Lehman Urban Transformative Education-Teachers Opportunity Corps (LUTE-TOC) Undergraduate Scholar
Application for Admission for Spring 2017
Application Directions
Use this Application for Admission to apply to The TOC program if you are:
A: An undergraduate who are interested in pursuing a teaching profession.
B: An undergraduate who are currently enrolled in a teacher education program.
C: A college transfer who submitted a Transfer Application for Admission on-line.
Call the Lehman CollegeTOC Office at 718-960-5137 with any questions.
Please complete the application form along with two completed recommendation formsand send to:
Ms. Traci Palmieri, Director
The Lehman College TOC Program
School of Education
Carman Hall Room 176
Lehman College
250 Bedford Park Blvd. West
Bronx, NY 10468
Section 1: Applicant Information (please print or type)
Name: Last ______First ______MI ______
Address: ______City State Zip Code
Phone(s): ______
E-Mail Address: ______
Date of Birth: ______Gender: MF New York State resident: Yes No
I am a: □ US Citizen □ Permanent Resident
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Section 2: Please indicate which of the following categories you identify with. You may check more than one.
□ Alaskan Native (Eskimo or Aleut)□ Hispanic or Latino
□ American Indian□ Native Pacific Islander
□ Asian□ White
□ Black or African American□ Other ______
□ Decline to State
Section 3: List all colleges and the dates attended (attach separate sheet if needed).
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Section 4:
# of Credits Completed: ______GPA: _____ Date degree expected: ______
Major (e.g., mathematics, chemistry, etc): ______
Education Minor: ______Leading to Teacher Certification: YesNo
Minor to Master’s: YesNo
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Section 5: List courses you still need to satisfy graduation requirements (attach a separate sheet if needed).
Note: Non-Lehman Applicants must submit their official copy of transcript along with the application.
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Section 6:
Name of Recommender One: ______
Name of Recommender Two: ______
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Section 7: Personal Statements, Short Essay: Becoming a Teacher
In 500 words, explain why you would like to be a teacher. Tell us what you would do differently from teachersyou have known. Tell us what you would emulate from teachers who have inspired you.
Please tell us any additional information about yourself that you believe would help the Admissions Committee for The TOC Programin reviewing your application.
The information that I have provided in this application is correct to the best of my knowledge.
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Applicant’s Signature Date
The City University of New York does not discriminate on the basis of race, religion, sex, age, creed, color, national origin, physical or mental disability, sexual orientation, marital status, citizenship status, or veteran status.
Please be aware that all documents submitted in support of an application for admission become the permanent possession of CUNY and will not be returned.
Please be certain that all of the information requested in the application is answered fully and correctly.
The CUNY policy regarding fraudulent documents can be viewed on our website at
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