Department of Education Educational Leadership Programs

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1 Application for Graduate Admission Department of Education Educational Leadership Programs Master of Science Certificate of Advanced Study SCHOOL OF GRADUATE AND PROFESSIONAL STUDIES

2 Instructions for Application Completion A graduate education program candidate may take as many as two courses (six credits) as a nonmatriculated student. A third course will not be permitted until admission is awarded. Therefore, the program candidate should complete the application requirements before registering for a third course. APPLICATION DEADLINES Admission decisions for the graduate education programs follow a rolling admission policy with the following guidelines: April 1 Fall matriculation October 1 Spring matriculation March 1 Summer matriculation ADMISSION NOTIFICATION Admission notification will be made by official letter within two weeks of the completed application process. APPLICATION CHECKLIST All application materials must be submitted in one packet to the Office of Graduate Admission. The following are required for application completion: Completed Application An earned bachelor's degree Nonrefundable Application Fee Please include a check or money order for $50 made payable to Le Moyne College. (The application fee is waived for Le Moyne alumni.) Official Transcripts Please have an official transcript from all undergraduate and graduate colleges and/ or universities attended sent directly to you to include in the application packet or sent directly to the Office of Graduate Admission at Le Moyne College. (For this application, Le Moyne will provide an official Le Moyne transcript for alumni.) Two Letters of Recommendation If applying to the school building leader or school district leader programs, at least one written recommendation must be included from a certified school administrator familiar with your work as a professional educator. Please ask these people to seal the envelope and sign over the sealed back before sending the letters of recommendation to you. Résumé Teaching Certificate(s) If applicable, please submit a copy if applying for the School Building or School District Leadership program. Verification of Employment Experience Form To be completed for applicants to the School Building Leadership and School District Leadership programs. Transfer Credit Evaluation Form Up to six Leadership/Education Administration graduate credits may be considered for transfer credit. If you are requesting transfer credit, you must submit this form with your application. Professional Standards Please sign and return. INTERNATIONAL APPLICANTS A Test of English as a Foreign Language (TOEFL) or International English Language Testing System (IELTS) score report is required of non-native English speaking applicants. A score of at least 79 is required on the TOEFL or at least a 6.5 on the IELTS. International applicants must have a course-by-course transcript evaluation completed by World Education Services (wes.org). It must also show that a bachelor's degree equivalent to one in the United States has been earned. In order to qualify for the Certificate of Eligibility (Form I-20) for an F-1 student visa, students must be admitted into the program full time and provide proof of sufficient funding for at least the first year of graduate study. To do so, students need to complete the Le Moyne College Certificate of Finance found at COMPLETED APPLICATION PACKET Please send completed application packet to: Office of Graduate Admission Le Moyne College Grewen Hall Salt Springs Road Syracuse, NY Phone: Fax: (315) (315) Note: New York state law requires all students to submit immunization records before registering for courses. Please find instructions and the Immunization Record and the Meningococcal Meningitis Vaccination Response forms at If you have questions, please contact Student Health Services at (315) For questions regarding certification requirements and programs, please contact the Department of Education office at (315)

3 Personal Data Application for Admission Date SS# (Optional; for NY State Education Department Reporting) Legal Name (Last, First, Middle) Other Name, If Applicable Permanent Address City State ZIP Country Phone ( ) Cell Home Date of Birth Month Day Year Female Male Do you consider yourself to be Hispanic/Latino? Yes No In addition, select one or more of the following racial categories to describe yourself: American Indian or Alaska Native Asian Black or African American Citizenship U.S. citizen Dual U.S. citizen; please specify other country of citizenship U.S. permanent resident visa, PRA # Other citizenship Do you need an I-20 issued by Le Moyne College? Yes No How did you hear about the graduate education programs at Le Moyne College? (Please check all that apply.) Attendance at a specialized graduate forum/fair (city) Alumnus/a (name) Faculty member at your undergraduate school Social Media Program brochure Placement/career counseling office at your undergraduate school Open house/campus visit Employer College Guide listing Friend/co-worker Relative Radio ad Printed ad (what publication) Native Hawaiian or Other Pacific Islander White Television ad Le Moyne College website Other Admission representative 2

4 Program of Study I am applying for the following program. Please check one. If you are interested in more than one, please contact the Department of Education for advising at (315) School Building Leadership (with New York state certification) Certificate of Advanced Studies (CAS) Master of Science in Education (MSEd) School District Leadership (with New York state certification) Certificate of Advanced Studies (CAS) Master of Science in Education (MSEd) School District Business Leader (with New York state certification) Certificate of Advanced Studies (CAS) Master of Science in Education (MSEd) MBA/School District Business Leader (CAS) Academic Plan I am applying for the following semester Fall Spring Summer Year I plan to study Full time (nine or more credits) Part time Academic History List below the college from which you graduated and other college(s) you have attended. All college-level work must be included. Please request that each of these institutions send official transcripts to you for inclusion in your application or directly to the Office of Graduate Admission at Le Moyne College. Institution Dates Major Degree Check if Date GPA (State, Country) Attended Field Earned Non-degree Awarded (4.0 scale) Have you ever been found responsible for a disciplinary violation at an educational institution you have attended from ninth grade (or international equivalent) forward, whether related to academic misconduct or behavioral misconduct, that resulted in your probation, suspension, removal, dismissal or expulsion from the institution? No Yes Have you ever been convicted of a misdemeanor or felony? No Yes If you answer yes to either or both questions, please attach a separate sheet that gives the approximate date of each incident and explanation of the circumstances. Other Are you eligible to receive Veteran's benefits? No Yes Current or Most Recent Employment Current or Most Recent Employer Job Title Dates of Employment Are you employed Full time Part time Employer Address Does your employer provide tuition benefits? Yes No 3

5 References Please list the names of two professional references who can attest to your ability to be successful in an educational leadership program. At least one written recommendation must be included from a certified school administrator familiar with your work as a professional educator. 1. Name Relationship 2. Name Relationship Statement Of Purpose Educational Leadership Program Applicants Please explain your motivation for entering the Le Moyne College Educational Leadership Program. Describe the environment you hope to create within your school building and/or district. How will the Educational Leadership Program help you achieve your professional goals? I certify that the information I have provided on this application is correct and complete. I understand that withholding information on this application or giving false information will make me ineligible for admission. Signature of Applicant Date (Your signature is necessary in order to process the application.)

6 Transfer Credit Request Form Who should use this form: Individuals requesting transfer credits. Up to six credits of course work in educational leadership and/or educational administration may be considered. For transfer credit evaluation, please complete this form and submit it with your application. If you have questions about this form or about transfer credit, please contact the Department of Education at (315) To Be Completed By Applicant Name (Last, First, Middle) Address City State ZIP Phone ( ) Evening ( ) Address Names of colleges and/or universities for which transcripts are being submitted for evaluation: Certificate Area of Study Please check the certificate area you wish to obtain. School Building Leadership School District Leadership School District Business Leader

7 Verification of Employment Experience Candidates for the Le Moyne College School Building Leadership and School District Leadership programs must have three (3) years experience as a teacher, administrator/supervisor or pupil personnel service provider. To Be Completed By Applicant Name (Last, First, Middle) Address City State ZIP Phone ( ) Phone ( ) Address To Be Completed By Human Resources The candidate named above has been employed from to In the position of At (school) District Signed, Human Resources Director Date Please print name Please send completed form packet to: Office of Graduate Admission Le Moyne College Grewen Hall Salt Springs Road Syracuse, NY Phone: (315) Fax: (315)

8 RECOMMENDATION FORM To the applicant: This form should be given to two individuals under whom you have studied or worked and are able to comment on your ability to be successful in an educational leadership program. If applying to the school building leader or school district leader programs, at least one written recommendation must be included from a certified school administrator familiar with your work as a professional educator. To Be Completed By Applicant Name (First, MI, Last) Date Address City State ZIP Phone Cell Home ( ) Program of Study Applying for Please Provide Name of Reference In accordance with the Family Educational Rights Privacy Act of 1974, please check one: I do I do not waive my right to read this statement. Signed Date To Be Completed By Recommender To the recommender: Please return this recommendation to the person requesting your assistance in a sealed envelope, with your signature across the envelope seal, within one week. Name (First, MI, Last) Organization Date Position Address City State Phone ( ) Address How long have you known the applicant? How well do you know the applicant? Very Well Well Somewhat In what capacity have you known the applicant? Recommendation based on applicant s ability to pursue graduate study: Strongly recommend Recommend Recommend with reservations Do not recommend On an attachment, please explain your recommendation and provide a brief assessment of the applicant s ability to successfully complete graduate studies. Signed Date

9 RECOMMENDATION FORM To the applicant: This form should be given to two individuals under whom you have studied or worked and are able to comment on your ability to be successful in an educational leadership program. If applying to the school building leader or school district leader programs, at least one written recommendation must be included from a certified school administrator familiar with your work as a professional educator. To Be Completed By Applicant Name (First, MI, Last) Date Address City State ZIP Phone Cell Home ( ) Program of Study Applying for Please Provide Name of Reference In accordance with the Family Educational Rights Privacy Act of 1974, please check one: I do I do not waive my right to read this statement. Signed Date To Be Completed By Recommender To the recommender: Please return this recommendation to the person requesting your assistance in a sealed envelope, with your signature across the envelope seal, within one week. Name (First, MI, Last) Organization Date Position Address City State Phone ( ) Address How long have you known the applicant? How well do you know the applicant? Very Well Well Somewhat In what capacity have you known the applicant? Recommendation based on applicant s ability to pursue graduate study: Strongly recommend Recommend Recommend with reservations Do not recommend In the space below, please explain your recommendation and provide a brief assessment of the applicant s ability to successfully complete graduate studies. Signed Date

10 PROFESSIONAL STANDARDS Standard Takes Initiative Demonstrates Reflective Practice Demonstrates Dependability Demonstrates Ethical Conduct Projects Positive Demeanor Demonstrates Flexibility Collaborates Provides Equitable Learning Opportunities for All Students Maintains Boundaries Maintains a Safe Learning Environment Maintains Personal/Professional Balance Performance Indicators Makes decisions and takes steps without continuous supervisory prodding; Displays industrious work ethic; Goes beyond minimal requirements Engages in self-analysis and learns from experience; Makes changes based on self-awareness; Seeks and accepts constructive criticism and feedback; Seeks ways to understand issues and ideas that are unfamiliar Meets deadlines and program requirements; Displays thorough development of required materials; Communicates in a timely manner; Follows through on commitments; Follows program policies Is honest; Acts with integrity; Is trustworthy; Adheres to confidentiality; Accounts for personal behaviors and decisions; Abides by content from Academic Integrity Online Tutorial and Exam Maintains appropriate appearance; Possesses a healthy sense of humor; Is congenial and resilient; Communicates high expectations for all learners Responds to needs of all learners; Changes and adapts when necessary, including experiences related to settings, resources, situations, and personalities. Considers other perspectives and points of view; Listens and respects opinions of others; Accepts responsibility for work within groups or professional communities; Builds upon others ideas; Is willing to compromise Is tolerant of and responsive to ideas and views of others; Respectful of and responsive to individual differences; Considers backgrounds, interests, abilities, and attitudes of all students when planning and teaching Maintains professional demeanor and behavior in a variety of professional relationships, such as principal/teacher, teacher/teacher, teacher/parent, and teacher/student Appropriately responds to situations that can negatively impact the learning environment and/or student/teacher well-being Meets academic and instructional expectations by managing one s personal and professional life and responsibilities; Appropriately prioritizes demands of profession; Recognizes own limits; Manages time effectively

11 PROFESSIONAL STANDARDS My signature on this form acknowledges that I have received, read, and understand the Le Moyne College Department of Education Professional Standards. I understand that upon enrolling in a graduate education program, I will be expected to demonstrate a satisfactory level of proficiency in these standards in order to move to the next stages of my professional preparation. Signature Date Printed Name Please submit this signed page with your application packet and retain the Department of Education Professional Standards for your personal files and future reference. If you have questions regarding the professional standards, please contact: Department of Education Le Moyne College 1419 Salt Springs Road Syracuse, NY PH: (315)

12 Department of Education Mission Statement Through scholarship, teaching and service, the Department of Education at Le Moyne College is a learning community in the Jesuit tradition dedicated to preparing and inspiring teacher leaders who practice participatory democracy and social justice in their classrooms and schools. Le Moyne College Mission Statement Le Moyne College is a diverse learning community that strives for academic excellence in the Catholic and Jesuit tradition through its comprehensive programs rooted in the liberal arts and sciences. Its emphasis is on education of the whole person and on the search for meaning and value as integral parts of the intellectual life. Le Moyne College seeks to prepare its members for leadership and service in their personal and professional lives to promote a more just society. OFFICE OF GRADUATE ADMISSION Le Moyne College Grewen Hall Salt Springs Road Syracuse, NY PH: (315) FAX: (315) GRADUATE PROGRAMS Le Moyne College Reilly Hall Salt Springs Road Syracuse, NY PH: (315) FAX: (315) Le Moyne College is an affirmative action/equal opportunity employer and equal opportunity institution Nondiscrimination Statement Le Moyne College is an Affirmative Action/ Equal Opportunity Employer, and does not discriminate on the basis of race, color, gender, creed, age, disability, marital status, sexual orientation, veteran status, or national or ethnic origin. For more information visit Rev. 4/15

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