California State University, East Bay

Education Specialist Credential: Extensive Support Needs Authorization

Candidate Completion Form

This form is to be submitted to the Credential Student Service Center as a part of your documentation

for the Education Specialist Credential: Extensive Support Needs Authorization. No application will be processed without this form.

CANDIDATE INFORMATION

Empl ID

Net ID

First Name

Last Name

Middle Initial

CSU East Bay Horizon Email Address

Phone Number

Alternative Email Address

If you hold a prior credential, please complete the following information

Credential

State

Expires

CANDIDATE ASSESSMENTS

Basic Skills Requirements

Method

Date

Subject Matter Competency

Method

Date

CalTPA Cycle 1

Date

CalTPA

Cycle 2

Date

RICA

Date

COURSE COMPLETION

Content Courses Grade Semester/Year

SPED 500 Educating All Students in Diverse Classrooms.

SPED 601 Research Based Practices for Students with
Disabilities

SPED 602A Autism Spectrum Disorder: Characteristics and Etiology

SPED 602B Low Incidence Disabilities: Characteristics and Instructional Practices

SPED 603 Collaboration and Transition

SPED 604 Mental Health and Positive Behavior Support

SPED 605 Communication and Technology

SPED 608 Instruction and Behavior Support: Extensive Support Needs

SPED 609 Advanced Assessment Curriculum and Instruction

SPED 610 Research and Professional Practices

SPED 693 Capstone Project

SPED 694 A Foundations of Instruction A

SPED 694 B Foundations of Instruction B

SPED 699 A Advanced Strategies in Special Education A

SPED 699 B Advanced Strategies in Special Education B

Field based Clinical Practice

SPED 614 Early Fieldwork Exploration

SPED 615 Fieldwork I: Early Fieldwork Extensive Support Needs

SPED 616 Fieldwork II: Fieldwork Extensive Support Needs

SPED 617 Final Student Teaching: Extensive Support Needs