Teacher Certification Program Entry Requirements Checklist

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1 Teacher Certification Program Entry Requirements Checklist Please print in ink. Completed application must be received by December 15 with a nonrefundable $60 application fee. Incomplete applications will not be reviewed. Note: In the case that you are not accepted your file will be kept for two years then destroyed. Requirements for program entry may change depending on pending changes in State Board for Educator Certification rules. Name: Last First Middle Completed, signed application and non-refundable application fee to be submitted to: ACC s Center for Teacher Certification 5930 Middle Fiskville Rd Austin, Texas Minimum Requirements for All Applicants! PACT Test Passed in certification area: Bachelor s degree from an accredited university with a minimum of 2.5 GPA with 24 credit hours in appropriate content area! Original college transcripts sent by colleges showing college/university coursework, number of subject hours, overall GPA, proof of Bachelor s degree, and any advanced degrees from an accredited university. If applying on-line for transcripts, designate ACC-TCP! If transcripts are from a foreign country, they must first be evaluated by a TEA Vendor and the evaluation must state that your degree is equal to an American Bachelor s degree; then you must pass the TOEFL. A list of TEA recognized vendors can be found at State_Certification/Foreign_Credential_Evaluation_Services/! Three references mailed to ACC from former/current employers (2) and people (1) who know of your teaching and leadership experience (Use the attached form on the application.)! Interview (Once your application has been submitted, you will be called to schedule an interview.)! Valid address and regular access to a computer! Financial ability to pay program fees and tuition by deadlines! Signed Candidate Agreement! One page resume listing any experiences in teaching children or work that would enhance teaching children In addition to the above minimum requirements, please be sure that you meet the following technical standards:! Ability to complete requirements independently! Ability to understand and implement directions! Ability to effectively communicate with students, faculty and staff Additional Requirements for Future Bilingual/Spanish Teachers! Ability to focus in a high distracting environment through multi-task completion! Academic ability in both English and Spanish (reading, writing, speaking) TOEFL (if degree is from another country), which must be passed (an overall passing score of 77 and a 26 on the speaking portion) PRIOR to admission and passing ESL score from ACC ESL Department.! If not an American citizen, an applicant for permanent status with an I-485 and Employment Authorization Document (EAD). ACC Teacher Certification Program Application 1

2 Program Application Please print in ink. Social Security Number Date: Name: Last First Middle Indicate other identifying name(s) that may appear on your documentation: Driver s License Number: State: Expiration Date: Date of Birth: Gender: Male Female Month/Day/Year Address: Street City State Zip Telephone: ( ) ( ) Daytime Phone Number Evening Phone Number address: Fax Number: Current School (if employed): School Name School District Select one certification: American Sign Language EC-12 Bilingual EC-6 Bilingual 4-8 English as a Second Language Generalist 4-8 Generalist EC-6 Generalist 4-8 Math 4-8 Math 7-12 Math/Science 4-8 Math/Science 7-12 Science 4-8 Science 7-12 Special Education EC-12 Technology Applications EC-12 The following voluntary information is for reporting purposes to provide statistical information requested by various State and Federal agencies: Ethnic Background (circle one): Hispanic / Latino Asian American Indian / Alaskan Native Native Hawaiian / Pacific Islander Black / African American White Other Austin Community College does not discriminate on the basis of age, gender, race, color, creed, religion, national or ethnic origin, disability, or veteran status in the administration of its employment practices, educational or admission policies, scholarships or loan programs, athletic or other school-administered programs. ACC Teacher Certification Program Application 2

3 BACKGROUND INFORMATION Are you eligible to work in the United States?! No! Yes Have you served in the military?! No! Yes Branch From To Education: Bachelor s Degree Required ACT/SAT/GRE/THEA scores Overall GPA is (Must be stated on transcripts) Score: All Colleges/Universities Attended City and State Type of Degree Granted Major/Minor DATES: From To Have you ever been accepted into another teacher certification program? If so, give program contact information and why you left that program. Check any of the boxes that apply: Certification/Permit! Texas Emergency Special Assignment Permit! Valid Out-of-State Teaching Certificate Other: Date Issued: Expires: Subject(s): Do you possess a certificate which is currently suspended, revoked, or pending such action in any state? If yes, explain: Have you ever been on an emergency certificate? If yes, please explain Additional Certifications/ Licensure Certifications/ Number Licensure Issued by Effective Date Expiration Date 3

4 Attach Current Resume 4

5 CRIMINAL BACKGROUND Background: To obtain your teaching certification, you must be hired to teach, and having a criminal history may keep you from employment. According to H.B (TEC21.917), Texas school districts will run a Criminal Background Check (CBC) to obtain criminal history information on every employee, candidate for employment, and observer in schools. The State Board for Educator Certification will also run a fingerprint check. A criminal history may keep you from employment with a school district AND from acceptance into the Teacher Certification Program. Have you ever been convicted of a crime other than a traffic ticket or parking violation?!no!yes If yes, on the space provided below, state the crime/s, location of the court where you were convicted, date of conviction and current disposition or status, including length of probation, parole, fine or time served. Attach additional sheets if necessary. **Have you received deferred adjudication for a crime?! No! Yes Note: you must answer yes, even if you have completed the deferred adjudication and you have been advised or do not feel that the crime is or should be reflected on your record. If yes, on the space provided below, state the crime/s, location of the court where you received deferred adjudication, date, and a current disposition or status. Attach additional sheets if necessary. **If you have received deferred adjudication for a crime, we encourage you to contact a lawyer to have the incident expunged from your record. Please attach additional sheets if necessary I certify that all of the above information is true, accurate, and complete. I understand that any misrepresentation or willful omission of facts shall be sufficient cause for disqualification of this application from further consideration. Signature of Applicant Date 5

6 CANDIDATE AGREEMENT I understand I must submit the application fee for my file to be reviewed by Austin Community College Teacher Certification Program. I understand that submission of this application does not obligate Austin Community College in any way and that the fee is non-refundable. I understand that meeting eligibility requirements does not guarantee an interview or acceptance into the Austin Community College Teacher Certification Program. I understand that there will be a required criminal background check (CBC), and the State Board for Educator Certification will complete fingerprinting with a national criminal background check before issuing a teaching certificate. Having a criminal background may keep me from program acceptance and employment in a school district. I hereby authorize Austin Community College to investigate, through whatever means deemed appropriate by the college, any information included in this application and facts resulting from the investigations to determine my suitability for entrance into the Teacher Certification Program. I release Austin Community College from any liability in connection with the investigation. I agree to abide by the policies, procedures, rules, and regulations of the Austin Community College Teacher Certification Program. Failure to do so will result in dismissal from the program. I understand that I must adhere to the program and state requirements to complete my teacher preparation and certification. I will be evaluated at various points during training, and must keep an 80 average and meet all requirements in order to stay in the program. I will be recommended for standard certification based on coursework, grades, test scores, and successful completion of internship with approval of Director, Coordinator, Supervisor, Campus Mentor, and Campus Principal. I understand that fees to the State Board for Educator Certification and exam vendor are subject to change and that exams must be taken when directed. I understand that Austin Community College s Teacher Certification Program will assist in internship placement, but is not responsible for job placement. I agree to pay for each semester by the deadlines indicated in this application. I understand that fees are subject to change, and I agree to ACC's refund policy for courses. Accounts with payments not received by the start of class will be charged an additional $25 late fee. By applying to and registering with Austin Community College, I agree to abide by the Student Discipline Policy and Student Rights and Responsibilities regulations published in the ACC College Catalog and Student Handbook. I authorize the exchange or disclosure of information between ACC s TCP, the assigned school district, the State Board for Educator Certification, The Texas Education Agency, and/or any entities related to teaching or working with children and/or participating or cooperating in teacher preparation and certification programs. Such information may relate to the application, suitability for internship, employment by a participating school, and/or continuation of the candidate in ACC s Teacher Certification Program. I certify that statements by me in this application are true, complete, and correct to the best of my knowledge and belief. I understand that any false statement, misrepresentations, or omission(s) made by me on the application or during the application process shall be grounds for refusal to be admitted to or withdrawal from the Austin Community College Teacher Certification Program. Confidentiality Statement- I am applying for the Teacher Certification Program at Austin Community College. I hereby give ACC permission to make inquiries concerning my performance in the past and general character. I agree that the information will not be disclosed to me, but will be treated as confidential by ACC. I waive any right to see this information and release ACC s Teacher Certification Program from liability involved with the investigation. I understand and agree to the above items. Print Name: Last First Middle Signature of Applicant: Date: 6

7 FEES All fees are eligible for ACC s installment plan except the Application Fee. Extra fees will be due for exams, textbooks, certification fees, etc. If you intern out of the ACC district, you will be expected to pay an additional $250/semester for supervision expenses. If you need assistance with loans, you may apply for the College Access Loan (CAL) after visiting with the Director and completing an application. All CAL loans for all courses must be secured by December 31. Certification Program Courses and Fees Cost Due Dates Application fee nonrefundable $60 By December 15 with application EDTC Methods for Special Populations $200 Feb. 05, 2016 EDTC Pedagogy and Professional $1500 Jan. 19, 2016 Responsibilities EDTC XXXX - Summer Content Specific Classes $1500 May 31, 2016 EDTC Successful Teaching Practices $500 August 2016 EDTC Fall Internship/Clinical Teaching $500 August 2016 EDTC Supporting the Teaching Experience $500 January 2017 EDTC Spring Internship $500 January 2017 TOTAL $5,260 Dates are subject to change 7

8 REFUNDS The ACC Continuing Education refund policy: 100% prior to the weekday before the first class day, and 100% if class is canceled by ACC. After classes begin, consult the table below. The number of days listed refers to business days (M-F), not class meeting days. YOU MUST CONTACT THE TEACHER CERTIFICATION STAFF IN WRITING FOR WITHDRAWAL FROM THE PROGRAM, LEAVE OF ABSENCES, ETC. Class Length in Weeks Last day for 70% Refund Last Day for 25% Refund 2 or fewer 2 N/A or more Payments must be made by deadlines, or you will pay an additional $25 late fee and may be dropped from the program. Contact the Teacher Certification Office at with any questions or for registration. Refund Processing: ACC mails refund checks to the address on file at the college. Check with Continuing Education registration staff to verify current and accurate information before the refund process is started. Credit card refunds will appear on your monthly statement as soon as possible after the official reporting date. You are responsible for interest charged to the credit card account while the refund is processed. (This may take up to six weeks.) ACC charges a $25 processing fee for any refunds that are reissued. Each course will be taught as listed, provided enrollment in each section justifies the offering. The schedule of time, room and instructor reflects our intent at the time of publication. Course offerings and prices are subject to change, and the listing is not a guarantee that they will be offered exactly as listed. Payment Methods: Credit card payments (Visa, MasterCard, and Discover Card) accepted in person, by telephone , by fax , or mail the registration form along with your check or money order to: Austin Community College, Center for Teacher Certification, 5930 Middle Fiskville Rd., Austin, TX Returned Items: A $25 fee will be charged and a hold will be placed on accounts with any of the following: * Checks returned stop pay or account closed and credit card charge backs. You will be dropped from all classes and be liable for the returned check fee and any non-refundable fees. Checks returned unpaid (NSF) must be replaced by cash or a money order. Otherwise, returned checks will be referred to a collection agency, which may assess further charges. 8

9 FINANCIAL AID At this time, only the following sources are available to ACC Teacher Certification candidates. Because Continuing Education units are awarded (rather than credit hours), standard FAFSA and other programs are not available at this time. Please contact these participating organizations for information and check with Coordinator or Director before submitting applications: College Access Loan (CAL) CAL provides alternative educational loans to Texas students and through the Higher Education ACP participants who are unable to meet the cost of attendance at Coordinating Board an institution of higher education or alternative certification educator preparation program. The CAL program is part of the Hinson-Hazelwood College Student Loan Program administered by the Texas Higher Education Coordinating Board (THECB). For a copy of the program rules, click on Hinson-Hazelwood College Student Loan Program. ACC s program is limited to a certain number of loan recipients, so contact the Director immediately before application to CAL. The office has an application available. Contact the Center for Teacher 9

10 Certification Director at WIA (Workforce Investment Act) and Dislocated Workers Troops to Teachers Veteran's Education Contact the Capital Area Workforce Development Board at: Contact Meryl Kettler or Contact Dan Galindo at TWC (101 E. 15th, Austin 78778) or call Contact ACC s Veteran Affairs Manager at Career Training Loans (Private) Workforce Solutions for displaced workers ACC at Contact Please make a copy of this applications and transcripts for your records. Thank you for choosing Austin Community College as your teacher preparation program. Applicant's Name Professional Reference Form Return this recommendation form directly to: Teacher Certification Coordinator 5930 Middle Fiskville Rd Austin, Texas / Fax: has applied to ACC's Teacher Certification Program. Will you assist us by sending/faxing the following information at your earliest convenience to the fax number given above? We trust that your interest in children will motivate your response. How long have you known applicant? Dates: from What is/was your relationship to applicant? Would you hire/rehire applicant? Yes No to Would you want this person to teach your children? 10

11 Please indicate by a check mark your confidential rating of the applicant s qualities as listed below: Characteristic Clearly Outstanding Exceeds Expectations Satisfactory Below Expectations Unsatisfactory Effective Communication Skills Initiative Academic and Professional Preparation Planning and Organizational Skills Professional Attitude Positive Attitude and Enthusiasm Emotional Stability and Maturity Dependability and Punctuality Please add additional comments on the back of this form. The applicant s acceptance into the program is dependent on your honest evaluation and returning the form as quickly and thoroughly as possible. Thank you. Printed Name Daytime Phone Number Address Organization/Company Signature Position 11

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