Michigan Work Experience Report Form for Michigan Pk-12 2025

1. Click ‘Get Form’ to open the Michigan Work Experience Report Form in our platform.
2. Begin by filling in the Teacher Identifiers section. Enter the first name, middle name, last name, and any other names used. Don’t forget to include at least one additional identifier.
3. Next, provide your PIC number, date of birth, and MOECS application number in the designated fields.
4. In the Verification of Education-Related Instructional Work Experience section, select the type of instructional entity and role(s) you held. Specify the grade levels and subjects taught.
5. Indicate the district or instructional entity name and address. For assignments completed consecutively, fill in the start and end dates. If not consecutive, enter the total number of days taught.
6. Finally, rate your service as successful or unsuccessful. If unsuccessful, provide an explanation on a separate document or email as instructed.
7. Complete the form by signing it as the Principal or School Designee and entering your name, title, email address, and telephone number.

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