Application for Professional Educator Diploma 2015/2016

Transcription

1 Application for Professional Educator Diploma 2015/2016 Please read the instructions on the next page carefully to help you complete the application correctly. For further information regarding offered programs and courses, visit Requirements for Admission - A photocopy of your bachelor s degree, with the stamp of the university. Additional higher education diplomas or master s degrees should also be submitted. - A photocopy of your Egyptian national ID card (Al Rakam Al Qawmi) or the page(s) in your passport that show photo, passport number and expiration date. - Basic instructional technology (computer) skills. - English proficiency. Applicants should register to take the Standardized English Proficiency Test (SEPT) at the Office of Enrollment Services, School of Continuing Education at the following locations: AUC Tahrir Square 24 El Falaki Street, Bab El Louk P.O. Box 2511 Cairo 11511, Egypt Sunday Thursday 9:00 am 5:00 pm AUC New Cairo Dr. and Mrs. Elias Hebeka Building Entrance from Gate 1 AUC Avenue, P.O. Box 74 New Cairo 11835, Egypt Sunday Thursday 9:00 am - 3:30 pm Hotline / fax / sce@aucegypt.edu For exemption from the SEPT, please attach English credentials.

2 Submit the completed application and all required documents after admission as follows: - Visit the School of Continuing Education at AUC Tahrir Square or AUC New Cairo to complete the SCE application and get student identification number (SID). The SCE application must be completed to reserve a place and time for the Standardized English Placement Test. The test can be taken at any of the School of Continuing Education facilities in Zamalek, Heliopolis or New Cairo. - The Professional Educator Diploma application and all required documents should be submitted by hand to the Graduate School of Education office, AUC Center for the Arts, room P002. Instructions for filling out the application: Please consult these instructions while filling out the application for admission to the Professional Educator Diploma program. Any errors or omissions in your application may lead to delays in processing. Do not write in the shaded areas. Form 1 - Application for Admission - Enter your full name as it appears in previous educational records and official documents. If your name has changed, you may attach a letter explaining any other names you have used. Your family name should be entered last. Please print. - Enter your permanent mailing address, phone number and address. Please be accurate, as all future University communication will be through this address and phone number. - Enter your country of citizenship. If you possess an Egyptian national identification card or an Egyptian passport, enter Egyptian. If you are a dual national (have passports from two different countries), you may write both nationalities. Responding to this question is not a requirement for admission. Information is used for statistical purposes. - When writing your birth date, enter the month first, then date and year (Example: 05/30/89). - For AUC employees or their family members, please complete question 8 on the application. - If you have ever been issued an AUC student identification number, please provide it. You will already have an SID if you have ever attended AUC courses or applied for admission to AUC. - In the table, supply information regarding the previous university education you have received. List the most recent degree first. Information should be provided even if you did not complete a program or if university credit was not given. - Once you have completed the application, read the certification statement carefully, then sign and date the application. Unsigned applications will not be processed. Page 2

3 A P P L I C A T I O N : S E C T I O N S I - V I I. Personal Information 1. Full name : 2. Permanent address First Middle Family/Last Telephone Mobile 3. Country of citizenship Second citizenship (if dual national) 4. National ID (for Egyptians) (For non-egyptians) Passport no. Country of issue Date of expiration 5. Place of birth, 6. Date of birth / / City Country Month Day Year 7. Gender Male Female 8. If you are an AUC employee or a family member of an employee, complete this section. AUC staff member Spouse or child of faculty or staff member Name of faculty or staff member Office or department II. Prior enrollment at AUC 9. If you ever applied for admission or registered for a course or degree at AUC, write your AUC student ID number: For Office Use Only: SID Number Page 3

4 III. Intended Program of Study Indicate which diploma you wish to enter (choose ONLY ONE): Put a check next to the program you wish to enter Diploma Teaching Early Years Learners Teaching Adolescent Learners Integrated Technology for Classroom Teachers Educational Leadership Inclusive Education for Diverse Learners (Starting Spring 2014) STEAM Education: Science, Technology, Engineering, Arts, Math Stage of Teaching To teach children in nursery, kindergarten and primary stages To teach students in preparatory and secondary stages To teach students in any stage To work as a school administrator at any stage To teach students with special needs To teach students using an interdisciplinary, project-based pedagogy IV. Educational Background Please list most recent experience first Name of university, location and major Degree received and number of credits completed Grade Point Average (GPA) or Overall Evaluation Date degree received Page 4

5 V. Employment Background Please list your previous employment below. You may add additional rows if necessary Name of employer Position held (Fulltime/Part-time) Beginning and ending dates Responsibilities Do you currently work at an Egyptian government (public) school? Yes No Why are you interested in joining the Professional Educator Diploma program? (Please respond in approximately one paragraph). Page 5

6 VI Signature I certify that the information on this application and all supplementary forms is complete and accurate to the best of my knowledge. Furthermore, I understand that withholding information, giving false information or submitting forged documents will make me ineligible for admission to the university or subject to subsequent dismissal. By signing this application, I agree to abide by the policies and regulations of the American University in Cairo (AUC). Signature Date The American University in Cairo does not discriminate on the basis of race, color, religion, gender, disability or ethnic origin. Information regarding gender, nationality and origin is used for statistical reports and is not an admission requirement. AUC upholds and strictly enforces the principles of academic integrity. For more information about the academic integrity policy, visit For Office Use Only To be completed by the Office of the Provost Is the faculty member identified in question 8 employed full-time? Yes No Signature Date To be filled by the Office of Human Resources How many years has the person identified in question 8 worked at AUC? Signature Date Page 6