Department of Health, Physical Education, and Sport Science

Fall 2008

GENERAL INSTRUCTIONS

ADMISSION TO TEACHER EDUCATION

DEPARTMENT OF HEALTH, PHYSICAL EDUCATION, AND SPORT SCIENCE

Read Carefully

For students seeking P-12 certification in health and physical education, application must be made for Admission to Teacher Education. In addition to the criteria for Admission to Teacher Education, the Department

of Health, Physical Education, and Sport Science requires that the following criteria also be met:

completed with a “C” or better: HPS 1000 & 2000; EDUC 2110; BIOL 2221; ENGL 1101 & 1102; passed the Regents’ Exam; and passed GACE Basic Skills Exam (state mandated exam).

achieved a GPA or AGPA of 2.75 (for students new to KSU - Fall 1999); for all coursework at KSU.

transfer students must have a 2.75 GPA on all general education core and lower division courses related to the major (Area F) taken at their previous institution(s) and KSU.

received a minimum letter grade of “C” in all required HPS major courses.

completed a minimum of three hours of professional skills courses with an AGPA of 2.75 orbetter.

submitted three acceptable faculty recommendations, a current completed course check sheet and a copy of passing GACE Basic Skills Test Scores (or transcript with SAT/ACT scores of 1000/43 for exemption).

exhibited responsible professional behavior in classes, field experiences and interactions with peers and faculty.

demonstrated interest in the field through participation in and contribution to majors' club and/or other professional activities.

expressed a desire to enter teacher education through a well-written personal narrativeemphasizing experiences relevant to teaching.

passed the Background Criminal History check.

As a health and physical education major seeking P-12 teacher certification, you will need to complete twosets of

forms:

I.Health and Physical Education (blue forms)

and

II.Professional Teacher Education Unit (yellow forms)

Please follow the instructions given on the next page for the completion and return of the yellow Professional Teacher Education Unit forms.

The HPS Department application (blue) should be completed in consultation with your academic advisor who will meet with you to verify your academic record and plan your course of study. The application must be completed and returned to the Chair of the HPS Departmental Admissions Committee on or before the date required for submission of the Professional Teacher Education Unit application (yellow).

HPS TEACHER EDUCATION
ADMISSION DEADLINE / SUBMIT
MATERIALS BY:
Fall Semester / March 15
Spring Semester / September 15

Effective: Spring 2009

APPLICATION FOR ADMISSION TO HPS PROGRAM

MAJOR: P-12 Health & Physical Education

DATE KSU#

NAME

LASTFIRSTMIDDLE

PERMANENT ADDRESS

MAILING ADDRESS

PHONE ______(home)______(cell)

E-MAIL ______

THE FOLLOWING INFORMATION MUST BE VERIFIED BY THE STUDENT'S ACADEMIC ADVISOR:

Passed / Grade / Date Passed
Yes / No
Regent’s Exam
Praxis I or GACE Basic Skills Exams*
Completed / GRADE
Yes / No
45 Hours
BIOL 2221
EDUC 2110
ENGL 1101
ENGL 1102
HPS 1000
HPS 2000

* Required Prior to being admitted. If exempt must provide documentation.

Activity Courses Completed:

Outstanding Program Admission Requirements(including courses enrolled in this semester):

______

Has this student made below a letter grade of "C" in any HPS course which has not been retaken and replaced with a grade of "C" or better? YES NO If "YES", please specify courses:

______

Has this student been convicted of a felony or have a criminal arrest record? YES NO

I confirm that all of the above information is correct.

DATE

APPLICANT'S SIGNATUREACADEMIC ADVISOR'S SIGNATURE

DIRECTIONS TO STUDENT: Attach to this form (1) the form for indicating professional involvement, (2) a current copy of the checksheet, (3) one copy of the proposed plan of study worked out by you and your advisor, and (4) personal narrative. When the application is complete, return to the Chair of the HPS Departmental Admissions Committee.

Three (3) letters of recommendation are required: one from your advisor and two from other faculty who are familiar with your work. Please type each individual’s name who will submit a copy of the recommendation form on your behalf.

NAMEDEPARTMENT

Academic Advisor HPS

Faculty Member

ADMISSION TO HPS PROGRAM

PROFESSIONAL INVOLVEMENT

List all activities in which you have been or plan to be actively involved while a student at KennesawStateUniversity. Include both campus and offcampus activities (e.g., HPS Majors Club, KSU student organizations, professional, community, and church organizations, etc.) (Add separate sheet if

necessary).

SPECIFIC NATURE

ORGANIZATIONOF INVOLVEMENTOFFICES HELDDATES

Type and attach to the application:

Submit an essay demonstrating a proficiency in English, setting forth the reasons for wanting to enroll in a teacher preparation program and emphasizing experiences relevant to teaching.

ADMISSION TO HPS TEACHER EDUCATION PROGRAM

RECOMMENDATION FORM #1 of 3

I have worked with in the following

Name of StudentName of Faculty Member

capacity/courses:Advisor Courses , ,

I do not desire further access to this document. It is my understanding that this recommendation will be part of my application to the Health and Physical Education Program and that only Health and Physical Education faculty may have direct access to it.

Signature of ApplicantDate

Please respond to the following statements by circling the number in the appropriate column. For those items that are not observed, circle the "X".

The student being evaluated: NOT OBSERVED/

ALWAYSUSUALLYSELDOMAPPLICABLE

54321X

1.Completes assignments on time.54321X

2.Meets standards defined by the

instructor.54321X

3.Demonstrates acquisition of

knowledge basic to discipline.54321X

4.Demonstrates ability to apply

knowledge basic to discipline.54321X

5. Works effectively with others.54321X

6.Demonstrates respect and

cooperation with instructor.54321X

7.Demonstrates initiative in

completing tasks.54321X

8.Accepts opinions and actions

different from his/her own.54321X

9.Communicates effectively verbally.54321X

10.Communicates effectively in

written form.54321X

11.Shows physical vitality and

alertness.54321X

The student being evaluated: NOT OBSERVED/

ALWAYSUSUALLYSELDOMAPPLICABLE

54321X

12.Exhibits a positive attitude.54321X

13.Dresses appropriately and is

well groomed.54321X

14.Exhibits enthusiasm and

friendliness.54321X

15.Shows maturity in the classroom.54321X

16.Shows maturity in professional

activities.54321X

Practices regular and punctual

Attendance.54321X

Comments on student's potential as a professional facilitator of learning.

Recommend Recommend with Reservation Do Not Recommend

SignatureDept. Date

When form is completed, please return to Chair of HPS Admissions Committee.

ADMISSION TO HPS TEACHER EDUCATION PROGRAM

RECOMMENDATION FORM #2 of 3

I have worked with in the following

Name of StudentName of Faculty Member

capacity/courses:Advisor Courses , ,

Signature of ApplicantDate

Please respond to the following statements by circling the number in the appropriate column. For those items that are not observed, circle the "X".

The student being evaluated: NOT OBSERVED/

ALWAYSUSUALLYSELDOMAPPLICABLE

54321X

1.Completes assignments on time.54321X

2.Meets standards defined by the

instructor.54321X

3.Demonstrates acquisition of

knowledge basic to discipline.54321X

4.Demonstrates ability to apply

knowledge basic to discipline.54321X

5. Works effectively with others.54321X

6.Demonstrates respect and

cooperation with instructor.54321X

7.Demonstrates initiative in

completing tasks.54321X

8.Accepts opinions and actions

different from his/her own.54321X

9.Communicates effectively verbally.54321X

10.Communicates effectively in

written form.54321X

11.Shows physical vitality and

alertness.54321X

The student being evaluated: NOT OBSERVED/

ALWAYSUSUALLYSELDOMAPPLICABLE

54321X

12.Exhibits a positive attitude.54321X

13.Dresses appropriately and is

well groomed.54321X

14.Exhibits enthusiasm and

friendliness.54321X

15.Shows maturity in the classroom.54321X

16.Shows maturity in professional

activities.54321X

Practices regular and punctual

Attendance.54321X

Comments on student's potential as a professional facilitator of learning.

Recommend Recommend with Reservation Do Not Recommend

SignatureDept. Date

When form is completed, please return to Chair of HPS Admissions Committee.

ADMISSION TO HPS TEACHER EDUCATION PROGRAM

RECOMMENDATION FORM #3 of 3

I have worked with in the following

Name of StudentName of Faculty Member

capacity/courses:Advisor Courses , ,

Signature of ApplicantDate

Please respond to the following statements by circling the number in the appropriate column. For those items that are not observed, circle the "X".

The student being evaluated: NOT OBSERVED/

ALWAYSUSUALLYSELDOMAPPLICABLE

54321X

1.Completes assignments on time.54321X

2.Meets standards defined by the

instructor.54321X

3.Demonstrates acquisition of

knowledge basic to discipline.54321X

4.Demonstrates ability to apply

knowledge basic to discipline.54321X

5. Works effectively with others.54321X

6.Demonstrates respect and

cooperation with instructor.54321X

7.Demonstrates initiative in

completing tasks.54321X

8.Accepts opinions and actions

different from his/her own.54321X

9.Communicates effectively verbally.54321X

10.Communicates effectively in

written form.54321X

11.Shows physical vitality and

alertness.54321X

The student being evaluated: NOT OBSERVED/

ALWAYSUSUALLYSELDOMAPPLICABLE

54321X

12.Exhibits a positive attitude.54321X

13.Dresses appropriately and is

well groomed.54321X

14.Exhibits enthusiasm and

friendliness.54321X

15.Shows maturity in the classroom.54321X

16.Shows maturity in professional

activities.54321X

Practices regular and punctual

Attendance.54321X

Comments on student's potential as a professional facilitator of learning.

Recommend Recommend with Reservation Do Not Recommend

SignatureDept. Date

When form is completed, please return to Chair of HPS Admissions Committee.

KENNESAW STATE UNIVERSITY
Department of Health, Physical Education, and Sport Science
Projected Class Schedule
Candidate: / Date: / Concentration: / P-12
KSU #: / Phone #: / Matriculation Date:
Fall Semester / Spring Semester / Summer Session
200_ / 200_ / 200_
Course / # / HRS / Course / # / HRS / Course / # / HRS
Total Hrs.: / Total Hrs.: / Total Hrs.:
Fall Semester / Spring Semester / Summer Session
200_ / 200_ / 200_
Course / # / HRS / Course / # / HRS / Course / # / HRS
Total Hrs: / Total Hrs: / Total Hrs:
Fall Semester / Spring Semester / Summer Session
200_ / 200_ / 200_
Course / # / HRS / Course / # / HRS / Course / # / HRS
Total Hrs: / Total Hrs: / Total Hrs.
Advisor: / Candidate:
Comments:
Candidate must pass GACE HPE Exams 115 & 116 for teacher certification
Completed Req.
Date / Date
Admitted toProgram: / GACE Basic Skills:
Practicum I Apply: / GACE HPE Exams:
Practicum II Apply: / Petition to Graduate:
Student Teach Apply:

UNDERGRADUATE TEACHER EDUCATION ADMISSION APPLICATION FEE

Students submitting an application after February 15, 2006 must pay a non-refundable undergraduate Admission to Teacher Education Application Fee of $20.00. T.E. admission applications will not be accepted after February 15, 2006, without proof of fee payment.

Payments for the Admission to Teacher Education Application Fee must be paid at the Bursar’s Office using check or money order only. All checks or money orders must be made payable to KSU. You will be able to obtain a receipt from the Bursar’s Office at the time of payment.

A copy of the Bursar’s Office receipt must accompany the application for admission to teacher education for any application submitted after February 15, 2006. If a student cannot locate this receipt, a duplicate receipt should be requested from the Bursar’s Office. Please note that requests for duplicate receipts will be processed in a timely manner, but will not be available immediately.

Location of Bursar’s Office: Carmichael Student Center 233

Types of Payment: Check or Money Order only

Bursar’s Office Phone: 770-423-6013

All T.E. applications (and copy of receipt) must be submitted to:

PTEU Admissions Coordinator

TeacherEducationAdvisementCenter (TEAC)

KHE 3018

____________

APPLICATION FOR ADMISSION TO TEACHER EDUCATION

SEMESTER APPLYING FOR: ______

Term/Year

1. NAME: ______MATRICULATION DATE: ______

Last First MI Term/Year

2. KSU ID: ______KSU E-MAIL:

OTHER: ______

3. ADDRESS: ______

Number & Street

______

City State ZIP

4. HOME PHONE: ______WORK: ______CELL: ______

5. GENDER: Female: ______Male: ______

6. STATUS: Full-time: ______Part-time: ______

7. (A) ETHNICITY:

American Indian/Alaskan Native: _____Hispanic: _____

Asian/Pacific American: _____Multiracial: _____

Black (Not Hispanic Origin): _____White (Not Hispanic Origin): _____

(B) CITIZENSHIP:

Alien, Non-resident: _____ Alien, Resident: _____ U.S. Citizen: _____

8. EARNED BS/BA DEGREE: Yes: _____ (If yes, see below) No: _____

Major: ______College: ______Degree: ______

9. APPLYING FOR ADMISSION TO:

□Art Education□Biology Education□Chemistry Education

□Early Childhood Education□English Education□French Education

□Health and Physical Education□History Education□Math Education

□Middle Grades Education/Concentrations: ______/______

□Music Education□Spanish Education

10. SUCCESSFULLY COMPLETED A TEACHER CADET/YOUTH APPRENTICESHIP PROGRAM?

Yes _____No _____ (If yes, please forward a copy of your certificate to TEAC or OFE)

BEFORE SIGNING:

□Attach the receipt for your application fee?

□Understand that you must request a supplemental Teacher Recommendation for each

EDUC 2201/2202/2204 taken at another institution? (EDUC 2110/2130 after SU07)

□N/A

□Complete a Criminal Background Request form if EDUC 2110 was taken at another institution?

Or if EDUC 2110 or EDUC 2201 was taken at KSU more than two years ago?

□N/A

To the best of my knowledge, all information on this application is accurate and complete.

Student signature: ______Date: ______

I have provided the student named above with professional advisement services to include teacher

education admission criteria and procedures.

KSU advisor’s signature: ______Date: ______

Return completed form with accompanying documents to Kennesaw Hall, 3018

PTEU Admissions Coordinator

TeacherEducationAdvisementCenter

Kennesaw Hall, Suite 3018

KennesawStateUniversity

1000 Chastain Road, #0126

Kennesaw, GA30144

Phone: (770) 423-6105

E-mail:

Revised 6/5/09

Kennesaw State University

BagwellCollege of Education

Office of Field Experiences

All school systems with which KennesawStateUniversity maintains a partnership for field experiences requires a clear criminal history and one million dollars of liability insurance before the student may be placed in a school for a field experience. Securing criminal history clearance and insurance coverage and maintaining both are the responsibility of the KSU student and speak to the student’s level of professionalism.

Criminal Background Check

KennesawStateUniversityhas chosen CertifiedBackground.com as our approved source for background checks.
Each KSU student will order and purchase his/her own background check directly online. The cost will be $30.00 payable by Visa, MasterCard or money order.
The results of the background check will be posted to the CertifiedBackground.com website in a secure, tamperproof environment. Once the order is submitted, the student will receive a secure password to view and print the results of the check. The results will be available in approximately 48-72 hours.

HOW TO ORDER

You will need your Student ID number, social security number,

Visa or MasterCard.

Go to and click on Students.
In the Package Code Box, enter KE61.
Select a method of payment: Visa, MasterCard, Money Order.
Answer all questions and click on Submit.

Contact for help: 1 (888) 666-7788

Liability Insurance

Complete the attached “Verification of Liability Insurance” form and return the form to your instructor at the end of class.

If you need to include attachments (see below) or delay turning in the form for any reason, please return to the Office of Field Experiences. You may not begin any field experience before the “Verification of Liability Insurance” form has been received in the OFE.

For a small fee, you may obtain coverage by joining one of the following student organizations:

Georgia Association of Educators (GAE)

Membership Signup:

Main Home Page:

Student Professional Association of Georgia Educators (SPAGE)

Membership Signup:

Main Home Page: Same as above.

If you choose a personal insurance carrier, you must verifywith the carrier that you have $1,000,000 of tort liability coverage. Attach that verification to your form.

If you choose to waive this $1,000,000 tort liability coverage, please write a statement to that effect, sign and date, and attach to your form.

KennesawStateUniversity

BagwellCollege of Education

Office of Field Experiences

VERIFICATION OF LIABILITY INSURANCE

The following is a part of the State Department of Education Guidelines for Professional Laboratory Experiences in Georgia Teacher Education Programs: “. . . Prior to professional laboratory experiences placement, students must provide evidence of having adequate tort liability or waive such coverage in writing.”

All school systems with which KSU maintains a partnership and in which students are placed for field (laboratory) experiences require liability insurance. Therefore, KSU students must secure coverage before a field placement will be arranged and must maintain that coverage for all subsequent field experiences. Signing below verifies this commitment.

______/______

Instructor’s name Course Title Section #

Admission to Teacher Education

I verify that I will obtain tort liability insurance in the amount of $1,000,000 before I begin the field experience noted above and I will maintain this coverage for all subsequent field experiences at KennesawStateUniversity.

Print Full Name Maiden Name

______

Name of Organization/ Company Application Date

KSU ID# Email Address Best Phone

______

Signature Today’s Date

Personal Affirmation

Full Name (PRINT) Maiden Name

I have resided in the following counties and states outside of Georgia (on or after my 17th birthday):

______

Please answer this question based on events that occurred on or after your 17th birthday. Do not include minor traffic incidences.

For any felony or for any misdemeanor, have you ever:

Plead guilty? Been found guilty? Entered a plea of nolo contendere? Been granted first offender status? Participated in a pre-trial diversion program? Been placed under a court order whereby an adjudication (judgment/disposition) or sentence was withheld?

______Yes ______NO

If you answered Yes to the above question, please write a narrative explaining the offense(s). Include the charge, date of incident, misdemeanor or felony, disposition (guilty, nolo, dismissed, first offender, etc.). Be able to produce court documents upon request.

______

SUBSEQUENT AFFIRMATION

I further understand that if I am involved in an incident(s) that requires a YES response to the above question and occurs between the date of my signature below and the date of my signature on the Student Teaching Application, I will report the offense to the Office of Field Experiences.

I affirm that the information that I provided above is true, correct and complete.

Signature Today’s Date

______

Best Phone Number