School of Education, Health and Human Behavior

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

FALL 2014
(Due date: April 1, 2014)

Submit this application by the due date even if eligibility requirements will not be competed until the end of Spring 2014. Written notification of admission status will be mailed or e-mailed to applicants in June 2014 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 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 2014 Partnership Program with 9-10 non-partnership program classes remaining may require taking classes in the Summer 2015 semester to graduate by Spring 2016.)  All copies of unofficial transcripts and test scores including Spring 2014 grades must be received by May 31st, 2014.

1. General Information
Address during the Program (if different from above)

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 Elementary Education Partnership Program for Fall 2014. 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 SOEHHB Student Services advisor copies of my most updated transcripts including Spring 13 grades by May 31st, 2014.

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.

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