Special Education: Undergraduate Program

Special Education: Undergraduate Program

Admission Application Form - EDINA PROGRAM

Application Deadline:October 15

To apply:

1. Complete all parts of this application form.

2. Attach a current unofficial MSU transcript,a DARS report, essay, and 2 completed Disposition Evaluations.(Essay prompt and Disposition Evaluation forms can be downloaded from the Special Education web site.)

3. Submit all materials to the Department of Special Education Office byOctober 15 at 4:00 p.m. to the attention ofDr. Teri Wallace 313 Armstrong Hall, Minnesota State University, Mankato, Mankato, MN 56001. Note: If you are sending in the mail, postmark of October 15th.

4. You will be notified of your admission status by November 15 using the email provided below.

Student Name:______/ Tech ID:______/ Date Submitted:______
Current Mailing Address:______
Phone Number: ______/ Email:______
Cumulative GPA: ______

Indicate the semester you have or will be taking the College of Education General Education Prerequisites below: Semester Grade

Math 201: / Equivalent:
HLTH 240 (310) / Equivalent:
HLTH 210 (First Aid/CPR) or CDIS 205: (Sign Language) / Equivalent:

Indicate the semester you have or will be taking the ABS Block One courses below: Semester Grade

SPED 408: Individuals with Diverse and Exceptional Needs / Equivalent:
SPED 409: Learning and Human Development for Diverse Learners / Equivalent:
SPED 401: IEP Writing and Professional Practice / Equivalent:
Equivalent:

Have you completed an AA or AS degree at a Community College? Yes ___ No ____ If so, where and when was it granted?______

Have you been accepted to Minnesota State Mankato? Yes ___ No ____

If you have passed the Minnesota Teacher Licensure Exams, please provide scores? Math______, Reading______, Writing______

NOTE: If you have completed an Associate’s degree and have attached a DARS, you do not need to complete the following.

Use a “W” to indicate writing intensive courses / Course Number and Name / Semester and Grade
Category 1A: Communications: English Comp
Category 1B: Communications: Speech and Oral Reasoning
Category 1C: Communications: Writing Intensive / 1.
2.
Category 2: Critical Thinking
Category 3: Natural Science / 1.
2.
Category 4: Mathematical/Logical Reasoning / MATH 201: Elements of Math
Category 5: History & The Social & Behavioral Sciences / 1. HLTH 240 (310): Drug Education
2.
Category 6: Humanities & The Arts / 1.
2.
Category 7: Human Diversity
Category 8: Global Perspective
Category 9: Ethical & Civic Responsibility
Category 10: People & The Environment
Category 11: Performance & Participation / CDIS 205 or HLTH 210 (circle one)
Category 12: First Year Experience
Category 13: Information Technology
Cultural Diversity Requirement / 1.
2.

FOR SPECIAL EDUCATION OFFICE USE ONLY:

Admission: YES ____NO ____ OTHER ____

Form Revised August 2013