University of Nebraska Kearney

UNK
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Academic and Career Services

EDUCATION CREDENTIAL DATA SHEET    

 

 

 

(Please complete in full)

 

Full Name
 
 
  
   
UNK ID or Birth Date

 
 
   
Email address

 
 
   
Current Address, Street, City, State & Zip

 
 
   
Permanent Address, Street, City, State & Zip

 
 
   
Phone Number
 
 
   
College(s) where degree obtained     
School
 
Most Recent Degree (MA, BA)

 
Date Received (mo/yr)

 
Previous School

 
Previous Degree

 
Date Received (mo/yr)

 
Additional School

 
Additional Degree

 
Date Received (mo/yr)

 
Certification (SAMPLE: Eled, Secondary) 
 
   
 Areas endorsed to teach  
 
    

Years Teaching Experience

 
 
   
Years Administrative Experience

 
 
   
 Todays' Date
 
   

 

According to the Family Education Rights & Privacy Act, PS 93-380, these credentials are to be used by the addressee for employment purposes or graduate school admission ONLY.  They should NOT be released to other individuals, organizations or prospective employers.  Under NO circumstances should these materials be revealed in part or whole to the candidate.  If you cannot accept confidential credentials, please call this office.