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The Connecticut ED 192 form is an essential document for individuals seeking a waiver for the Connecticut Academic Skills Assessment, which is a requirement for those pursuing educator certification in the state. This form serves as an application for the waiver, allowing candidates to bypass the traditional Praxis I tests in reading, writing, and mathematics. To initiate the waiver process, applicants must submit a completed ED 192 form along with an official score report from one of several accepted standardized tests, such as the SAT, ACT, GRE, or PAA. The application requires personal information, including the applicant's name, Social Security number, and contact details. Additionally, candidates must indicate their race or ethnicity, although this information is optional. The form outlines the minimum score requirements for each testing option, emphasizing the importance of providing official score reports directly from the testing agencies. This ensures that the application is processed efficiently and accurately. The Connecticut State Department of Education reviews submitted applications and scores to determine eligibility for the waiver, ultimately streamlining the certification process for prospective educators in Connecticut.

Documents used along the form

The Connecticut Ed 192 form is an essential document for individuals seeking a waiver for the Connecticut Academic Skills Assessment. Alongside this form, several other documents are commonly required to facilitate the application process. Each of these documents serves a specific purpose, ensuring that applicants meet the necessary criteria for certification in the state. Below is a list of these documents along with a brief description of each.

  • Official Score Reports: These are required from testing agencies such as SAT, ACT, GRE, or PAA. They provide the Bureau of Educator Standards and Certification with verified scores that demonstrate the applicant's qualifications for the waiver.
  • Motor Vehicle Bill of Sale Form: To ensure legal accountability in vehicle transfer transactions, consider using the comprehensive Motor Vehicle Bill of Sale documentation for accurate record-keeping.
  • Testing Agency Contact List: This document includes contact information for agencies that administer the required tests. It helps applicants understand how to obtain their official score reports and navigate the reporting process efficiently.
  • Application Instructions: This guide outlines the steps necessary to complete the Ed 192 form and submit the accompanying documents. It provides clarity on the requirements and ensures that applicants do not overlook important details.
  • Score Conversion Tables: These tables assist in determining equivalencies between different standardized tests. They are crucial for applicants who may have taken various assessments to ensure that their scores meet the established criteria for the waiver.

In conclusion, submitting the Connecticut Ed 192 form along with the necessary accompanying documents is vital for prospective educators seeking certification in Connecticut. Each document plays a significant role in verifying qualifications and facilitating the waiver process. Properly completing and submitting these materials can greatly enhance an applicant's chances of success.

Preview - Connecticut Ed 192 Form

ED 192

CONNECTICUT STATE DEPARTMENT OF EDUCATION

REV. 12/11

Bureau of Educator Standards and Certiication

C.G.S. 10-145f

P.O. Box 150471 – Room 243

 

 

Hartford, CT 06115-0471

 

www.ct.gov/sde

APPLICATION FOR CONNECTICUT ACADEMIC SKILLS ASSESSMENT WAIVER

The Connecticut Academic Skills Assessment Waiver Application will not be processed until this completed application and an OFFICIAL score report are received by the Bureau of Educator Standards and Certiication. (Scores sent by waiver candidates will NOT be accepted.) See Page 6 for application directions.

PERSONAL INFORMATION (Print all information in blue ink and in uppercase letters.)

LAST NAME

FIRST NAME

SOCIAL SECURITY NUMBER

ADDRESS (Street)

(City)

(State)

(Zip Code)

Bachelor’s Institution Attending/Attended

MI

 

GENDER (M/F)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BIRTH DATE (Month-Day-Year) – Required

(Apt #)

FORMER LAST NAME(S)

PHONE

(Home)

(Work)

E-MAIL ADDRESS

Race/Ethnicity

1.

Native American

 

 

 

2.

Asian/Paciic Islander

 

 

 

 

 

 

3.

Black

 

 

 

(Optional)

4.

White

 

 

 

5.

Hispanic

Essential Skills Testing Requirement Waived Based Upon (Check one):

SAT

ACT

GRE

Refer to the Testing Agency Contact List (Page 3) for directions to have an oficial score report sent to the Con- necticut State Department of Education.

PAA Complete Page 4 in order to have an oficial PAA score report sent to the Connecticut State Department of Education.

PAGE 1

APPLICATION FOR CONNECTICUT ACADEMIC SKILLS ASSESSMENT WAIVER

The Connecticut Academic Skills Assessment Waiver Application will NOT be processed until this com- pleted application and SAT/ACT/GRE/PAA scores are received by this ofice.

A waiver is an alternative to taking and passing the academic skills tests (Praxis I – PPST) required by the State of Connecticut for prospective educators. This information is provided to those who are inter- ested in and meet the criteria to waive the academic skills test requirement.

Who Must Meet The Academic Skills Requirement?

Individuals seeking formal admission to a Connecticut college or university educator preparation pro- gram, or seeking certiication in Connecticut, must fulill the academic skills requirement by taking and passing all three Praxis I tests: reading, writing and mathematics; or by fulilling one of the waiver op- tions listed below.

A waiver may be granted by furnishing oficial* proof of having met one of the following:

 

 

Minimum Standards For An Academic Skills Assessment Waiver

 

 

 

 

Combined

 

Verbal/English

Math /

 

Analytic

 

ESLAT /

 

 

 

 

 

 

 

Test

 

Verbal/Math

 

Critical Reading

Quantitative

 

Writing

 

TOEFL

 

Name

Date Test Taken

Score

 

Score

Score

 

Score

 

Score

 

SAT**

Prior to March 31, 1995

1000

 

No less than 400

No less than 400

 

 

 

 

 

 

On/After April 1, 1995

1100

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ACT**

Prior to October 1989

 

 

20

17

 

 

 

 

 

 

On/After October 1989

 

 

22

19

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GRE**

Prior to October 1, 2002

1000

 

450

500

 

 

 

 

 

 

On/After October 1, 2002

1000

 

450

500

 

4.5

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PAA

 

Equivalent to 1000

 

 

 

 

 

 

 

 

 

 

(refer to

 

 

 

 

 

 

 

 

 

 

conversion table)

 

No less than 400

No less than 400

 

 

 

510

 

 

 

 

 

 

 

 

 

 

 

 

*Oficial SAT, ACT, GRE and PAA scores are those scores sent directly from the respective testing company. Test score reports forwarded to the Connecticut State Department of Education from ap- plicants will only be accepted when the testing agency no longer has your test scores on ile.

**If you have taken the SAT/ACT/GRE on more than one occasion, your highest verbal score and your highest mathematics score will be combined.

PAGE 2

TESTING AGENCY CONTACT LIST

Scholastic Aptitude Test (SAT) Scores

The College Board maintains historical SAT scores on ile. Information about obtaining historical SAT results, including the score request form, is available online at: www.collegeboard.com/student/testing/ sat/scores/sending.html or call: 866-756-7346. The Program Code for the Connecticut State Depart-

ment of Education is 3132.

Mail your completed form to:

SAT Program

P.O. Box 8057

Mt. Vernon, IL 62864

American College Testing (ACT) Scores

The ACT maintains historical ACT scores on ile. Information about reporting historical ACT results, including the score request form, is available online at: www.actstudent.org/scores or call:

319-337-1313. The ACT Code for the Connecticut State Department of Education is 0625.

Mail your completed form to:

ACT Records

P.O. Box 451

Iowa City, IA 52243-0451

Graduate Record Examination (GRE) Scores

The Educational Testing Service (ETS) retains individual GRE test records for a period of ive years. If you have taken the GRE within the past ive years, please contact ETS online at: www.gre.org or call: 888-473-7267. Original reports must be ordered from ETS. Mail your completed form to ETS-ASR/ GRE, Box 371463, Pittsburgh, PA 15250-7463

.

Upon receipt forward the original score report to:

Bureau of Educator Standards and Certiication

Waiver Coordinator

P.O. Box 150471, Room 243

Hartford, CT 06115-0471

Candidates who took the GRE more than ive years ago must submit an oficial transcript showing their GRE scores, or an original document of the GRE score report sent to the candidate with the Connecticut Academic Skills Assessment Waiver Application form (ED 192).

PAGE 3

Connecticut State Department of Education

APPLICATION FOR CONNECTICUT ACADEMIC SKILLS ASSESSMENT WAIVER

Prueba de Aptitud Academica (PAA) Score Request

This form should be completed and mailed to the College Board in Puerto Rico ONLY if you received a total score on the PAA equivalent* to a score of 1000 on the Scholastic Aptitude Test (SAT), with neither the mathematics nor the verbal sub- test score below the equivalent of 400 points. Also, a minimum score of 510 on the English-as-a-Second-Language Achieve- ment Test (ESLAT) or the Test of English as a Foreign Language (TOEFL) is required.

I formally request that the College Board, Puerto Rico Ofice, forward my PAA scores to the Connecticut State Department of Education, Bureau of Educator Standards and Certiication.

PLEASE PRINT LEGIBLY AND PROVIDE AS MUCH INFORMATION AS POSSIBLE

The following information will facilitate this request.

Social Security Number:

 

 

 

 

Name at time of testing:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Birth:

 

 

Current Name (If different from above):

 

 

 

 

 

Gender:

 

 

 

 

 

 

 

 

 

 

 

 

 

High School Attended:

 

 

 

 

 

 

 

 

 

 

 

 

Current Mailing Address:

 

 

 

 

 

 

 

 

 

 

 

Street:

 

City/Town:

State:

Zip:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone Number:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date/Location of administration for which score report is requested:

Test Date:

Test Center:

 

 

 

 

Please mail my PAA score report to:

CONNECTICUT STATE DEPARTMENT OF EDUCATION

Bureau of Educator Standards and Certiication

Waiver Coordinator

P.O. Box 150471 - Room 243

Hartford, CT 06115-0471

Signature:

Date:

 

 

 

 

*Refer to Abbreviated Equivalency Table 1. Equivalent SAT scores are determined from an expanded table.

Important: Please contact the College Board for current information on fees for score reporting:

COLLEGE BOARD

Oicina de Puerto Rico y América Latina

P.O. Box 71101

San Juan, PR 00936-8001

Phone: 787-772-1200

Fax: 787-759-8629

E-mail: PROLAA@collegeboard.org

Website: http://oprla.collegeboard.com

PAGE 4

PAGE 5

ED 192 – TABLE 1

ABBREVIATED CONVERSION TABLE EQUATING PAA SCALED SCORES TO SAT SCORES

 

VERBAL

 

 

MATHEMATICAL

 

 

Equivalent

 

Equivalent

 

Equivalent

 

Equivalent

 

 

 

 

PAA – Verbal

SAT – Verbal

PAA – Verbal

SAT – Verbal

PAA – Math

SAT – Math

PAA – Math

SAT – Math

Score

Score

Score

Score

Score

Score

Score

Score

 

 

 

 

 

 

 

 

800

785

462

289

800

785

438

290

787

757

454

283

790

743

427

286

774

709

446

278

779

676

416

282

761

660

438

272

768

629

406

278

749

617

430

267

758

593

395

274

736

584

421

262

747

564

384

269

723

557

413

257

736

539

374

265

710

535

405

252

726

518

363

261

697

516

397

248

715

499

352

257

684

500

389

243

704

482

342

253

672

485

381

238

694

467

331

249

659

472

373

234

683

453

320

245

646

460

364

229

672

440

310

241

633

449

356

225

662

429

299

237

625

438

348

221

651

418

288

232

617

428

340

216

640

408

278

228

609

419

332

212

630

399

267

224

601

410

324

208

619

390

256

220

592

401

316

204

608

382

246

216

584

393

307

200

598

374

235

212

576

384

299

196

587

366

224

209

568

376

291

192

576

359

214

205

560

369

283

188

566

353

203

197

552

361

275

184

555

346

200

188

544

354

267

180

544

340

 

 

535

347

259

176

534

334

 

 

527

340

250

172

523

329

 

 

519

333

242

168

512

323

 

 

511

326

234

163

502

318

 

 

503

319

226

158

491

313

 

 

495

313

218

155

480

308

 

 

487

307

210

152

470

303

 

 

478

301

202

150

459

299

 

 

470

295

200

148

448

295

 

 

 

 

 

 

 

 

 

 

Note: The lowest score reported on both the PAA and SAT is 200.

Equivalent scores are based upon the equivalency table developed by William H. Angoff and Linda L. Cook, reported in Angoff, W.H. and Cook, L.L (1988). “Equating the Scales of the Spanish-Language Prueba de Aptitud Academica and the English-Language Scholastic Aptitude Test of College Entrance Examination Board.” Princeton, NJ: Educational Testing Service.

ED 192 – INSTRUCTIONS

REV. 12/11

C.G.S. 10-145f

HOW TO APPLY FOR A CONNECTICUT ACADEMIC SKILLS ASSESSMENT WAIVER

1.Complete form ED 192 – “Application For Connecticut Academic Skills Assessment Waiver.”

2.Mail Page 1 of the completed form (ED 192) to the address below.

3.Contact the respective testing company (SAT, ACT, GRE or PAA) and have your test scores reported to the Connecticut State Department of Education (CSDE). See contact list on Page 3. Test score re- ports forwarded to the CSDE from waiver applicants will only be accepted when a testing agency no longer has your scores on ile. Please note that it may take up to six weeks for the testing company to get your scores to the CSDE.

4.Upon receipt of your ED 192 and your SAT/ACT/GRE/PAA scores, you will be mailed written veri- ication of your Academic Skills Assessment Waiver.

If you have questions concerning the Connecticut Academic Skills Assessment Waiver, please write, phone, fax or email:

CONNECTICUT STATE DEPARTMENT OF EDUCATION

Bureau of Educator Standards and Certiication

Waiver Coordinator

P.O. Box 150471 – Room 243

Hartford, CT 06115-0471

Phone: 860-713-6969; Fax: 860-713-7017

Email: teacher.cert@ct.gov

Website: www.ct.gov/sde

PAGE 6

Common Questions

What is the Connecticut Ed 192 form?

The Connecticut Ed 192 form is an application for the Connecticut Academic Skills Assessment Waiver. This waiver allows prospective educators to bypass the academic skills tests, known as Praxis I, if they meet certain criteria. The form must be completed and submitted along with official score reports from standardized tests like the SAT, ACT, GRE, or PAA.

Who needs to fill out the Ed 192 form?

Individuals seeking admission to a Connecticut educator preparation program or those applying for educator certification in Connecticut must fill out the Ed 192 form. This is particularly relevant for those who wish to waive the academic skills testing requirement.

What information is required on the Ed 192 form?

The form requires personal information such as your name, social security number, contact details, and educational background. You will also need to indicate your gender and race/ethnicity, though providing this demographic information is optional. Additionally, you must specify which standardized test scores you are using to apply for the waiver.

How do I submit my test scores with the Ed 192 form?

To submit your test scores, you must have the official score reports sent directly from the testing agency to the Connecticut State Department of Education. Scores sent by applicants will not be accepted. Ensure that you check the specific requirements for each testing agency to facilitate this process.

What standardized tests can I use to apply for the waiver?

You can use scores from the SAT, ACT, GRE, or PAA to apply for the waiver. Each test has specific score requirements that must be met to qualify. For example, a minimum SAT score of 1100 is required if taken after April 1, 1995. Make sure to refer to the guidelines for the exact score thresholds needed for each test.

What happens after I submit the Ed 192 form?

After submitting the completed Ed 192 form along with your official test scores, the Bureau of Educator Standards and Certification will process your application. If everything is in order, you will be notified regarding the status of your waiver application.

Is there a deadline for submitting the Ed 192 form?

While specific deadlines may vary, it is essential to submit your Ed 192 form and accompanying documents as early as possible. This ensures that your application is processed in a timely manner, allowing you to meet any program or certification deadlines.

Where can I find more information about the Ed 192 form?

For more details, you can visit the Connecticut State Department of Education's website. They provide comprehensive information about the waiver application process, including guidelines and contact information for further assistance.

Guide to Filling Out Connecticut Ed 192

Completing the Connecticut Ed 192 form requires careful attention to detail. Ensure that all information is accurate and that you follow the steps closely. Once you have filled out the form, you will need to submit it along with your official score report to the Bureau of Educator Standards and Certification.

  1. Obtain a blank Connecticut Ed 192 form.
  2. Use blue ink and print all information in uppercase letters.
  3. Fill in your personal information:
    • Last Name
    • First Name
    • Middle Initial
    • Social Security Number
    • Address (Street, City, State, Zip Code)
    • Former Last Name(s) (if applicable)
    • Phone Number (Home and Work)
    • Email Address
    • Gender (M/F)
    • Birth Date (Month-Day-Year)
  4. Indicate your race/ethnicity by checking the appropriate box.
  5. Select the essential skills testing requirement you wish to waive by checking one of the options: SAT, ACT, GRE, or PAA.
  6. Refer to the Testing Agency Contact List provided in the form to obtain your official score report. Follow the directions specific to the test you took.
  7. Complete Page 4 if you are requesting a PAA score report.
  8. Double-check all entries for accuracy and completeness.
  9. Sign and date the form at the designated area.
  10. Mail the completed form along with your official score report to the Bureau of Educator Standards and Certification at the address provided on the form.

Dos and Don'ts

When filling out the Connecticut Ed 192 form, consider these important guidelines to ensure a smooth application process.

  • Do print all information clearly in blue ink and in uppercase letters.
  • Do provide an official score report directly from the testing agency.
  • Do double-check all personal information for accuracy before submission.
  • Do ensure that you meet the minimum standards for the academic skills assessment waiver.
  • Do follow the specific instructions outlined on the application form.
  • Don't submit the application without an official score report.
  • Don't use pencil or any ink color other than blue for filling out the form.
  • Don't forget to sign and date the application before sending it.
  • Don't leave any required fields blank; all sections must be completed.
  • Don't send test scores from your personal records; they will not be accepted.