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The document is a data and verification form for applicants seeking a Professional Education License at North Carolina Central University's School of Education. It collects personal information, educational background, program details, employment status, and any criminal history from the applicant. The form requires signatures from both the applicant and the program coordinator to verify completion of the program.

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Versions	Form popularity	Fillable & printable
2009	4.1 Satisfied (38 Votes)

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