Progress is not saved in this system. You will need to start over if you leave or close the appendix page.
Important Notes:
  • Grantees may not request to increase annual resident projections or receive additional grant funds.
  • If modifying multiple grants, a separate Updated Appendix D must be completed for each.
  • If adding LEA partner(s), an Appendix E form is required for each LEA being added.
Directions:
  1. Carefully read and follow the directions to complete the online form and generate a PDF.
  2. Once complete, download the PDF and save it using this naming convention: Grant# LEAName NewAppD (e.g., TRI24 Smith USD NewAppD).
  3. Email the completed PDF to Commission staff at TeacherResGrants@ctc.ca.gov by 5:00 pm on April 30, 2027.
Section I: A response to this section is required if the grantee is requesting to add new residency areas. If not adding new credential areas, this section may be skipped.
  • Enter a value in every field for each residency area that applies to this grant. See example below.
  • Percentages and averages may include one decimal place (e.g., 75.5%).
  • For each credential area being added, provide the percentage of teachers within the LEA/consortium that hold clear teaching credentials over the last three academic years by residency areas selected.
  • For each credential area being added, provide the average number of teachers within the LEA/consortium hired on less than a preliminary credential over the last three academic years by residency areas selected.
  • For each credential area being added, provide the average number of certificated teacher vacancies within the LEA/consortium over the last three academic years by residency areas selected.
  • Grantees must copy from the existing Appendix D the exact same residency areas and projection numbers into the “Targeted Number of Residents Annually” column on the table. Do not add data for any preexisting components of the grant. Instead, place “0” in the data collection fields.

    Grantees may then request to add any new residency areas by placing an “x” in the “Targeted Number of Residents Annually” column for each.

For example, a grantee whose original grant was funded to support an annual cohort of 20 residents earning Education Specialist credentials and is requesting to add credential areas, should complete the table as follows:

Example of a completed residency area table
Residency Area Percentage of Teachers for the Last Three Years that Hold Clear Teaching Credentials Average Number of Teachers for the Last Three Years Hired as PIPs, STSPs, and Interns Average Number of Teacher Vacancies for the Last Three Years Targeted Number of Residents Annually
Special Education 0% 0 0 20
Special Education with Bilingual Authorization 80% 2 2 x
Single Subject in a STEM Area 65% 7 10 x

By submitting this form, the grantee agrees that:

  • The IHE partner(s) for this grant must have a Commission-approved program for each area selected.
  • Once residents obtain a preliminary teaching credential, the grantee will hire residents as teachers of record in a position that matches their residency training and in accordance with the local need outlined in the approved grant application. This is especially important for residents earning either a Multiple Subject or PK-3 ECE Specialist credential to teach TK or kindergarten. If the program is designed to prepare TK or kindergarten teachers, residents must be hired in those settings even though their credentials authorize them to teach other grade levels.
You have errors on your form!
 * 
 * 
Residency Area Percentage of Teachers for the Last Three Years that Hold Clear Teaching Credentials Average Number of Teachers for the Last Three Years Hired as PIPs, STSPs, and Interns Average Number of Teacher Vacancies for the Last Three Years Targeted Number of Residents Annually
Special Education
Special Education with Bilingual Authorization
Single Subject in a STEM Area
Single Subject in a STEM Area that Authorizes Teaching of Computer Science
Single Subject in a STEM Area with Bilingual Authorization
Single Subject Non-STEM with Bilingual Authorization
Multiple Subject (to teach in TK or Kindergarten)
PK-3 ECE Specialist Instruction Credential (to teach in TK or Kindergarten)
Multiple Subject with Bilingual Authorization
PK-3 ECE Specialist with Bilingual Authorization
Dual Credential Please specify the two credentials below:


Diversifying Teacher Workforce that Reflects the LEA Community’s Diversity – Special Education
Diversifying Teacher Workforce that Reflects the LEA Community’s Diversity – Multiple Subjects and/or PK-3 ECE with or without added authorizations
Diversifying Teacher Workforce that Reflects the LEA Community’s Diversity – Single Subjects with or without added authorizations
Section II: A response to this section is required if requesting to add LEA partners. If not adding LEA partners, this section may be skipped.
  • Estimate the target number of residents that will be placed per school site listed. Applicants may include a range of residents to be placed at an individual school site (e.g., 0-2 residents per year at XYZ school). The sum of the maximum numbers in each range must be equal to the total residents projected on the table above.
  • Include existing and newly proposed residency areas and LEA/consortium partner schools, as appropriate.
  • DO NOT USE *** as this will become a new line.

Section III: A response to this section is required if requesting to amend the definition the program uses when recruiting residents to diversify the workforce. If not revising the definition, this section may be skipped.
  • Definitions may include, but are not limited to, race, ethnicity, gender, sexual orientation, other protected status, socioeconomic status, and education (e.g., first-generation college going).

0 of 300 words
DO NOT USE *** as this will become a new line.
Type in the characters displayed in the image below to verify you are human.