Do You Need an Institutional Program Verification Form?

If you need OCFBI to complete an institutional program verification form for your licensure application, please prepare a cover sheet with the following information:

Alternate Route: If you are an alternate route student, please contact your advisor to get their signature on the licensure form Stephanie Etheridge or Harper Laird

Alternate Route Licensure Information Form MAT-X and Alternate Route Licensure Information Form MAT-S

Educational Leadership, Psychometry, School Counseling, School Psychology and Teacher Leadership: Please complete the Licensure Form:

Licensure Information Form

You can submit this information to our office via email, fax, or mail.

Our Contact information is:

Office of Clinical/Field-Based Instruction, Licensure, and Outreach
Attn: Donna Shea
Box 9710
Mississippi State, MS 39762

Phone: (662) 325-7684
Fax: (662) 325-0615
Mail Stop 9710

Please be aware that if you graduated Mississippi State before December 1997, your transcript is not posted online in Banner, and OCFBI staff will require additional time to request a copy from the registrar's office.

Supplemental Endorsement Information