Office of Clinical Experiences, Certification & Advisement
Founders Hall, Rm. 1110, Box 1062
Edwardsville, IL, 62026
(618) 650-3940
ocecahelpdesk@siue.edu

ELEMENTARY PARTNERSHIP APPLICATION
FALL 2012
(Due date: April 1, 2012)

Submit this application by the due date even if eligibility requirements will not be competed until the end of Spring 2012. Written notification of admission status will be mailed or e-mailed to applicants in June 2012 to the address provided in section I. The application eligibility requirements are as follows:

1)     Completion of all skills courses (or approved equivalents) with a grade of C or better: ENG 101, ENG 102, SPC 103/104/105, PHIL 106, and CMIS 108.
2)     Completion of CI 200 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 ICTS Basic Skills Test.
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. Candidates must have PSYC 201 (Child Psychology) or the equivalent by the end of the summer 12 to remain eligible for the Elementary Education Partnership Program in the fall. All copies of unofficial transcripts and test scores including Spring 12 grades must be received by May 31st, 2012.

SECTION I

1. General Information

Last Name
First Name
SIUEID
Address
City
State
Zip
Phone
Cell Phone
SIUE E-mail
Other E-mail
Address during the Program (if different from above)
Address
City
State
Zip
Elementary School attended
Middle School attended

SECTION II:

2. 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.

3. 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. OCECA 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 OCECA will not make changes after placements are established.

4. SPECIAL CIRCUMSTANCES: You will intern in diverse schools all over the region and may be required to drive up to 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:
http://www.siue.edu/education/advisement/backgroundcheckinfo.shtml

Based on the above information, I am eligible to apply for admission to the Elementary Education Partnership Program for Fall 2012. 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 OCECA advisor copies of my most updated transcripts including Spring 12 grades by May 31st, 2012.

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.

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

Agree
Disagree

http://www.siue.edu/education