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In an era where professional qualifications are scrutinized more than ever, the Application for Kansas Upgrade to Professional License, commonly known as Form 21, stands as a crucial stepping stone for educators aiming to enhance their credentials in Kansas. This comprehensive form serves a dual purpose: it not only facilitates the transition from an initial or conditional license to a full professional license but also acts as a safeguard, ensuring that only individuals of good moral character and appropriate qualifications hold such positions. Applicants are required to provide detailed personal information, including prior names and social security numbers, alongside specifics about their educational background. However, what truly sets this application apart are its stringent checks on an applicant's legal and professional history. Questions regarding past criminal convictions, disciplinary actions against professional licenses, and even specific offenses related to education such as altering student test scores demand honest disclosures, which are verified meticulously to uphold the integrity of the education system. Moreover, Form 21 underscores the importance of mentorship in professional development by requiring verification of a year-long district-administered induction and mentoring program, a prerequisite that emphasizes practical, on-the-job learning alongside theoretical knowledge gained through formal education. With a non-refundable processing fee, the form underscores the commitment required from applicants, ensuring that only those serious about their professional advancement in education pursue this path. Overall, Form 21 plays a pivotal role in elevating educational standards within Kansas, providing a thorough vetting process to maintain a highly qualified, ethical, and competent teaching workforce.

Example - 21 Kansas Form

F O R M 21

Application for Kansas

Upgrade to

P R O F E S S I O N A L L I C E N S E

SECTION A – TO BE COMPLETED BY APPLICANT

1.

Social Security Number

___ ___ ___ - ___

___ - ___ ___

___ ___

 

 

 

 

 

 

 

 

 

 

2.

Legal Name

(First)

(Middle)

(Last)

 

 

 

 

 

 

 

 

 

3.

List all prior names (maiden, alias, previous married, etc.)

 

 

 

 

 

 

 

 

 

 

 

4.

Mailing Address

 

 

City

 

State

Zip Code

 

 

 

 

 

 

 

 

5.

Birthdate (MM/DD/YYYY)

6. Gender

7. Phone:

___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___

 

 

Male

 

 

 

 

 

 

 

 

 

Female

Alternate Phone:

___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___

 

 

 

 

 

 

 

8. a. Have you ever been convicted of a felony?

 

 

 

 

 

NO

YES

If yes, please attach a copy of the court documents regarding conviction.

b.Have you ever been convicted of ANY crime involving theft, drugs, or a child?

NO

YES

If yes, please attach a copy of the court documents regarding conviction.

c.Have you entered into a criminal diversion agreement after being charged with any offense described in question 8a or 8b?

NO

YES

If yes, please attach a copy of the diversion agreement.

d.Are criminal charges pending against you in any state involving any of the offenses described in question 8a or 8b?

NO

YES

If yes, please attach a copy of the court documents regarding your case.

e.Have you had a teacher’s or school administrator’s certificate or license denied, suspended, revoked or been the subject of other disciplinary action in any state?

NO

YES

If yes, please indicate the action taken:

denied,

suspended or

revoked.

Which state(s)?

Please attach a copy of the documents regarding the official action taken.

f.Is disciplinary action pending against you in any state regarding a teacher’s or administrator’s certificate or license?

NO

YES

If yes, please attach a copy of the official documents regarding the action pending against you.

g.Have you ever been disbarred or had a professional license or state issued certificate denied, suspended, revoked or been the subject of other disciplinary action regarding any profession in Kansas or any other state?

NO

YES

If yes, please indicate the action taken:

denied,

suspended or

revoked.

Which state(s)?

Please attach a copy of the documents regarding the official action taken.

h.Have you ever been terminated, suspended, or otherwise disciplined by a local Board of Education for falsifying or altering student tests or student test scores?

NO

YES

If yes, which district(s)?

When?

i.Have you ever falsified or altered assessment data, documents, or test score reports required for licensure?

NO

YES If yes, what state(s)?

When?

 

 

 

9. List all degrees earned: (example: BA, MS, EDS, etc.) If you earned a new degree since your initial license, attach official transcripts.

Institution:_________________ Degree:__________ Year Earned:________

Institution:_________________ Degree:__________ Year Earned:________

Institution:_________________ Degree:__________ Year Earned:________

Institution:_________________ Degree:__________ Year Earned:________

10.I certify that I am of good moral character and that the information on this application is true and complete to the best of my knowledge. I understand that any misrepresentation of facts may result in the denial or revocation of my license.

Signature of Applicant

Date

Include a $54.00 Application Fee made payable to the Kansas State Department of Education.

 

 

Money order or cashier’s check preferred. Personal checks accepted.

 

 

DO NOT SEND CASH.

 

MAIL TO: Teacher Education and Licensure, KSDE, 120 SE 10th Avenue, Topeka, KS 66612-1182.

 

Processing fee CANNOT be refunded and does not guarantee a license will be issued.

 

Form 21 – Professional License

1

Revised 03-12

 

 

VERIFICATION OF AN INDUCTION AND MENTORING PROGRAM

Each conditionally or initially licensed teacher, school specialist or school leader must complete a year-long, district- administered induction and mentoring program to pass the performance assessment as a prerequisite to receiving a professional license.

Mentored Teacher/School Specialist/School Leader information

This form should be completed by the district or building administrator where the mentoring program occurred.

Name (First)

(Middle)

(Last)

 

 

 

Social Security Number ___

___ ___ - ___

___ - ___ ___ ___ ___

OR

 

 

Teacher identification number from license

_______________________________________

If the current school year is the mentor year, do not complete and submit until after May 15th

I verify:

The above named applicant successfully completed a year-long induction and mentoring program provided by the district. (By verifying this information, a professional license will be issued upon fulfillment of all other regulatory requirements.)

District Name and Number where mentoring occurred

Accreditation Information

NO YES

 

 

State Accredited School?

 

 

If not state accredited, attach verification of accreditation status.

Building Name

 

 

 

 

 

 

 

 

Beginning Date of mentored

Ending date of mentored

Assignment of teacher/school specialist/leader

Grade level

experience (MM/DD/YYYY)

experience (MM/DD/YYYY)

during mentored experience

 

 

 

 

 

 

 

 

 

 

 

Administrator’s Name (Please Print or Type)

Administrator’s Position

(May be district or building)

School Phone Number

Administrator’s Signature

Who was the mentor?

Date

_______________________________________________________

_________________________________

Mentor’s Name:

 

Mentor’s SS# or teacher ID#

 

 

 

Form 21 – Professional License

2

Revised 03-12

 

 

Form 21 – Professional License

3

Revised 03-12

 

 

File Data

Fact Name Description
Form Purpose The Form 21 is an application for upgrading to a Professional License in Kansas.
Applicant Responsibilities Applicants must provide personal information, education history, and disclose any criminal or disciplinary history.
Professional Character Verification Applicants must attest to their good moral character and the truthfulness of the information they provide.
Governing Laws This form is governed by regulations set forth by the Kansas State Department of Education, ensuring that educators meet state standards.

21 Kansas - Usage Guide

Once you have decided to upgrade your Kansas teaching license to a professional level, your journey starts with accurately completing the Form 21. Given the gravity of this document in the licensure process, it's crucial to approach it meticulously. Filling out this form is more than a mere administrative task; it's the first step in validating your qualifications and integrity as an educator. With careful attention to detail and the gathering of necessary documentation ahead of time, you can ensure a smoother process. Let's go through the steps required to successfully complete the Form 21.

  1. Write your Social Security Number in the space provided.
  2. Enter your legal name, including first, middle, and last names, in the respective fields.
  3. List all prior names you have used, such as maiden, alias, or previous married names.
  4. Provide your complete mailing address, including the city, state, and zip code.
  5. Enter your birthdate in the format MM/DD/YYYY.
  6. Select your gender by checking the appropriate box for male or female.
  7. Fill in your phone number and an alternate phone number if you have one.
  8. For questions 8a through 8i, honestly answer each query about your legal and professional background. If you answer "YES" to any, attach the required documents as specified in each question.
  9. List all degrees you have earned, including the institution, the degree, and the year it was earned. If you’ve earned a new degree since your initial license, attach official transcripts.
  10. Sign and date the form to certify your good moral character and the truthfulness of the information provided. Make sure to review your entries for accuracy and completeness.
  11. Include a $54.00 application fee payable to the Kansas State Department of Education. Note the preferred forms of payment and the address to which everything should be mailed. Remember, sending cash is not advised, and the processing fee is non-refundable.

After completing and reviewing Form 21 for accuracy and attaching all necessary documentation, mail it to the Teacher Education and Licensure, KSDE, at the address provided on the form. This submission is a significant step in advancing your teaching career in Kansas. It demonstrates your commitment to upholding the highest standards of professional conduct and your dedication to enriching the educational experiences of your students. Now, it's a matter of waiting for the review and processing of your application, which is an anticipation of moving forward in your professional journey.

Get Clarifications on 21 Kansas

What is Form 21 in Kansas?

Form 21 is an application used in Kansas for educators seeking to upgrade their teaching or administrative license to a professional level. This form is vital for those who have completed their initial or conditional licensing phase and meet the criteria for professional licensure.

Who should complete Section A of Form 21?

Section A of Form 21 should be completed by the applicant. It requires personal information, including Social Security Number, legal name, previous names, mailing address, birthdate, gender, and contact information. It also asks about the applicant's criminal history, previous disciplinary actions related to educational or other professional licenses, and educational background.

Is there a fee associated with submitting Form 21?

Yes, there is a $54.00 application fee that must accompany Form 21 when it is submitted. The Kansas State Department of Education prefers payment in the form of a money order or cashier’s check, but personal checks are also accepted. Cash should not be sent.

Where should Form 21 be mailed?

The completed Form 21, along with the application fee and any required documents, should be mailed to: Teacher Education and Licensure, KSDE, 120 SE 10th Avenue, Topeka, KS 66612-1182.

What documents should be attached with Form 21 if the applicant has been convicted of a felony or any crimes related to theft, drugs, or children?

Applicants must attach copies of the court documents regarding their conviction if they answer "YES" to having been convicted of a felony or any crimes involving theft, drugs, or a child. This also applies to any criminal diversion agreements or pending criminal charges related to these offenses.

What happens if there has been disciplinary action against my teacher's or administrator's certificate?

If you've experienced disciplinary action against your teaching or administrative license in any state, you should indicate the action (denied, suspended, revoked) and attach copies of the documents regarding the official action taken. This is critical for the review process to understand the circumstances and to assess your eligibility for licensure.

Is it necessary to list all educational degrees on Form 21?

Yes, listing all educational degrees is crucial as it provides the Kansas State Department of Education with a detailed view of your academic background. This information helps in determining your qualifications for the professional license. If you've earned a new degree since your initial license, you are required to attach official transcripts.

What is the VERIFICATION OF AN INDUCTION AND MENTORING PROGRAM section?

This section is essential for conditionally or initially licensed teachers, school specialists, or school leaders. It confirms the successful completion of a year-long, district-administered induction and mentoring program, which is a prerequisite for receiving a professional license. This section should be completed by the district or building administrator of the school where the mentoring program occurred.

Can the processing fee be refunded?

No, the processing fee cannot be refunded once submitted. This fee covers the cost of processing the application and does not guarantee that a license will be issued.

What constitutes "good moral character" on Form 21?

The certification of good moral character attests to the applicant's integrity, conduct, and professionalism. This is evaluated through the information provided in the application, including responses regarding any criminal history, disciplinary actions, and the honesty and completeness of the application itself. It's a declaration that the applicant meets the ethical standards expected of a professional educator.

Common mistakes

When individuals are filling out the Form 21 Application for Kansas Upgrade to Professional License, several common mistakes can detract from the accuracy and effectiveness of their application. Understanding these pitfalls can help applicants avoid them and improve their chances of a successful licensation process. Below are eight common missteps to be mindful of:
  1. Not providing complete Social Security or Teacher Identification Numbers: Every digit of these numbers is crucial for accurately processing and tracking the application through the licensure system.

  2. Skipping over prior names: For those who have changed their names due to marriage, divorce, or other reasons, failing to list all prior names can lead to confusion and delays in background checks and the verification process.

  3. Mailing Address errors: Incomplete or incorrect mailing addresses, including the city, state, and zip code, can lead to misdirected or lost correspondence, significantly delaying the application process.

  4. Omitting conviction or disciplinary action details: Neglecting to attach documents regarding convictions, diversion agreements, or disciplinary actions, as required in Section A, questions 8a through 8h, can halt the review process.

  5. Not listing all degrees earned: Not including every degree, along with the institutions' names and the years earned, can impact the evaluation of the applicant’s educational background. Remember, attaching official transcripts for new degrees is essential.

  6. Forgetting to sign and date the application: An unsigned or undated form is considered incomplete and will not be processed until rectified, delaying licensure.

  7. Incorrect application fee payment method: Applicants sometimes forget that while personal checks are accepted, money orders or cashier’s checks are preferred—and cash is not accepted. Compliance with the payment method speeds up the processing.

  8. Neglecting the Verification of an Induction and Mentoring Program section: For those applicable, failing to have the mentoring program verification completed and signed by the responsible administrator can be a critical oversight, as successful completion is a prerequisite for achieving a professional license.

Addressing these common mistakes with care and attention to detail can significantly streamline the application process, leading to a smoother path toward professional licensure in Kansas.

Documents used along the form

When applying for a professional license in Kansas using Form 21, additional documentation and forms may be necessary to complete the licensing process comprehensively. These documents play a critical role in verifying the applicant's qualifications, background, and suitability for the professional license they seek. Here's a breakdown of some other forms and documents often used in conjunction with Form 21.

  • Official Transcripts: These verify your educational background, including degrees earned and institutions attended. Official transcripts are usually required to prove that you meet the educational qualifications for the professional license.
  • Background Check Authorization Form: To ensure the safety and trustworthiness of professionals, a background check is mandatory. This form authorizes the relevant authorities to conduct a background check on the applicant.
  • Fingerprinting Service Form: Alongside a background check, fingerprinting is often required as a part of the screening process to check for any criminal history.
  • Proof of Induction and Mentoring Program Completion: For initially licensed teachers, school specialists, or school leaders in Kansas, documentation proving the successful completion of a district-administered induction and mentoring program is necessary.
  • Continuing Education Certificates: These certificates are proof of any continuing education courses completed by the applicant, showcasing their efforts to stay current in their field.
  • Court Documents: If the applicant has answered 'Yes' to any questions regarding past convictions or disciplinary action, court documents or official records must be attached to provide details of the circumstances and resolutions.
  • Professional Reference Letters: Reference letters from colleagues, superiors, or academic mentors can provide insights into the applicant’s character, work ethic, and professional achievements, supporting their application for a professional license.

The integration of Form 21 with these additional documents establishes a thorough vetting process, ensuring that candidates meet all legal and professional standards required for their respective licenses. Such comprehensive documentation helps maintain high standards of professionalism and competence in the workforce. It's essential for applicants to diligently gather and submit all required information to facilitate a smooth and successful application process.

Similar forms

The 21 Kansas form is similar to other professional certification and license application forms used in various states. For instance, just like the form used for applying for medical licenses in many states, the 21 Kansas form collects comprehensive personal information, educational background, and requires disclosures regarding any past criminal activities, professional discipline, or licensure actions. Both types of forms are designed to verify the applicant's qualifications, ensure good moral character, and protect the public's welfare by screening out individuals who have histories that might make them unsuitable for professional practice.

Another document similar to the 21 Kansas form is the application for a commercial driver's license (CDL) in various states. Although the purpose of a CDL application is different, focusing on the eligibility to drive commercial vehicles rather than on professional teaching credentials, both forms share common features. They collect personal identification details, past legal issues, and any history of license denial or revocation. Furthermore, both require the applicant to attest to the truthfulness of the provided information and include the possibility of denial or revocation of the license or certificate if false information is discovered. This parallel underscores the universal need across professional fields to ensure that individuals entrusted with certain responsibilities can perform them safely and ethically.

Dos and Don'ts

When you are ready to fill out the Form 21 for a Professional License upgrade in Kansas, it's essential to approach the application process with care and attention to detail. To assist you, here are ten recommendations on what you should and shouldn't do:

  • Do carefully review the entire form before starting to ensure you understand what is required.
  • Do provide your Social Security Number accurately to avoid any delays with your application.
  • Do list all your prior names including maiden, alias, and previously married names, to ensure consistency and transparency in your application.
  • Do attach a copy of court documents if you answer "Yes" to any questions about convictions or criminal charges to provide necessary clarification.
  • Do include all degrees earned along with the institution name, degree, and year earned for a complete educational background overview.
  • Do sign the application to certify that the information provided is true and complete to the best of your knowledge.
  • Do not leave any questions unanswered—complete every section fully to avoid delays in processing your application.
  • Do not send cash. Use a money order, cashier’s check, or personal check for the application fee to ensure the payment process is secure.
  • Do not falsify or withhold information, as this can result in the denial or revocation of your license.
  • Do not forget to attach the Verification of an Induction and Mentoring Program form if this is a requirement for your professional licensure upgrade.

Adhering to these guidelines can streamline your application process and enhance the likelihood of a positive outcome. Remember, accuracy, honesty, and completeness are crucial when applying for professional licensure.

Misconceptions

Navigating the complexities of professional licensure in Kansas, specifically through the Form 21, can occasionally lead to misunderstandings. Below is a list of nine misconceptions commonly associated with the Form 21 and their explanations to provide clarity and assistance.

  • Only new applicants need Form 21. This is a misconception because both new applicants and those seeking to upgrade their licensure to a professional level need to complete Form 21.
  • Convictions unrelated to theft, drugs, or child involvement do not need to be disclosed. In reality, the form specifically asks about any felony convictions and any crimes involving theft, drugs, or a child. It's important to disclose all relevant legal history to ensure the accuracy of the application.
  • Information on past names is optional. The form requires applicants to list all prior names, including maiden, alias, or previous married names, to ensure a thorough background check can be completed.
  • A social security number is optional for the application. A social security number is, in fact, required for the application process. This helps in accurately identifying and processing the applicant's information.
  • Mentoring and induction program details are only needed for new teachers. Even those upgrading their licenses must provide information about their participation in a year-long, district-adminised induction and mentoring program, as it's a prerequisite for receiving a professional license.
  • Disciplinary actions in other states don’t affect the Kansas application. If an applicant has had a certificate or license denied, suspended, revoked, or been subject to disciplinary action in any state, it needs to be disclosed. This includes actions related to any professional license, not just teaching.
  • Applications are processed without a fee if they are incomplete. The processing fee is non-refundable and is required regardless of whether the application is complete or results in licensure.
  • Electronic transmissions of the form are acceptable. As of the last update to the form, applications must be mailed to the Kansas State Department of Education with the appropriate fee and supporting documents. Electronic submission is not mentioned as an option.
  • False information on the form has no real consequences. Providing false information or omitting important details can result in the denial or revocation of the license. It's imperative to be truthful and comprehensive in the application to maintain professional integrity.

Understanding these misconceptions and approaching the Form 21 with accurate information and a clear understanding of the requirements will help ensure a smoother process for obtaining or upgrading a professional license in Kansas.

Key takeaways

Completing and using the Form 21 for a Kansas Professional License application involves understanding key aspects that ensure accuracy and compliance. Here are crucial takeaways that applicants must keep in mind:

  • Personal Information and Background Checks: Applicants are required to provide detailed personal information, including social security number, legal name, and any prior names used. Additionally, disclosing past convictions, pending criminal charges, or any history of disciplinary action against professional licenses or certifications is essential. Failing to disclose such information accurately may result in the denial or revocation of the professional license.
  • Educational and Professional History: All degrees earned must be listed, and if a new degree has been earned since the initial license was granted, official transcripts must be attached. This documentation supports the applicant's qualifications for the professional license upgrade.
  • Verification of Induction and Mentoring Program Completion: For those conditionally or initially licensed, verification that a year-long, district-administered induction and mentoring program was completed is necessary. This program is a prerequisite for receiving a professional license, and the verification must be completed by a district or building administrator.
  • Application Fee: An application fee of $54.00 is required, which is non-refundable and does not guarantee that a license will be issued. The preferred forms of payment are money order or cashier’s check, although personal checks are accepted. Cash should not be sent with the application.

Applicants should ensure that all information provided is accurate and complete to the best of their knowledge. Misrepresentation or omission of facts may lead to serious consequences, including the denial or revocation of the professional license. By carefully following these guidelines, applicants can navigate the application process more smoothly towards achieving their professional licensing goals in Kansas.

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