and one or more reflections are required for each of the core courses.

Pre-assessment and Plan of Action templates
You will develop your Pre-assessment and Plan of Action in OLPD 5385—Licensure Seminar. Completion of these forms is required by the Minnesota Board of School Administrators (as stated in M.R. 3512) and the University of Minnesota. Because they will guide your work in the field experience, you must complete them before registering for OLPD 5396—Field Experience in PK-12 Administration.

Culminating requirements report [WORD]
This form summarizes your professional and academic experiences. We submit it to the Minnesota Department of Education once you complete the program. It is to be completed at the END of your program.

Pre-panel checklist [PDF]
This form helps you to prepare for the completion of your file, materials from which we must send to the Minnesota Department of Education as part of our endorsement of you.

Competency Grids and Lists

Each form below contains a complete list of the competencies for a particular area of licensure. The language and structure of these documents correlate to the Minnesota Department of Education's competencies identified in MS 3512. You must complete the evaluation form prior to appearing before your review panel.

Certificate Completion

Final certificate clearance depends on completion of all course requirements, including the posting of final grades to the student’s transcript, and approval by program faculty.

In addition to completing all program requirements, students must complete the online Application for Degree form (see instructions).

CEHD Graduate Student Operations clears certificates on a monthly basis. Forms must be submitted on or before the first day of the month that the student intends to graduate. Students who submit forms after the first day of the month will be cleared to graduate at the end of the following month.

Successful completion of the certificate will be noted on the student's official University of Minnesota transcript and an official certificate will be issued.

Revised May 4, 2015

New Program Option

Executive Ph.D. program

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