CWU ID: ______

Application for Admission to Teacher Preparation Program

Name ______

Last First Middle Maiden

E-Mail Address______Social Security Number ______

Birth date______Female_____ Male_____ Year in College ___FR ___SO ___JR ___SR ___GR

Eth. Origin _____Asian _____Black _____Hispanic _____Native American _____Caucasian _____Other

Preferred Mailing Address______

Street City State Zip

PHONE #s: Daytime ( )______Cellular ( )______Evening ( )______

What teacher preparation program are you pursuing (please fill in either section A or B):

A. CERTIFICATION ONLY: (If you already have a 4-year degree and are just obtaining certification)

ENDORSEMENT AREAS:______

B. DEGREE AND CERTIFICATION: (If you are pursuing a 4-year degree):

Major______Minor______

List all colleges attended (including CWU) and dates of attendance (unofficial transcripts must be included with your application):

______

______

Date you took or plan to take the WEST-B exam: ______(Passing scores must be on file for full admittance)

Date you had your fingerprints scanned by either the ESD or the CWU Certification Office: ______

Circle the CWU campus you plan to attend: Ellensburg – Yakima – Des Moines – Wenatchee – Pierce – Kent – Lynnwood

(*If you are planning on attending one of the university center programs (i.e., Des Moines, Wenatchee, etc.), please contact the center for the address in which to mail the application material).

SUBMIT THE FOLLOWING ITEMS WITH THIS APPLICATION:

__ Character and Fitness Supplement

__ Signed Fingerprinting/Certification Requirements form

__ Two Recommendation Forms (Confidential forms must be received in sealed envelopes and signed across the seal by the

recommender) – one form must be submitted from a certified teacher or professor. Forms completed by relatives are not accepted.

__ Transcripts from all colleges attended, except for CWU. These are independent of those sent for university application purposes.

__ Proof of purchase (copy of receipt or email) of the College LiveText edu solutions software (may be purchased online from

www.college.livetext.com or from the CWU Wildcat Shop.) If you are applying to an off-campus co-hort program (e.g., Des

Moines, Lynnwood, Pierce, Kent, Wenatchee, or Yakima), proof of purchase will not be required until you have been accepted into that

specific cohort.

__ Submission of the Dispositional Survey (once you activate your LiveText account, you will automatically be sent the

Admission Dispositional Survey which will be located in your Forms box). Please complete the survey and click the Submit button.

New admittance requirement: Candidates must successfully complete EFC 210, EFC 310, and PSY 314 in order to be at least conditionally admitted to the Teacher Preparation Program. Candidates must also successfully complete a minimum of 40 pre-observation hours in a K-12 public school classroom. Please contact the Department of Foundations and Curriculum at 509-963-1448 for more information.

I UNDERSTAND THAT I MUST HAVE A MINIMUM 3.0 GPA FOR THE LAST 45 GRADED QUARTER CREDITS TO BE FULLY ADMITTED AND BE ALLOWED TO STUDENT TEACH AND GRADUATE.

Applicant Signature______Date______

Return application packet to the following address: CWU Certification Office

400 E. University Way

Ellensburg, WA 98926-7414