Program Application
*pending GAPSC approval on May 18, 2010
Application Process: Please send in ONE packet including ALL items listed below to:
Pioneer RESA GaTAPP Program
Pioneer Regional Educational Service Agency
P.O. Box 1789, 1324 Highway 254
Cleveland, Georgia 30528
Incomplete application packets will not be accepted! Include the following items:
______Transcripts from all colleges and universities attended (legible copies accepted)
______A minimum GPA of 2.5 is required only for Core Academic Pathway
______Copy of GACE Basic Skills score reports or exemption through one of the following:
Completion of a Master’s degree (or higher):
degree earned ______date ______institution ______
ACT Score ______
Must meet combined Verbal and Math minimum score of 43
GRE Score ______
Must meet combined Verbal and Quantitative minimum score of 1030
SAT Score ______
Must meet combined Verbal and Math minimum score of 1000
______GACE Content Assessment passing score report (or passing score on Praxis II prior to September 1, 2006)
______GACE Professional Pedagogy Assessment passing score report (or passing score on Praxis II Principles of Learning and Teaching prior to September 1, 2006) – required ONLY for OYSP Pathway.
______Personal essay (typed on a separate page)
GaTAPP Application
Personal Information:
Name______
Address______
City______State______Zip Code ______
County of Residence______Home phone______
Cell ______Work ______
Email ______
Subject & Grade Teaching Assignment______(i.e. 8th grade Math, 6th grade Science, etc.)
List All Colleges Attended and Dates:
Degree: ______Date Awarded ______
Major ______GPA:______
(i.e. MA Electrical Engineering)
Institution______
(i.e. Georgia State University)
Degree: ______Date Awarded ______
Major ______GPA:______
Institution______
Degree: ______Date Awarded ______
Major ______GPA:______
Institution______
Was (were) your college(s) accredited at the time of your graduation? __ YES __NO
Check date of accreditation at www.ope.ed.gov/accreditation
ACCREDITATION IS MANDATORY.
Work History (most recent first)—Last 3 to 5 years
Employer ______Phone ______
Position Held ______Supervisor ______
Reason for Leaving ______
Beginning Date ______End Date ______
Employer ______Phone ______
Position Held ______Supervisor ______
Reason for Leaving ______
Beginning Date ______End Date ______
Are you legally authorized to work in the U.S. on a full-time basis? YES____ NO____
Have you ever:
Been dismissed from employment? YES____ NO____
Had credentials denied, revoked or suspended in any state? YES____ NO____
Received an unsatisfactory performance evaluation from an employer? YES____ NO____
Been placed on disciplinary probation or been suspended from any position? YES___ NO____
Been or are you now under investigation for unethical conduct? YES____ NO____
Been convicted of a felony, misdemeanor or pled nolo contendre, or are
you now under investigation for violation of any such offense? YES____ NO____
(You must include ANY offense for which a fine of $100 or more was imposed.)
Do not include any offense that occurred before your eighteenth birthday. YES_____ NO____
If you answered ‘YES’ to any of the have you ever questions, you MUST attach an explanation and supporting documents. If you fail to complete ALL of the above section, your application package will not be processed.
PERSONAL ESSAY – include on a separate page.
In a minimum of one page, explain your reasons for entering the teaching field, your goals and aspirations for this profession.
I CERTIFY ALL INFORMATION IS VERIFIED AND TRUE.
Legal Signature ______Date ______
For Office Use Only:
Payment______
Program Start Date______