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Click ‘Get Form’ to open the Virginia Verification Form in our editor.
Begin by filling out Part I. Enter your Social Security Number, Date of Birth, Last Name, First Name, Middle Name, Suffix, Address, Name of Institution, Degree Earned, and Date of Degree Conferral.
In Part II, circle 'YES' or 'NO' to indicate if the applicant has satisfactorily completed a state-approved preparation program. List the endorsements in the provided area.
Proceed to Part III to document Student Teaching, Internship, and/or Practicum Experience. Fill in Course Title, Course Number, Clock Hours, and specify grades and subjects taught.
If applicable, complete Part IV by certifying requirements as a representative of a Virginia college or university. Provide your signature along with the date and your title.
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EXPERIENCE VERIFICATION FORM - DPOR - Virginia.gov
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