Application for Student Teaching Rev fall 2020

University of Arkansas at Pine Bluf Admission to the Professional Semester Student Teaching Teacher Candidate: _Student ID # Date: _ CHECKLIST/APPLICATION INSTRUCTIONS Submit application for admission form DATE RECEIVED Submit a copy of Approved Degree Plan (Approved by Advisors) The Degree Plan must contain the signature of the advisor(s), chairperson and Dean of the School of Education (where required) Submit University Clearance Form (Finalized week of Student Teacher Clinical Seminar) Submit a Student Arkansas Education Association (S-AEA) application form beginning the semester student teaching is to be completed (fall or spring) or show that he/she possess proof of $100,000 liability insurance policy Submit a letter of recommendation from advisor or department chairperson Provide an official up-to-date transcript of all college courses including transfer courses from other colleges or universities The transcript must reflect a Cumulative Grade Point Average of 2.70 or above Attach an original copy of all test scores: o Act Score 21.25 and a Score of or above in Writing o Praxis II: Content Knowledge/Subject Assessment o Principles of Learning and Teaching/Pedagogy o Special Education Majors not take PLT o Special Education Core Knowledge and Applications (5354) o Fundamental Subjects: Content Knowledge (5511)On-Screen Scientific Calculator provided) o For candidates starting a program beginning fall 2017, this license requires a reading testFoundations of Reading More information about this test is available on the Arkansas Division of Elementary and Secondary Education web page o Elementary K-6th Grades Majors have to take the following CK; o Elementary Education Multiple Subtests (5001)-If you Revision Date: 09/24/2020 plan to take all tests during one (1) setting (5001): o Elementary Reading & Lang Arts Subtest (5002) o Elementary Mathematics Subtest (5003) o Elementary Social Studies Subtest (5004) o Elementary Science Subtest (5005) o For candidates starting a program beginning fall 2017, this license requires a reading testFoundations of Reading More information about this test is available on the Arkansas Division of Elementary and Secondary Education web page o Foundations of Reading if enrolled fall’17 going forward STUDENT TEACHERS MUST ATTAIN PASSING SCORES ON ALL TESTS PRIOR TO THE START OF STUDENT TEACHING Submit proof of a recent negative TB Skin Test (No older than months) Provide a Doctor Statement (a complete Physical Examination) 10.Obtain the UAPB Nurses’ signature on the Campus Clearance Form prior to the start of the Professional Semester 11.Submit proof of Authorization For Release of Confidential Information Contained within the Arkansas Child Maltreatment Central Registry 12.Submit proof of Individual Record Check Form, Background Check Consent Form and Electronic Finger Printing 13.IDEAS Course Certificates: o Child Maltreatment (2hrs.); o Gatekeepers: Youth Suicide Prevention Awareness (3hrs); o Parental Involvement (2hrs.)-Parental Involvement – students will need to take at least separate courses in order to equal the two (2hrs) needed; o Dyslexia Awareness (1hrs) o The directions for ideasmyarkansaspbs.org: Go to ideasmyarkansaspbs.org If that website does not work, type it in google and click on it from there Click on create a new account and sign up using the correct spelling of your name that you used when you signed up for fingerprinting When asked to choose an organization, click on University Preparatory Program and then click on UAPB It should let you in To get to the courses, click find learning at the top of the website Revision Date: 09/24/2020 and then click on courses Type in the above mentioned name of the courses you have to take and enroll in them 14.Student teachers must show proof that he/she has exited University College and must have been admitted to the School of Education prior to submission of this application University of Arkansas at Pine Bluff Pine Bluff, AR 71601 Application for Admission to Student Teaching (Please Type) (Do Not Fold) Date: _ I, , hereby apply for permission to register for Student Teaching for the _Semester of the academic year 20 My major is I understand that the Admission, Retention and Exit Committee has the authority to deny my admission or withdraw me from student teaching, if I not attain or maintain the required standard for admission and continuance Signature 01 Name: _ (Last) (First) (Middle or Maiden Name) 02 Gender: _ 03 If your are a Music Major, indicate if you are vocal or instrumental: 04 Are you being certified K-12? If so, what are the areas or levels in which you are seeking certification? ( Social Security Number: _ ) K-6th Grades -Elementary Education Revision Date: 09/24/2020 ( ( ( ( ( ( ( ( ( ) Middle Level (4th -8th Grade) - Science and Mathematics ) Middle Level (4th -8th Grade) - Science and Social Studies ) Middle Level (4th -8th Grade) - Mathematics and Social Studies ) Middle Level (4th -8th Grade) – Language Arts and Social Studies ) Middle Level (4th -8th Grade) - Language Arts and Mathematics ) Middle Level (4th -8th Grade) - Language Arts and Science ) Middle Level (4th -8th Grade) - Language Arts, Math, Science and Social Studies ) Secondary Grades (7th- 12th Grades) Major Area: ) K-12th Grades (K-12th Grades) Major Area: Degree Plan Approval Date: (Attach Approved Degree Plan to Application) 05 Praxis Exam Scores Art K-12 Test Code: Business Technology Test Code: #5134 #5101 Elementary Education K-6 Test Codes are listed after each subtest: English Education Test Code: # 5039 Family & Consumer Science Test Code: #5122 Middle Level Education 4-8 Cont & Analysis Passing Score: 158 PLT 157 Business Education : Content Knowledge Passing Score: 154 Elementary Education PLT 160 Multi Subject: 5001 Reading/Lang/ Arts #5002 Passing Score 157 Mathematics #5003 Passing Score 157 Social Studies #5004 Passing Score 155 Science #5005 Passing Score 159 English Lang, Lit &Comp: PLT 157 Content & Analysis Passing Score: 168 Family and Consumer PLT 157 Science CK: 153 Must have of the Subject PLT 160 Areas Passed: Middle School Language Arts #5047 Passing Score: 164 Middle School Math #5169 Passing Score: 165 Middle School Science #5442 Revision Date: 09/24/2020 Passing Score: 147 Middle School Social Studies # 5089 Passing Score: 149 CK 147 Agri Science Technology #5701 PLT 157 Industrial Technology #5051 CK 159 Life/Earth Science PLT 157 PLT 157 Biology/Life Science #5235 CK 142 Chemistry #5245 CK 150 Physical Science: Chemistry # 5245 or Physics #5265 Physics #5265 Mathematics Content Knowledge #5161 Music Instrumental & Vocal Test Code # 5113 Chemistry CK: 150 or Physics CK: 135 CK: 135 PLT 157 CK 160 Cont & Instr 162 PLT 157 Physical Education, Wellness, & Leisure PLT 157 Health & Physical Ed Test Code # 5857 CK 144 Physical Ed: Content & Design/Coaching C & D/Coach 169 Test Code # 5095 Social Studies Cont & Interp 153 Test Code #: 5086 PLT 157 06 Permanent Home Address: _ _ Local Address: _ Telephone Number: Revision Date: 09/24/2020 (Permanent) 07 (Local) Is Student Teaching the last course you need to complete your degree requirements? Yes _ No *Please list course(s) needed _ _ _ _ _ _ If for any reason I cancel or postpone my student teaching during the semester stated on this application, I agree to submit a written statement to the Chairperson of the Admission, Retention and Exit Committee before the end of the semester in which my application was submitted and the statement will become a part of my permanent student teaching file I understand that when I elect to my student teaching, I must reapply at the appropriate sign-up period _ Student’s Signature _ Date _ Advisor’s Signature _ Date _ Academic Advisor Secondary Education Major _ Da Revision Date: 09/24/2020 University of Arkansas at Pine Bluff School of Education TO: DEPARTMENT CHAIRPERSON OR ADVISOR _ Department Chairperson/Advisor Date: Student: has made application for enrollment in Directed Teaching Your candid opinion of the applicant in the following areas is desired Will you please rate the applicant on the form below and return it to the School of Education, Dawson Hicks Hall? Check each item under one of the rating columns Recommendation from the Chairperson/Advisor TRAITS No Opportunity to observe Weak-needs improvement Satisfactory acceptable StrongHighly Competent 01 Conscientious desire to Teach 02 Ability to work hard at task upon completions 03 Willingness to work diligently 04 Ability to get along with people 05 Desire to work with people 06 Warm feeling for young people 07 Physical Health 08 Mental Health 09 Pleasing manner, appearance, habits and conduct 10 Sufficient maturity to take complete charge of a group of pupils 11 Leadership qualities 12 Communicative skills 13 Mastery of subject manner 14 Initiative 15 Resourcefulness 16 Ethical character 17 Open mindedness 18 Responsibility and reliability Revision Date: 09/24/2020 ... before the end of the semester in which my application was submitted and the statement will become a part of my permanent student teaching file I understand that when I elect to my student teaching, ... School of Education prior to submission of this application University of Arkansas at Pine Bluff Pine Bluff, AR 71601 Application for Admission to Student Teaching (Please Type) (Do Not Fold) Date:... Type) (Do Not Fold) Date: _ I, , hereby apply for permission to register for Student Teaching for the _Semester of the academic year 20 My major is