Graduate Educator Preparation Program Admission Application

Personal Information
Name (complete, legal name)*
Please provide your name as it appears on your driver's license.
First Middle Last
Date of Birth*
Gender*
Phone*
Email*
Address*
U.S. Residential Address Required

Street Address Apt / Unit City State ZIP Code
Ethnicity*
Please indicate your ethnicity. This information is used for statistical purposes only by the Texas Education Agency. Admission to the Educator Preparation Program is determined without regard to ethnicity.
Race*
Please indicate your race. This information is used for statistical purposes only by the Texas Education Agency. Admission to the Educator Preparation Program is determined without regard to race.
Program*
Certification Desired*
Certification Desired*
Certification Desired*
Writing Assignment
Candidate's appropriateness for Certification Sought:*
Complete the following writing assignment as directed below. Criteria: Assignment must be in paragraph form using formal Standard English and fit in the space below. This assignment should represent your BEST professional writing. Explain in 600 characters or fewer: If seeking initial teacher certification, please address why you would like to be a teacher. If you are already a certified teacher, please address why you are seeking to continue your education and why you have chosen the particular Master's degree selected above to pursue.
Academic History
If seeking MEd (initial certification only) or ACP Initial Certification, please indicate your highest earned degree:
Degree Type*
University*
Undergraduate Major(s)*
Undergraduate Minor(s)
Certification Level Desired*
All certification areas except EC-6 and Special Education (if intending to teach in EC-6 grad levels) require a minimum of 12 hours in the content area if PBC or 24 hours, with 12 being upper level, if MEd. Students may also qualify to teach a content area by taking and passing a Pre-Admission Content Test (PACT) through TEA.
Specialization Area Desired*
Indicate your desired area of specialization.
Specialization Area Desired*
Indicate your desired area of specialization.
Specialization Area Desired*
Indicate your desired area of specialization.
Specialization Area Desired*
Indicate your desired area of specialization.
Courses*
List all courses taken in the Content Area if 4-8, 7-12 or All-Level.
Total # of hours in the Content Area.*
Total # of upper-level hours (3000 & 4000)*
Acknowledgement
Acknowledgement of Acceptance*
By checking the box below, I hereby acknowledge my receipt of the below information. I also understand that my performance evaluations for field work, clinical teaching, and/or student teaching will be shared with the campus administrator. In accordance with Article 6252-13c, Texas Civil Statues, the Commissioner of Education may suspend or revoke a teaching certificate or refuse to issue a teaching certificate for a person who has been convicted of a felony or misdemeanor for a crime which directly relates to the duties and responsibilities of the teaching profession. All applicants for Texas certification will be screened for a record of felony or misdemeanor conviction through the Texas Department of Public Safety (DPS) and Home Land Security. NOTICE: All potential certificate applicants with criminal felony or misdemeanor convictions should contact the Certification Officer immediately to seek clarification of their certification status.
- I Accept

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Graduate Educator Preparation Program Admission Application

Personal Information

Writing Assignment

Academic History

Acknowledgement