School of Education, Health and Human Behavior

Founders Hall, Rm. 1110, Box 1062
Edwardsville, IL, 62026

FALL 2015
(Due date: April 1, 2015)

Submit this application by the due date even if eligibility requirements will not be competed until the end of Spring 2015. Written notification of admission status will be mailed or e-mailed to applicants in June 2015 to the address provided in section I. The program eligibility requirements are as follows:

1)     Completion of all skills/foundations courses (or approved equivalents) with a grade of C or better.
2)     Completion of CIED 100 / CI 200 and PSYC 201 or its equivalent with a grade of C or better.
3)     Combined GPA (all post-secondary work) of 2.5 or higher.
4)     Good academic standing at SIUE (if applicable).
5)     Passing score on the ILTS Basic Skills Test, Test of Academic Proficiency, or using ACT score in lieu of testing requirement
6)     Completion of 42 semester hours or more of college level course work.
7)     No more than 9-10 non-partnership program classes remaining at the end of summer term prior to fall program admission.  (Starting the Fall 2015 Partnership Program with 9-10 non-partnership program classes remaining may require taking classes in the Summer 2016 semester to graduate by Spring 2017.)  All copies of unofficial transcripts and test scores including Spring 2015 grades must be received by May 31st, 2015.

1. General Information


2. Using an ACT score in lieu of taking ILTS Basic Skills Test or Test of Academic Proficiency: (Please select one)

3. Partnership Program Admission requirements will be completed after: (Please select one)



4. CONFLICT OF INTEREST: Candidates are placed in schools for field experiences and student teaching within a 40 mile radius of the University; however, candidates may not be placed in schools in which they have a potential conflict of interest.  Conflicts to be avoided are schools in which the candidate has attended, has relatives employed or attending or has any other potential conflicts that may impact his or her placement at the school.  Please list any schools within a 40 mile radius of SIUE in which you may have a potential conflict of interest and the type of conflict.


5. HARDSHIPS: Please list any schools/districts/areas within a 40 mile radius of SIUE that would pose a hardship and the type of hardship.  Hardships might be driving distance from your home, schools that do not have special accommodations to meet your needs, distance from daycare, etc.  SOEHHB Student Services cannot guarantee you will not be placed in any schools listed,  but we will work to best accommodate your needs within the program parameters in seeking a field placement.  Please take notice that SOEHHB Student Services will not make changes after placements are established. 

6. SPECIAL CIRCUMSTANCES: Special Circumstances You will intern in diverse schools all over the region and may be required to drive up to 20-40 miles from campus. You are required to provide your own transportation. If there are any special accessibility needs or accommodations we should consider when making your placements, please provide an explanation.


Important Application Information:

Criminal Background Check:

All students must complete a criminal background check and be clear of all enumerated offenses (those offenses that would prohibit one from becoming certified to teach in the State of Illinois). The background check must be complete before the full admission into the program. Information on the background check and current dates may be found at

Based on the above information, I am eligible to apply for admission to the Early Childhood Education Partnership Program for Fall 2015. I understand that being eligible (or declared) does not guarantee admission.

I have read and understand the admission policy and the Partnership Information sheet. If I am attending institutions other than SIUE, I understand that it is my responsibility to provide my SOE Student Services advisor copies of my most updated transcripts including Spring 15 grades by May 31st, 2015.

I also understand that it is my responsibility to verify with my advisor my GPA from all previous college course work and test scores that are being submitted to the faculty to verify accuracy that are being submitted to the faculty to verify accuracy. If I am admitted, I give my advisor permission to enroll me in the Partnership Program courses.


The edTPA is an Illinois teaching licensure requirement for all teacher candidates who graduate after September 1, 2015. As part of the edTPA, the teacher candidate must video his/her teaching performance and the impact this instruction has on student learning. Studentsí images and their voices must be recorded and student work samples scanned as evidence that learning occurred. The handling and use of the recordings and the student work samples must be done in such a manner that students and their work remain confidential throughout the process.

Following are your responsibilities in this process:

I will use any student work samples, any audio recordings and/or any video recordings for the sole purpose of the preparation and submission for the edTPA assessment as directed by my instructors at SIUE. I will not use these work samples or recordings for any other purpose.

I will do whatever is reasonable to protect the confidentially of any student work samples, and audio recordings and/or any video recordings of the students that I collect as part of my field experience or student teaching experience. I will only use first names of the students and will avoid using the name of the school and/or district when identifying student work samples or making recordings.

I understand that any scanned student work samples, any audio recordings and any video recordings will ONLY be uploaded to secure servers at SIUE for the purpose of evaluating my teaching knowledge, skills, and dispositions. Also, I will promptly delete any and all of these student work sample images, audio recordings, and/or video recordings from any devices other than the secure servers at SIUE; this deletion will occur absolutely no later than 24 hours after the end of the semester in which the images or recordings were made.

7. By submitting this application, I give consent for SIUE to share any educational records, background check information, and edTPA information with school partners.