Request to Update Credential

Credential Update Request
Primary Contact Name*
CTED or LEA District
Primary Email*
example@example.com
Primary Phone Number
Please enter a valid phone number.
Requested Change

Update Fact sheet Information OnlyRemove Credential from Multiple ProgramsAdd CTE Credential to Local Occupational ProgramUpdate Credential NameRemove Multiple CredentialsAdd CTE Credential to ProgramDiscontinue CredentialRemove Credential from ProgramAdd CTE Credential to Multiple Programs
Credential
Multiple Credentials*
Please state below the date this credential has been discontinued.
Effective Discontinued Date*

MonthDayYear
Date
New Credential Name*
Program Area*
Program*
Local Occupational Program*
Multiple Programs*
Please provide below a valid website address of the credentialing agency or community college for verification of changes.
Website Verification*
Please supply the updated factsheet to the below field. Industry Fact Sheet Form , Community College Fact Sheet Form
Attach Updated Factsheet*

Cancelof
Supporting Documentation

Cancelof
Reason for Update*
TimeStamp

MonthDayYear
Date
Hour MinutesAM/PM Option

Please supply the finalized factsheet below. Industry FactSheet, Community College Factsheet
Finalized Factsheet*

Submit updated PDF to be added to the CTE website.
Cancelof
PS Approval Status

ApprovedDenied
Below supply the reasons for denying this update. Please use full sentences and review the denial letter that will be emailed to the submitter.
Denial Reason

After the request has been reviewed by program specialist, the submission will be sent to Cindy Gutierrez for the final approval.
Internal Notes*
Should be Empty:

Please review the request to submit this update. If the information is correct, please select submit below.

Update:	{typeA121}
To:	{typeA128}

Credential Update Request