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Texas Standardized Credentialing Form

The document is a standardized credentialing application for Texas that includes an attachment for listing other professional degrees. The attachment contains fields to provide the name and location of the issuing institution as well as the degree, attendance dates, and other identifying information for up to six other professional degrees earned by the applicant.

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Desi
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21 views1 page

Texas Standardized Credentialing Form

The document is a standardized credentialing application for Texas that includes an attachment for listing other professional degrees. The attachment contains fields to provide the name and location of the issuing institution as well as the degree, attendance dates, and other identifying information for up to six other professional degrees earned by the applicant.

Uploaded by

Desi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Texas Standardized Credentialing Application

Attachment A Other Professional Degrees

OTHER PROFESSIONAL DEGREE


Issuing Institution:
ADDRESS
CITY
DEGREE

STATE/COUNTRY

POSTAL CODE

ATTENDANCE DATES(MM/YYYY TO MM/YYYY)

OTHER PROFESSIONAL DEGREE


Issuing Institution:
ADDRESS
CITY
DEGREE

STATE/COUNTRY

POSTAL CODE

ATTENDANCE DATES(MM/YYYY TO MM/YYYY)

OTHER PROFESSIONAL DEGREE


Issuing Institution:
ADDRESS
CITY
DEGREE

STATE/COUNTRY

POSTAL CODE

ATTENDANCE DATES(MM/YYYY TO MM/YYYY)

OTHER PROFESSIONAL DEGREE


Issuing Institution:
ADDRESS
CITY
DEGREE

STATE/COUNTRY

POSTAL CODE

ATTENDANCE DATES(MM/YYYY TO MM/YYYY)

OTHER PROFESSIONAL DEGREE


Issuing Institution:
ADDRESS
CITY
DEGREE

STATE/COUNTRY

POSTAL CODE

ATTENDANCE DATES(MM/YYYY TO MM/YYYY)

OTHER PROFESSIONAL DEGREE


Issuing Institution:
ADDRESS
CITY
DEGREE

STATE/COUNTRY

POSTAL CODE

ATTENDANCE DATES(MM/YYYY TO MM/YYYY)

OTHER PROFESSIONAL DEGREE


Issuing Institution:
ADDRESS
CITY
DEGREE

LHL234 Rev.01/07

STATE/COUNTRY

POSTAL CODE

ATTENDANCE DATES(MM/YYYY TO MM/YYYY)

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