APPLICATION FOR UNCONDITIONAL ADMISSION TO A
GRADUATE EDUCATOR PREPARATION PROGRAM (GEPP/GTEP)

Please Print

Last Name First Middle Maiden
Street Address City State Zip
Student ID (starts with L) Social Security Number Birthdate
L
Phone Number UNA Portal Email Address
@una.edu

Indicate your sex:

___Male ___Female

Indicate your ethnicity:

___Hispanic/Latino ___N/A

Indicate your race:

___American Indian or Alaska Native ___Asian___Black or African American ___Native Hawaiian or Other Pacific Islander
___White

Check the graduate teacher education program(s) you are applying for (select all that apply):

*School Counseling and Instructional Leadership candidates are not required to submit this application.

Alternative (5th year) Master’s Programs / Traditional Master’s Programs / Education Specialist Programs
Biology / Biology / Elementary Education
Business Marketing / Business Marketing / Teacher Leader
Chemistry / Chemistry
English Language Arts / Collaborative Teacher K-6
ESOL / Collaborative Teacher 6-12
General Science / Elementary Education
General Social Science / ESOL
History / English Language Arts
Mathematics / General Science
Music, Choral / General Social Science
Music, Instrumental / Geography
Physical Education / History
Mathematics
Music, Choral
Music, Instrumental
Physical Education
Physics

Continued on reverse side of application

Additional information

Requirements for unconditional admission to GEPP are outlined in the catalog.

Applications will be reviewed and audited by the Certification Officer.

If denied admission to GEPP, candidates must re-apply to be reviewed again at a later date.

If admitted to GEPP, your admission status may be revoked if you fall below the required standards, including (but not limited to) unacceptable disposition ratings, unacceptable grade point average, revocation of background clearance, or inactivity in the program.

Candidates may not take more than five graduate classes prior to unconditional admission to GEPP.

Advisor signatures:

*If your advisor is not available, you may obtain signatures from the appropriate department chair(s) instead.

Education Advisor Signature* Date
(both Elementary and Secondary Majors) / Teaching Field Advisor Signature* Date
(All secondary education “teaching field” majorsexcept PE)

Student signature

By signing this application, I affirm that:

I am knowledgeable of and agree to abide by UNA’s policies concerningGEPP.

I understand that incomplete applications will not be reviewed.

I understand that documentation of all requirements must be on file in the Office of Educator Preparationprior to this application being reviewed.

Student Signature Date

Return this application to the Office of Educator Preparation – SH515