How to Fill Out Connecticut Form ED 126: Statement of Professional Experience

Connecticut’s Form ED 126, the Statement of Professional Experience, is the document that verifies your prior teaching or service history when you apply for a Connecticut educator certificate. You fill in only your identifying information at the top. The superintendent’s office at each district or approved school where you worked completes the employment grid, checks whether you served successfully, and signs the attestation.1Connecticut State Department of Education. Statement of Professional Experience ED 126

When You Need an ED 126

The form is required any time you apply for a Connecticut educator certificate and have prior experience to document, whether that experience was in-state, out-of-state, or in a foreign school.

The most common scenarios:

  • You hold a valid certificate from another state and are applying for a Connecticut certificate. If you have at least 20 school months of successful teaching under that certificate, the ED 126 documents that experience so the Bureau of Certification can determine your certificate level. With fewer than 20 months, you may still need the form, but it won’t bump you to a higher level.2Connecticut State Department of Education. Out-of-State Educator Certification – Enhanced Reciprocity States
  • You are advancing a Connecticut certificate to the professional level, which requires at least 50 school months of successful service in a Connecticut public school or approved nonpublic school.3Connecticut State Department of Education. How Do I Advance My Certificate
  • You are seeking an administrative endorsement, or an endorsement in remedial reading and remedial language arts.
  • You have foreign K–12 experience from the past ten years. In that case, attach a copy of the certificate or license that authorized the foreign service.4Connecticut State Department of Education. Obtaining Connecticut Educator Certification

What You Fill In at the Top

The form is a single page split between two parties. Print all information in blue ink using uppercase letters.1Connecticut State Department of Education. Statement of Professional Experience ED 126

Your section asks for five items:

  • Last name, first name, and middle initial
  • Social Security number
  • Date of birth in month-day-year format

Stop there. The form explicitly states that applicants do not complete anything below the identifying fields.1Connecticut State Department of Education. Statement of Professional Experience ED 126 If you fill in the employment grid yourself, the form will be rejected.

What the Superintendent’s Office Fills In

Everything below the identifying fields goes to the superintendent’s office at the district or school where you worked. The employment grid captures:

  • Position held, such as teacher, administrator, or social worker
  • Subject and field (middle and secondary teachers must have each subject listed individually)
  • Grade level
  • The endorsement code that corresponds to the position. Connecticut uses a numerical system; examples include 305 for Elementary PK–6, 015 for English 4–12, and 070 for School Psychologist.5Connecticut State Department of Education. Endorsement Codes
  • Full-time or part-time status. Full-time means 50 percent or more; anything below is part-time.
  • Start and end dates for each position in month/year format
  • Adult education hours served per school year, if applicable

A checkbox at the bottom of the grid covers school psychologist interns who completed their internship without being under contract. If that applies to you, make sure the office checks it.

One Form Per Employer

You need a separate ED 126 for each school district or approved nonpublic school where you worked.1Connecticut State Department of Education. Statement of Professional Experience ED 126 Three districts over your career means three ED 126 forms, each signed by the superintendent or executive director at that district. Combining employers on a single form will require a redo.

This is the step that stalls most applications. Tracking down former employers takes time, especially across state lines, so start early.

The Attestation and Signature

At the bottom of the form, the superintendent, executive director, or their designee checks one of two boxes: that the applicant served successfully in the listed positions, or that the applicant did not.1Connecticut State Department of Education. Statement of Professional Experience ED 126 The signer then provides an original handwritten signature. Signature stamps are not accepted.

The attestation block also requires the signer’s printed name, title, employing agency name, city, state, zip code, telephone number, email address, and the date. Those contact details matter because the Bureau of Certification may reach out to verify the information. If the superintendent who knew you has retired, the current superintendent or a designee can still sign; the attestation is based on district records, not personal memory.

What to Submit With the ED 126

The ED 126 is not submitted on its own. It goes in as part of your full certification application package, which typically includes:4Connecticut State Department of Education. Obtaining Connecticut Educator Certification

  • Your application, filed online through the Connecticut Educator Certification System (CECS) or on paper (the ED 170 for initial applicants from approved programs, or another appropriate application type)
  • The $50 application fee, payable by Visa, MasterCard, or Discover online. Paper filers send a money order, certified bank check, or cashier’s check payable to “Treasurer, State of Connecticut.” Personal checks are not accepted. The fee is nonrefundable.
  • Official transcripts from every postsecondary institution you attended, each bearing the embossed or color seal of the issuing institution
  • One ED 126 per employing district or school, each with an original superintendent signature
  • Copies of out-of-state certificates or licenses, front and back, with a key to any certification codes. These must cover every year of service listed on your ED 126 forms.
  • An ED 125, if applicable, completed by the certification officer or dean at your college or university, with the institution’s embossed or color seal and an original signature

Online applicants create an account on the CECS portal and can upload supporting documents or mail them separately.6Connecticut State Department of Education. CECS Login Paper applications go to the Bureau of Certification at the Connecticut State Department of Education.

Mistakes That Delay Certification

The ED 126 looks simple, but applications stall when small details are off:

  • Signature stamps instead of an original signature. The form prohibits them.1Connecticut State Department of Education. Statement of Professional Experience ED 126
  • The applicant filling in the employment grid. That section belongs to the superintendent’s office; a grid in your handwriting will not be accepted.
  • Missing out-of-state certificate copies. Every year of service listed on an ED 126 must be backed by a copy of the certificate or permit that authorized it.
  • Combining multiple employers on a single form.
  • Using black ink or lowercase letters. The form specifies blue ink and uppercase.

Downloading the Form and Timing Your Request

The current version is ED 126 REV. 7/19, available as a PDF from the Connecticut State Department of Education’s certification forms page.1Connecticut State Department of Education. Statement of Professional Experience ED 126 Print it, fill in your identifying information at the top, then hand or mail it to the superintendent’s office at each district where you worked.

Give former employers plenty of lead time. A district pulling records from years ago won’t turn the form around overnight. Starting at least a few weeks before you plan to submit your certification application saves the single most common headache in the process.