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Summer 2014 Pre-Teaching Action Research Internship @ Centennial Place Academy

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Application deadline: Monday, April 7, 2014 by 11:59 p.m.

A complete application includes a completed applicationand two references. All materials must be received bySusan Belmonte at no later than April 7, 2014 at 11:59 p.m. Incomplete applications will not be considered.

GENERAL INFORMATION:

FIRST NAME:

LAST NAME:

GENDER:

GT#:

MAJOR:

MINOR:

EXPECTED GRADUATION DATE (MONTH/YEAR):

DATE OF BIRTH (MM/DD/YY):

EMAIL ADDRESS:

PHONE NUMBER:

How did you hear about the Pre-Teaching Centennial Place Academy Internship program?

COLLEGES AND UNIVERSITIES ATTENDED

List all colleges and universities you have attended or currently attend beginning with the most recent.

institution / dates of attendance / major content area / minor content area / degree level

HONORS, SCHOLARSHIPS, AND AWARDS

Lists all honors, scholarships, and awards received to attend college or while in college.

honor/scholarship/award / brief description / date received/dates valid

TUTORING, COACHING, AND MENTORING EXPERIENCE (includes volunteer and paid positions as well as other experience working with the K-12 age group) You may list experiences prior to coming to college.

organization / Responsibilities / age range(s) / date range

ADDITIONAL K-12 VOLUNTEER EXPERIENCE

Category includes volunteer and paid positions as well as other experience working with the K-12 age group) You may list experiences prior to coming to college and include information about leadership positions held.

organization / responsibilities / age range(s) / date range

EXTRA CURRICULAR ACTIVITIES AT GEORGIA TECH AND IN THE COMMUNITY (not K-12 oriented)

activity / description

CURRENT EMPLOYMENT

*The internship is a 30-hour a week commitment for ten weeks during summer term. The stipend for the internship comes from Georgia Tech funds, and university policies require that undergraduates work no more than 20 hours per week for any university unit or for a combination of units. You will not be able to work for Georgia Tech and intern. You will not be able to start the internship if you are on record as an employee for another Georgia Tech entity. If currently employed, please provide details.

organization / responsibilities / hours per week / supervisor (first and last name) / last day of employment

FINANCIAL AID

The internship will require you to work full-time during the summer and limit or exclude you from taking any courses for academic credit. The internship hours are tuition-free, audited hours. Financial aid programs often have strict rules about how many credit hours one must take in order to qualify for financial assistance. If you receive financial aid, you must check with a financial aid advisor to insure that you will be able to participate in an internship and keep your financial aid.

______I verify that have consulted with a financial aid advisor before submitting my application.

ACADEMIC ADVISOR

The internship will require you to work full-time during the summer and limit or exclude you from taking any courses for academic credit. You must check with your academic advisor before applying to insure that the internship will not prevent you from obtaining your academic goals.

______I verify that have consulted with an academic advisor before submitting my application.

LANGUAGES SPOKEN

language / level of proficiency (novice, intermediate, advanced, fluent) in speaking, reading and writing

REFERENCES

You need two references from individualswho can speak to your personal qualities as they relate to the internship. References should detail youracademic and personal strengths and your areas of improvement. At least one reference must come from a Georgia Tech faculty member. References may not come from friends or family members. Referees should email their references directly to Susan Belmonte, Pre-Teaching Advisor () no later than April 7, 2014 at 11:59 p.m. References emailed by applicants will not be accepted.

Please list your two references.

name / position / department/company

DEMOGRAPHICS

Under Title VI of the Civil Rights Act of 1964, we are required to ask the following question of U.S. citizens and permanent residents. Answers will not affect our admissions decisions. Your cooperation is requested and appreciated.

How do you describe yourself? (Optional)

______African-American
______Asian or Pacific Islander
______Hispanic/Latino

______Native American (American Indian, Alaska Native, Native Hawaiian)
______White, Non-Hispanic
_____Other (Please Specify) ______

TRANSCRIPT REVIEW PERMISSION

Applicants must have a 2.5 or above GPA and be in good academic standing to be eligible for this internship.

May representatives of the Pre-Teaching program check your transcripts? ____yes ____no

ESSAY QUESTIONS (Please respond to all four essay prompts.)

Essay #1: Why are you interested in this internship?
Essay #1 response
Essay #2: How would you acquire background knowledge about problem-based inquiry learning (PBIL) and Science, Technology, Engineering, and Mathematics (STEM) education for middle school before starting the internship?
Essay #2 response
Essay #3: What do you think the process should be for planning an action research project centered on the cultural development of a PBIL and STEM program at the middle school level?
Essay #3 response
Essay #4: Provide an example of how you would create an engaging, PBIL lesson to teach a basic scientific or mathematical concept using only tangible items such as candy, cardboard, string, water, etc. Assume that you will have no technology available. You may pick the concept. Be sure not to describe teaching a specific skill (calculating perimeter) as opposed to a concept (e.g. understanding force and motion).
Essay #4 response

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