Alternate Application to the Teacher Certification Program (TCP)

Note: This application is to be used by any student who meets one of the following conditions:

1. Student completed EDUC 300 prior to August 2014,

2. Student completed the equivalent of EDUC 300 at another institution, or

3. Student is admitted to the Graduate-Level Teacher Certification (post-baccalaureate) program.

Personal Data

Last Name:	First Name:	(Maiden):

Student ID#:	DOB: / /	SSN:

Street Address:

City, State, Zip:

Local Phone: ( )	Cell phone: ( )	Email:

Campus Location:	Advisor:

Ethnic Origin: (optional)	Gender (optional):

Area of Certification:	I have declared my education certification minor for this area.

Service Learning

List below information related to volunteer service learning experiences. Activities that qualify for ‘service learning’ include, but are not limited to: attending student/parent/teacher conferences or school-sponsored events; coaching youth sports; teaching Sunday School; volunteering at schools (beyond scheduled field experience hours); volunteering with a non-profit organization (ex: First Steps, Food Bank, Red Cross, Boys & Girls Club, etc.); participating in KDP and/or TEACH activities.

Memberships (Clubs and Organizations):

Related Work Experience: (Most recent listed first)

Position #1:	Dates:

Position #2:	Dates:

Position #3:	Dates:

Position #4:	Dates:

Position #5:	Dates:

Education Data

GPA

To be recommended to the state for certification, students must have a cumulative GPA of 2.75 or above; no grade lower than “C” in professional education courses; GPA of 3.0 or above in education/psychology courses.

I meet the GPA requirements and have no grade lower than “C” in professional education courses.

I do not meet the GPA and/or no grade of “C” requirements.

Explanation if requirements not met:

Core Courses

Students must complete the core courses prior to entry to the TCP: EDUC 100, EDUC 300/505, EDUC 200/542, and EDUC 230/560.

I have completed all core courses.

I have not completed all core courses.

Explanation if requirements not met:

MoGEA (not required for post-bacc students)

English	Writing	Math Science/Social Studies

Professional Commitment

In three or four paragraphs, discuss your commitment to the teaching profession. Why do you want to become a teacher? What evidence do you have that you are a good fit for the profession? What have you done, or what will you do to ensure that you are an effective teacher? Use specific examples from field experiences and education courses to support your statements.

Strengths and Areas of Improvement

In four or five paragraphs, summarize your strengths and identify areas in need of improvement in relation to the Missouri Teacher Standards (oeq-ed-TeacherStandards | Missouri Department of Elementary and Secondary Education (mo.gov)). Be specific. You may attach to your application up to three artifacts from your coursework or work in the field that serve to highlight your strengths. Based on your areas of improvement, identify three-to-five specific and measurable goals that you would like to master prior to student teaching.

SUBMIT THE COMPLETED FORM ALONG WITH ARTIFACTS TO EducatorPrep@ccis.edu AND UPLOAD A COPY TO COUGARTEACH. BE SURE TO KEEP A COPY FOR YOUR RECORDS.