College of Education & Integrative Studies

C A L I F O R N I A S T A T E P O L Y T E C H N I C U N I V E R S I T Y, P O M O NA College of Education & Integrative Studies Department of Education

TRANSITION PLAN Clear Education Specialist Credential

 Mild/Moderate  Moderate/Severe  Other: ______

The Transition Plan is completed by Preliminary ES Credential candidates during their last quarter of Clinical Practice. It includes the individual’s strengths along with areas of need and interests that will be addressed in the Individual Induction Plan in the Clear Credential preparation program. Education Specialist candidates must complete this plan in collaboration with their Clinical Practice University Supervisor (US) and Intern Support Provider (if applicable), during their last block of Clinical Practice. The US submits a completed, signed copy of this form (along with other required documents) to the Credential Services Office. The Credential Analyst must have a copy of the Transition Plan in order to recommend the candidate for the Preliminary Credential. Candidates: keep the original of this signed, completed form for your records.

Candidate: ______Bronco #: ______

Address: ______Phone: ______

Email: ______Date: ______

Preliminary Credential Requirements Date Passed/Completed Comments Subject Matter Competency RICA US Constitution (course or exam) CPR Certification CSU Exit Survey

For each of the areas below, cross-reference TPE’s and CSTP’s.

Identify Areas of Strengths Identify Areas of Interest Identify Areas of Need Do you hold other teaching credentials and/or authorizations?

Other areas of strength include:

University Supervisors: Please give a blank copy of this form to ES candidate at the beginning of their final quarter of CP. 1 C A L I F O R N I A S T A T E P O L Y T E C H N I C U N I V E R S I T Y, P O M O NA College of Education & Integrative Studies Department of Education

Preparation Steps (What are your present and future goals?):

Candidate’s Credential(s) Goals: Other Goals (cross –reference w/ Interests & Needs, above

 Preliminary Education Specialist

 Level II Education Specialist

 Clear Credential Education Specialist

 Multiple Subject Preliminary

 Multiple Subject Clear

 Single Subject Preliminary

Content Area:

 Single Subject Clear

 Added Authorizations (describe):

 Other (describe):

Interns Only List your Support Provider/mentor. One Support Provider per credential (M/M, M/S, Other):

Name Credential(s) Held Issue Date(s) Document Number(s)

Supportive Information Cal Poly Pomona University Supervisor: Phone #:______Email: ______

Cal Poly Pomona Credential Analyst: Ms. Geri Hunt Phone #: (909) 869-2306 Email: [email protected]

Candidate Signature: CPP University Supervisor Signature: Intern Support Provider Signature:

Date: Date: Date:

University Supervisors: Please give a blank copy of this form to ES candidate at the beginning of their final quarter of CP. 2