Practice Application

2017-2018IllinoisNBRenewalCandidateFee SubsidyApplication

WelcometotheapplicationfortheIllinoisNBRenewal CandidateFeeSubsidy.

TheNational BoardResourceCenter(NBRC)atIllinoisStateUniversityIs excitedtoannouncethattheapplicationfortheIllinoisNBRenewal CandidateFeeSubsidyisopenfromOctober 27,2017at10amtoApril30,2018atmidnight.

Timeline:

•ApplicationopensOctober 27, 2017at10am.

• YoumustmakepaymenttoNBPTS byJanuary31,2018.

• YoumustcompletetheIllinoisNBrenewal applicationlaterthanApril30, 2018atmidnight.

•Names ofapplicantswillbepostedtotheNBRCwebsiteeveryMonday, TuesdayandWednesdayfromNovember 13, 201710amthroughMay3,2018.

•YoumustsubmityourPPGtoNBPTSbyMay,2018 (actual date determined by NBPTS).

•Paymentsof$1,250willbemadetoNBPTSinJuly-August2018.

STOP!Donotproceeduntilyou:1)completethispracticeapplicationand2)read thedetailsabouttheIllinoisNBRenewalFeeSubsidyApplication.

Section I

  1. First Name:

2. LastName:

3.MiddleName:

4. MaidenName:

UseN/Aifthisquestiondoesnotapply.

5.Birthday:

mm/dd/yyyy

6. SocialSecurityNumber:

Last4digits only!XXX·XX·----

7.HomePhone:

Includeareacode-nospacesordashes-3094361635

8.WorkPhone:

Includeareacode-nospacesor dashes-3094381635

9. HomeAddress-Street:

10.HomeAddress-City:

11.HomeAddress-State:

12.HomeAddress-Zip:

13.HomeAddress-County:

14.Email:

Email addresswhereyoucanbereachedatalltimesincludingsummer. School emailstendtobeblocked.

Pleasebesurethis istypedaccurately

15.ConfirmEmail:

16.CurrentTeachingPosition·

Selectallthatapply.

  • HighSchool
  • Middle School
  • ElementarySchool
  • Pre-School
  • Currently notteaching
  • Other,
  • pleasespecify

17.Currentpositioninthepublic schoolsystem:

Selectallthatapply

  • Teacher
  • Counselor
  • Administrator
  • InstructionalCoach
  • Retired
  • Curriculum Director
  • Other, pleasespecify

18.Nameofschoolwhereyouarecurrentlyemployed:

19.SchoolAddress-Street:

20. SchoolAddress-City:

21. SchoolAddress-State:

22.SchoolAddress-Zip:

23.SchoolAddress-County(notcountry):

24. Region,County,District,Type(RCDT)Code:

ExampleCityofChicago-150162990·25·0000

- click on RCDTSCode LookupRCDTS Lookup Page Search by District.

25.NBPTSTeachingCertificate-IncludetheDisciplineandDevelopmentalLevel- Example-Art/EarlyandMiddleChildhood: Use this link to understand and decided which NB certificate you will chose to complete The certificate should complement your Illinois license.

26.WhatisyourRenewalCandidateIdentificationNumber?

YourRenewalCandidateIDstartswithC011andisfollowedbyfiveadditionalnumbers

27. Youmustbeinyour8thor9thyearofNBcertification tobegintherenewalprocess.

WhatistheyearofyourlastNBcertification?

Section II

  1. Is your school on the Academic Early Warning List? (
  1. Is your school on the Academic Watch List?
  1. Does your school have 50% or more students on free or reduced price lunch status?
  1. To be eligible for the Illinois NB Renewal Candidate Fee Subsidy, all candidates must hold a valid Illinois Educator Identification License(IEIN). This applies even if your current position does not require one. This information can be found in the Illinois Educator Licensure Information System (ELIS)(

Primary Information –

Full Name:Jane Doe

IEIN:123456

DOB:mm/dd/yyyy

Gender:female

Former Name:Deer

  1. To be eligible for the Illinois NB Renewal Candidate Fee Subsidy, all candidates must hold a valid Professional Educator License (PEL). This applies even if your current position does not require one. This information can be found in the Illinois Educator Licensure Information System (ELIS) under “MY CREDENTIALS” (

Select / License ID / License / Status Code
Select / 1234567 / Professional Educator License

To be eligible for the Illinois NB Renewal Candidate Fee Subsidy, applicants must agree to the questions below and authorize their signature to confirm agreement

  1. Do you agree that your Illinois license is current and valid and unencumbered?
  1. Do you agree that you that you applied to NBPTS and paid the $1,250 assessment fee for the 2017-2018 renewal registration cycle?
  1. Do you agree that your NB certificate is current and not expired?
  1. Do you agree that you are in your eighth or ninth year of your NB certification?
  1. Do you agree to submit the completed NB Profile of Professional Growth (PPG) to NB between April 1, 2018 and May, 2018?
  1. The Illinois NB Renewal Candidate Fee Subsidy will be paid directly to NBPTS for those candidates who are approved for the Illinois NB Renewal Candidate Fee Subsidy, paid the $1,250 assessment fee for the 2017-2018 cycle and submit a completed PPG to NB by May, 2018. NBPTS will post this payment to the NB account of the Renewal Candidate applicant in July-August 2018. The applicants’ personal credit card will be reimbursed for the total $1,250 paid to NB by the applicant. Do you agree that you understand that the Illinois NB Renewal Candidate Fee Subsidy will be paid directly to NBPTS for those applicants who are approved to receive the Subsidy, who paid the $1,250 assessment fee for the 2017-2018 cycle, and who agree to submit the completed NB Profile of Professional Growth (PPG) to NB between April 1, 2018 and May, 2018?
  1. Do you agree that you submitted complete and correct information in the Illinois NB Renewal Candidate Fee Subsidy Application?
  1. Check agree to authorize your signature to confirm agreement to your responses in Section II.

SECTION III – District Administrator Information

  1. Official school district name:
  1. Address of District (Street):
  1. Address of District (City):
  1. Address of District (State):
  1. Address of District (Zip Code):
  1. Title of District Administrator:
  • Superintendent
  • Assistant Superintendent
  • Principal
  • Human Resources Director
  • Other
  1. Name of District Administrator:
  1. Telephone number of District Administrator (no spaces or dashes):
  1. Email of District Administrator: