Alternate Route Application: Structured Literacy/Dyslexia Interventionist | The Center for Effective Reading Instruction

Applicant Profile Information
Name*
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- International Address?
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Business Address For Online Listing - International*
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Email*
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Highest Degree Held*
Major*
Personal Statement*
In order to receive certification as a Structured Literacy/Dyslexia Interventionist, you must provide a personal statement of no more than 5 typewritten pages that addresses your equivalent qualifications, with an emphasis on documenting equivalent knowledge and skill to that of certification candidates prepared through and IDA Accredited Provider. Section max file upload size 20MB.
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Upload degree or transcript*
In order to receive certification as a Structured Literacy/Dyslexia Interventionist, you must hold a bachelor's degree. Your degree can be in a field other than education. Please upload a copy of your degree or transcript showing completion of your degree. Section max file upload size 25MB.
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Accepted file types: pdf, jpeg, png, gif, doc.
Resume/CV*
Section max file upload size 20MB.
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Please explain any other training received
Alternate Route Documentation: Structured Literacy/Dyslexia Interventionist
Colleague Support Letters*
Two letters of support from colleagues in the field who hold the same, or equivalent level, of certification. Letters should speak to (a) your competencies with regard to serving the needs of students from a Structured Literacy perspective, with reference to and alignment with the KPS, as appropriate; and (b) their knowledge of your demonstrated ability to meaningfully impact student learning outcomes. Section max file upload size 20MB.
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One Student Case Study*
One student (developing reader emphasizing single syllable word reading) case study, complete with background information, dates served, pre-post assessment data, priority scope and sequence established for the student that considers pre-assessment data and background information, discussion of progress/lack of progress, and recommendations in response to post-assessment data. Case study should be no more than 10 pages. Section max file upload size 20MB.
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Letter of Support from a Parent*
One letter of support from a parent of a student (or the student themselves, if of the age of consent) that describes your relationship to the student, describes the frequency and duration of your work with the student, and speaks to the measurable and observable impact your work had on the student. Section max file upload size 20MB.
CEERI or KPEERI Report
Section max file upload size 10MB.
Are you Applying From an IDA Accredited Institution/Program?*
- Yes
- No
Please State Name of Institution of Program*
Are you Currently Teaching at a Public or Private School?*
- Public
- Private
What Grade(s) do you Teach?*
- Pre-Kindergarten
- Kindergarten
- 1st Grade
- 2nd Grade
- 3rd Grade
- 4th Grade
- 5th Grade
- 6th Grade
- 7th Grade
- 8th Grade
- 9th Grade
- 10th Grade
- 11th Grade
- 12th Grade
Is your School in an Urban, Priority, or Rural district?*
- Yes
- No
How Many Students do you Impact in One Academic Year With Structured Literacy in the Classroom?*
Why Did you Seek CERI Certification? (optional)
Applicant Affirmation
IDA Branch*
By checking 'I agree', I give permission for CERI to share my contact information with my local IDA branch
- I agree
- I disagree
Affirmation*
I affirm that all of the information provided on this application is true and accurate and fully responsive to the questions asked. I have read and agree to abide by the code of ethics of the Center For Effective Reading instruction that are found within the Knowledge and Practice Standards. I agree to abide by all standards required to maintain my certification, including payment of annual fees and participation in continuing professional development activities. I understand that, once certified, my certification status may be made available to the public.
- I agree
- I decline
Name as Applicant Would Like it to Appear on Certification
Name on Certification*
Please type your name exactly as you would like it to appear on your Certification:
Payment
1 Year Certification
Fee: $275
$125 application fee plus a one time $150 review fee.

3 Year Certification
Fee: $525
$375 application fee plus a one time $150 review fee.
Structured Literacy/Dyslexia Interventionist Alt Route Certification*
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Applicant Profile Information

Alternate Route Documentation: Structured Literacy/Dyslexia Interventionist

Applicant Affirmation

Name as Applicant Would Like it to Appear on Certification

Payment