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The Connecticut Ed 192 form serves as an essential application for individuals seeking a waiver from the Connecticut Academic Skills Assessment requirement, a key step for prospective educators in the state. This form allows candidates to bypass the necessity of passing the Praxis I tests in reading, writing, and mathematics by providing official proof of meeting alternative criteria, such as SAT, ACT, GRE, or PAA scores. To ensure a smooth application process, individuals must submit a completed form along with their official score reports directly from the respective testing agencies. The form collects personal information, including name, social security number, and contact details, while also requiring candidates to specify their race or ethnicity, which is optional. Furthermore, applicants must indicate which testing requirement they wish to waive and provide details about their educational background. By understanding the key components of the Ed 192 form, individuals can better navigate the process of becoming certified educators in Connecticut, ultimately contributing to the state's educational landscape.

File Information

Fact Name Description
Purpose of Form The Connecticut Ed 192 form is used to apply for a waiver of the Connecticut Academic Skills Assessment, which is a requirement for prospective educators in the state.
Governing Law This form is governed by Connecticut General Statutes Section 10-145f, which outlines the certification requirements for educators.
Submission Requirements To process the application, candidates must submit the completed form along with an official score report from a qualifying test such as the SAT, ACT, GRE, or PAA.
Eligibility Criteria Individuals seeking to waive the academic skills requirement must meet specific score thresholds on the aforementioned tests, as detailed in the form.

Connecticut Ed 192 Sample

ED 192

CONNECTICUT STATE DEPARTMENT OF EDUCATION

REV. 12/11

Bureau of Educator Standards and Certiication

C.G.S. 10-145f

P.O. Box 150471 – Room 243

 

 

Hartford, CT 06115-0471

 

www.ct.gov/sde

APPLICATION FOR CONNECTICUT ACADEMIC SKILLS ASSESSMENT WAIVER

The Connecticut Academic Skills Assessment Waiver Application will not be processed until this completed application and an OFFICIAL score report are received by the Bureau of Educator Standards and Certiication. (Scores sent by waiver candidates will NOT be accepted.) See Page 6 for application directions.

PERSONAL INFORMATION (Print all information in blue ink and in uppercase letters.)

LAST NAME

FIRST NAME

SOCIAL SECURITY NUMBER

ADDRESS (Street)

(City)

(State)

(Zip Code)

Bachelor’s Institution Attending/Attended

MI

 

GENDER (M/F)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BIRTH DATE (Month-Day-Year) – Required

(Apt #)

FORMER LAST NAME(S)

PHONE

(Home)

(Work)

E-MAIL ADDRESS

Race/Ethnicity

1.

Native American

 

 

 

2.

Asian/Paciic Islander

 

 

 

 

 

 

3.

Black

 

 

 

(Optional)

4.

White

 

 

 

5.

Hispanic

Essential Skills Testing Requirement Waived Based Upon (Check one):

SAT

ACT

GRE

Refer to the Testing Agency Contact List (Page 3) for directions to have an oficial score report sent to the Con- necticut State Department of Education.

PAA Complete Page 4 in order to have an oficial PAA score report sent to the Connecticut State Department of Education.

PAGE 1

APPLICATION FOR CONNECTICUT ACADEMIC SKILLS ASSESSMENT WAIVER

The Connecticut Academic Skills Assessment Waiver Application will NOT be processed until this com- pleted application and SAT/ACT/GRE/PAA scores are received by this ofice.

A waiver is an alternative to taking and passing the academic skills tests (Praxis I – PPST) required by the State of Connecticut for prospective educators. This information is provided to those who are inter- ested in and meet the criteria to waive the academic skills test requirement.

Who Must Meet The Academic Skills Requirement?

Individuals seeking formal admission to a Connecticut college or university educator preparation pro- gram, or seeking certiication in Connecticut, must fulill the academic skills requirement by taking and passing all three Praxis I tests: reading, writing and mathematics; or by fulilling one of the waiver op- tions listed below.

A waiver may be granted by furnishing oficial* proof of having met one of the following:

 

 

Minimum Standards For An Academic Skills Assessment Waiver

 

 

 

 

Combined

 

Verbal/English

Math /

 

Analytic

 

ESLAT /

 

 

 

 

 

 

 

Test

 

Verbal/Math

 

Critical Reading

Quantitative

 

Writing

 

TOEFL

 

Name

Date Test Taken

Score

 

Score

Score

 

Score

 

Score

 

SAT**

Prior to March 31, 1995

1000

 

No less than 400

No less than 400

 

 

 

 

 

 

On/After April 1, 1995

1100

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ACT**

Prior to October 1989

 

 

20

17

 

 

 

 

 

 

On/After October 1989

 

 

22

19

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GRE**

Prior to October 1, 2002

1000

 

450

500

 

 

 

 

 

 

On/After October 1, 2002

1000

 

450

500

 

4.5

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PAA

 

Equivalent to 1000

 

 

 

 

 

 

 

 

 

 

(refer to

 

 

 

 

 

 

 

 

 

 

conversion table)

 

No less than 400

No less than 400

 

 

 

510

 

 

 

 

 

 

 

 

 

 

 

 

*Oficial SAT, ACT, GRE and PAA scores are those scores sent directly from the respective testing company. Test score reports forwarded to the Connecticut State Department of Education from ap- plicants will only be accepted when the testing agency no longer has your test scores on ile.

**If you have taken the SAT/ACT/GRE on more than one occasion, your highest verbal score and your highest mathematics score will be combined.

PAGE 2

TESTING AGENCY CONTACT LIST

Scholastic Aptitude Test (SAT) Scores

The College Board maintains historical SAT scores on ile. Information about obtaining historical SAT results, including the score request form, is available online at: www.collegeboard.com/student/testing/ sat/scores/sending.html or call: 866-756-7346. The Program Code for the Connecticut State Depart-

ment of Education is 3132.

Mail your completed form to:

SAT Program

P.O. Box 8057

Mt. Vernon, IL 62864

American College Testing (ACT) Scores

The ACT maintains historical ACT scores on ile. Information about reporting historical ACT results, including the score request form, is available online at: www.actstudent.org/scores or call:

319-337-1313. The ACT Code for the Connecticut State Department of Education is 0625.

Mail your completed form to:

ACT Records

P.O. Box 451

Iowa City, IA 52243-0451

Graduate Record Examination (GRE) Scores

The Educational Testing Service (ETS) retains individual GRE test records for a period of ive years. If you have taken the GRE within the past ive years, please contact ETS online at: www.gre.org or call: 888-473-7267. Original reports must be ordered from ETS. Mail your completed form to ETS-ASR/ GRE, Box 371463, Pittsburgh, PA 15250-7463

.

Upon receipt forward the original score report to:

Bureau of Educator Standards and Certiication

Waiver Coordinator

P.O. Box 150471, Room 243

Hartford, CT 06115-0471

Candidates who took the GRE more than ive years ago must submit an oficial transcript showing their GRE scores, or an original document of the GRE score report sent to the candidate with the Connecticut Academic Skills Assessment Waiver Application form (ED 192).

PAGE 3

Connecticut State Department of Education

APPLICATION FOR CONNECTICUT ACADEMIC SKILLS ASSESSMENT WAIVER

Prueba de Aptitud Academica (PAA) Score Request

This form should be completed and mailed to the College Board in Puerto Rico ONLY if you received a total score on the PAA equivalent* to a score of 1000 on the Scholastic Aptitude Test (SAT), with neither the mathematics nor the verbal sub- test score below the equivalent of 400 points. Also, a minimum score of 510 on the English-as-a-Second-Language Achieve- ment Test (ESLAT) or the Test of English as a Foreign Language (TOEFL) is required.

I formally request that the College Board, Puerto Rico Ofice, forward my PAA scores to the Connecticut State Department of Education, Bureau of Educator Standards and Certiication.

PLEASE PRINT LEGIBLY AND PROVIDE AS MUCH INFORMATION AS POSSIBLE

The following information will facilitate this request.

Social Security Number:

 

 

 

 

Name at time of testing:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Birth:

 

 

Current Name (If different from above):

 

 

 

 

 

Gender:

 

 

 

 

 

 

 

 

 

 

 

 

 

High School Attended:

 

 

 

 

 

 

 

 

 

 

 

 

Current Mailing Address:

 

 

 

 

 

 

 

 

 

 

 

Street:

 

City/Town:

State:

Zip:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone Number:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date/Location of administration for which score report is requested:

Test Date:

Test Center:

 

 

 

 

Please mail my PAA score report to:

CONNECTICUT STATE DEPARTMENT OF EDUCATION

Bureau of Educator Standards and Certiication

Waiver Coordinator

P.O. Box 150471 - Room 243

Hartford, CT 06115-0471

Signature:

Date:

 

 

 

 

*Refer to Abbreviated Equivalency Table 1. Equivalent SAT scores are determined from an expanded table.

Important: Please contact the College Board for current information on fees for score reporting:

COLLEGE BOARD

Oicina de Puerto Rico y América Latina

P.O. Box 71101

San Juan, PR 00936-8001

Phone: 787-772-1200

Fax: 787-759-8629

E-mail: PROLAA@collegeboard.org

Website: http://oprla.collegeboard.com

PAGE 4

PAGE 5

ED 192 – TABLE 1

ABBREVIATED CONVERSION TABLE EQUATING PAA SCALED SCORES TO SAT SCORES

 

VERBAL

 

 

MATHEMATICAL

 

 

Equivalent

 

Equivalent

 

Equivalent

 

Equivalent

 

 

 

 

PAA – Verbal

SAT – Verbal

PAA – Verbal

SAT – Verbal

PAA – Math

SAT – Math

PAA – Math

SAT – Math

Score

Score

Score

Score

Score

Score

Score

Score

 

 

 

 

 

 

 

 

800

785

462

289

800

785

438

290

787

757

454

283

790

743

427

286

774

709

446

278

779

676

416

282

761

660

438

272

768

629

406

278

749

617

430

267

758

593

395

274

736

584

421

262

747

564

384

269

723

557

413

257

736

539

374

265

710

535

405

252

726

518

363

261

697

516

397

248

715

499

352

257

684

500

389

243

704

482

342

253

672

485

381

238

694

467

331

249

659

472

373

234

683

453

320

245

646

460

364

229

672

440

310

241

633

449

356

225

662

429

299

237

625

438

348

221

651

418

288

232

617

428

340

216

640

408

278

228

609

419

332

212

630

399

267

224

601

410

324

208

619

390

256

220

592

401

316

204

608

382

246

216

584

393

307

200

598

374

235

212

576

384

299

196

587

366

224

209

568

376

291

192

576

359

214

205

560

369

283

188

566

353

203

197

552

361

275

184

555

346

200

188

544

354

267

180

544

340

 

 

535

347

259

176

534

334

 

 

527

340

250

172

523

329

 

 

519

333

242

168

512

323

 

 

511

326

234

163

502

318

 

 

503

319

226

158

491

313

 

 

495

313

218

155

480

308

 

 

487

307

210

152

470

303

 

 

478

301

202

150

459

299

 

 

470

295

200

148

448

295

 

 

 

 

 

 

 

 

 

 

Note: The lowest score reported on both the PAA and SAT is 200.

Equivalent scores are based upon the equivalency table developed by William H. Angoff and Linda L. Cook, reported in Angoff, W.H. and Cook, L.L (1988). “Equating the Scales of the Spanish-Language Prueba de Aptitud Academica and the English-Language Scholastic Aptitude Test of College Entrance Examination Board.” Princeton, NJ: Educational Testing Service.

ED 192 – INSTRUCTIONS

REV. 12/11

C.G.S. 10-145f

HOW TO APPLY FOR A CONNECTICUT ACADEMIC SKILLS ASSESSMENT WAIVER

1.Complete form ED 192 – “Application For Connecticut Academic Skills Assessment Waiver.”

2.Mail Page 1 of the completed form (ED 192) to the address below.

3.Contact the respective testing company (SAT, ACT, GRE or PAA) and have your test scores reported to the Connecticut State Department of Education (CSDE). See contact list on Page 3. Test score re- ports forwarded to the CSDE from waiver applicants will only be accepted when a testing agency no longer has your scores on ile. Please note that it may take up to six weeks for the testing company to get your scores to the CSDE.

4.Upon receipt of your ED 192 and your SAT/ACT/GRE/PAA scores, you will be mailed written veri- ication of your Academic Skills Assessment Waiver.

If you have questions concerning the Connecticut Academic Skills Assessment Waiver, please write, phone, fax or email:

CONNECTICUT STATE DEPARTMENT OF EDUCATION

Bureau of Educator Standards and Certiication

Waiver Coordinator

P.O. Box 150471 – Room 243

Hartford, CT 06115-0471

Phone: 860-713-6969; Fax: 860-713-7017

Email: teacher.cert@ct.gov

Website: www.ct.gov/sde

PAGE 6

Common mistakes

Filling out the Connecticut ED 192 form can be a straightforward process, but several common mistakes can lead to delays or even rejection of the application. One frequent error is failing to provide an official score report. The form explicitly states that scores sent by waiver candidates will not be accepted. It is crucial to ensure that the official score report is sent directly from the testing agency to the Bureau of Educator Standards and Certification. Without this document, the application cannot be processed.

Another common mistake involves incorrectly completing personal information. Applicants must print all information in blue ink and in uppercase letters. Omitting details such as the social security number, or providing incorrect information about the name or address can lead to complications. Double-checking each entry for accuracy before submission can help prevent these issues.

Many applicants also overlook the requirement to select the appropriate testing option. The form allows candidates to choose from SAT, ACT, GRE, or PAA as the basis for the waiver. Failing to check one of these options can result in the application being considered incomplete. It is essential to carefully review the instructions and ensure that the correct box is marked.

Lastly, some individuals forget to sign and date the form. The signature is a necessary affirmation that the information provided is accurate and complete. Without a signature, the application will be deemed invalid. Taking a moment to review the entire form for completeness, including the signature and date, can save time and effort in the long run.

Key takeaways

Here are some key takeaways about filling out and using the Connecticut Ed 192 form:

  • The Ed 192 form is used to apply for a waiver of the Connecticut Academic Skills Assessment.
  • Applicants must submit the completed form along with an official score report from an accepted testing agency.
  • Scores sent by the applicant will not be accepted; only official reports from testing agencies are valid.
  • Fill out the personal information section using blue ink and uppercase letters for clarity.
  • Ensure that all required fields, such as social security number and birth date, are completed accurately.
  • Check the appropriate box to indicate which testing requirement is being waived (SAT, ACT, GRE, or PAA).
  • Keep in mind that a waiver is an alternative to taking the Praxis I tests required for educator certification in Connecticut.
  • Contact the respective testing agencies for guidance on obtaining official score reports if needed.

Similar forms

The Connecticut Ed 192 form, which serves as an application for a waiver of the Connecticut Academic Skills Assessment, shares similarities with the Praxis I test registration form. Both documents cater to prospective educators seeking certification in Connecticut. The Praxis I form outlines the requirements for taking the tests in reading, writing, and mathematics, while the Ed 192 form provides an alternative pathway for those who meet specific criteria. Essentially, both forms are geared towards ensuring that educators possess the necessary academic skills, but the Ed 192 form offers a waiver option based on standardized test scores from other assessments like the SAT or ACT.

Another document that resembles the Connecticut Ed 192 form is the SAT score report request form. Just like the Ed 192 form, this document is essential for individuals who need to submit official test scores to meet certification requirements. The SAT score report request form allows candidates to request their scores directly from the College Board, ensuring that the scores are sent in an official capacity. Similarly, the Ed 192 form requires candidates to provide official score reports from the SAT, ACT, GRE, or PAA to validate their eligibility for the waiver. Both forms emphasize the importance of submitting verified scores to facilitate the certification process.

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The GRE score report request form is yet another document that parallels the Ed 192 form. The GRE form is used by individuals seeking to report their graduate-level test scores to various institutions, including the Connecticut State Department of Education. Much like the Ed 192 form, which requires candidates to submit their GRE scores to apply for a waiver, the GRE score report request form ensures that the scores are sent directly from the Educational Testing Service (ETS). Both forms are integral in verifying the academic qualifications of prospective educators, albeit at different educational levels.

Lastly, the ACT score report request form also bears similarity to the Connecticut Ed 192 form. This document allows individuals to request their ACT scores to be sent to educational institutions or certification bodies. Similar to the Ed 192 form, which requires official ACT scores as part of the waiver application process, the ACT score report request form ensures that the scores are delivered directly from the testing agency. Both forms play a crucial role in the certification journey for educators, emphasizing the need for verified academic performance to meet state requirements.