Last Name First Name MI Tribal Affiliation Mailing Address (include street address or PO Box)

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1 APPLICATION FOR INDIGENOUS ROOTS TEACHER EDUCATION PROGRAM K- 8 ELEMENTARY EDUCATION AND ESL Initial Certification/Undergraduate program Last Name First Name MI Tribal Affiliation Mailing Address (include street address or PO Box) (include city, state, zip code) Home Phone Cell Phone E- mail address Social Security Number I understand that this program requires a Payback Agreement (Signature) Completion of 42 or more credit hours (preferably AA degree) transferred from Beginning Professional Courses (which have you had): Adolescent Development Education Foundations Other PPST R M W Concentration: ESL American Indian Language (6 or more credits) Technology Requirement College of Education and Human Sciences Admissions Check List Application Cover Sheet Rule 20 Form Oath of Honesty Form Official or Unofficial Transcripts Mailed with Application Questionnaire/Portfolio writing sample: Accomplishments, Diversity, Commitment to Teaching Three Letters of Recommendation Receipts (showing registration for the PPST and Criminal History Check) Apply to UNL Admissions (Not for students who already have a BA/BS) Undergraduate students applying for the Initial Certification/Undergraduate program must also submit an official application to UNL, and mail official transcripts to UNL. When you apply online you will not be required to pay the initial admissions fee. The UNL Undergraduate Admissions application can be found at If you already have a BA or BS degree, and wish to apply for the Initial Certification/Undergraduate Program, you will not need to submit an application to the UNL undergraduate program. These students will instead apply for UNL s graduate school program after being

2 admitted into the Indigenous Roots Teacher Education Program. The ROOTS acceptance letter will describe the process for applying for graduate school at UNL. For more information on the application process please contact Nancy Engen- Wedin at To register for the PPST go to For more information on how to register for the PPST contact Karen Albert at To register for the Criminal History Check go to For questions or more information about the Criminal History Check contact Dave Van Horn at Mail All Application Materials to: Nancy Engen- Wedin, Director Indigenous Roots Teacher Education Program Teaching, Learning Teacher Education University of Nebraska Lincoln 118 Henzlik Hall, Lincoln, NE

3 Statement on Moral Character Teaching is a profession that requires its potential candidates to be individuals of integrity. Prospective teachers must be able to demonstrate that they are individuals of strong moral character who can make mature decisions for themselves and for their students. Teachers are responsible for the education, safety, and well-being for anyone in their charge. Therefore, Teachers College is interested in working with individuals of high moral character who can serve as representatives of our College and the University of Nebraska-Lincoln. With this in mind, should the College discover behavior on the part of the candidate which establishes a lack of integrity or moral/ethical character, Teachers College reserves the right to deny entry to or dismiss anyone from any program which leads to certification. Behavior which establishes a lack of integrity or moral/ethical character may exist when a student has a record of arrests and/or convictions which impacts the candidate s ability to represent himself or herself as a professional in the field of education, or other information exists which Teachers College reasonably determines renders the candidate a risk to the educational community or demonstrates a likelihood of illegal activity. Name (Please Print) Social Security Number Signature Date College of Education and Human Sciences Copy

4 Nebraska Department of Education Competency Requirement For admission into a teacher education program, Nebraska state department of Education requires all applicants to pass a competency test in Reading, Writing and Mathematics. This is done through the Praxis I (Pre-Professional Skills Test). The applicant has the choice to take this test on paper or on the computer. Comparison of Exams Paper Computer Computer- delivered multiple choice and Format Paper and pencil multiple choice and essay essay Scores 170 (Reading) 170 (Reading) 172 (Writing) 172 (Writing) 171 (Math) 171 (Math) Cost $40 per section $80 per section* $130 Combined Test* Availability Results Sending Scores Specific dates, see s/praxisi_deadlines for dates Available online 4 weeks after test. Scores may be available sooner via phone, for more information see At registration, you will have the opportunity to search for the University of Nebraska Lincoln and select it for you free score report. The code is If you do not do this at registration, you will have to pay to send a copy to UNL. By appointment year- round, availability based on test center Available online 4 weeks after test. Scores may be available sooner via phone, for more information see At registration, you will have the opportunity to search for the University of Nebraska Lincoln and select it for you free score report. The code is If you do not do this at registration, you will have to pay to send a copy to UNL. *For the computer based test, you can sign up for individual sections (Reading, Writing, Math) or the Combined test which contains all three sections needed. Information and registration materials are available in the Teachers College Student Services Center, 105 Henzlik Hall between 7:30 am and 5:00pm Monday through Friday, or on-line at

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6 Directions for Requesting a Criminal History Background Check Please read through the following instructions carefully. For the purpose of these instructions, you are considered to be a CEHS-Initial Entry to College student. The Vendor who will conduct the check is One Source The Background Check Company (One Source) To complete the request, go to One Source s website at On the home page, select Student Login and then select UN-L in the pop-up window. This will take you to a page entitled University of Nebraska - At Lincoln. You should now be on the University of Nebraska At Lincoln page. Go to the red bullets with black, bold lettering and select the CEHS-Initial Entry designation. As this page states, please read all of the instructions before you begin to complete the form. After having read the instructions, please scroll down and enter the required information. Note that payment of the $25.00 fee for the review is made directly to One Source. If you do not have a credit or debit card, you may call to arrange for an alternate form of payment. After you complete the form, enter your request by clicking on the ENTER ORDER button located at the bottom of the page on the right side. Entering your order will cause another page to appear on the screen. This page presents the OneSource release form with which you must agree in order for the review to be conducted. If you can agree, please do so. If you have questions about the release, please contact Dave Van Horn ( or dvanhorn2@unl.edu). Having clicked on the I Agree button completes your registration for the background check. You should then close all windows related to the process. As a part of this background review, you must also complete and sign a form that allows for a review of any records you may have with the Nebraska Department of Health and Human Services (HHS). While the One Source website allows you to download and print the HHS form, for your convenience we have included a copy of the form in the application materials. Please use the copy of the DHHS form that is provided in the application. Signing this form gives permission for HHS to search its records regarding adult and child abuse. Please return the signed form to Karen Albert, Indigenous Roots Teacher Education Program, 118 Henzlik Hall, P.O. Box , Lincoln, NE

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8 NEBRASKA STATE DEPARTMENT OF EDUCATION REGULATIONS SIGNATURE FORM I. The three tests are Pre-Professional Skills Test (PPST); Content Mastery Examination for Education (CMEE); and Computer-Based Test (CBT). I have been given information about the basic skills tests used by the State of Nebraska for Admissions to an approved Nebraska teacher or administrator program and for recommendation for an initial teacher certification. I understand that I am required to achieve passing scores on one of the above mentioned basic skills test before I will be admitted to the Teacher Education Program and allowed to enroll in 300 level methods courses or student teaching and before I can be recommended for an entry level teaching certificate. I may retake the CMEE or any portion of the PPST as many times as I choose until I have received acceptable scores. II. CONVICTED OF A FELONY OR MISDEMEANOR RULE I understand that if I have been convicted of a felony or misdemeanor in any State, special circumstances apply to my application for teacher certification and I will meet with Dave Van Horn or Dr. Tom Wandzilak, the Teachers College Certification Officer, to discuss these special circumstances as soon as possible. I also understand that if a court or any other governmental body has determined that I am any of the following: a mentally ill and dangerous person, mentally incompetent to stand trial, acquitted of criminal charges because of insanity, an incapacitated person in need of a guardian, or unable to manage your property due to mental illness, mental deficiency, chronic intoxication, that I will also meet with Dr. Wandzilak. (See Moral Character statement that is attached. This statement is also located in the undergraduate Bulletin.) Name (Please Print) Social Security Number Signature Date College of Education and Human Sciences Copy

9 INDIGENOUS ROOTS TEACHER EDUCATION PROGRAM Elementary Teacher Education 1.Provide a personal statement explaining your academic achievement over the minimum 2.5 GPA requirement for admissions into this program. (Please consider your participation in honors programs, special awards, or other academic accomplishments.) As part of this personal statement you may also include comments or quotes from someone who is completing a letter of recommendation for you. Exceptional Accomplishments 2. Provide a personal statement explaining any exceptional accomplishments in service to others, leadership, second language, Native language or cultural activities, writing, mathematics, science, computer skills, music, art, or other special skills or talents. (Consider listing publications, performances, or awards. Consider also describing experiences in any of these talent areas.) As part of this personal statement, you may also include comments or quotes from someone who is completing a letter of recommendation for you. Cross-Cultural Experiences 3. Provide a personal statement explaining any cross-cultural experiences that suggest that you have an understanding of and ability to work successfully with members of diverse groups. (Consider describing your understandings of and sustained experiences with ethnicity, socio-economic level, religion, gender, disability, labor, management, sexual orientation, and national origin.) As part of this personal statement, you may also include comments or quotes from someone who is completing a letter of recommendation for you. Commitment to the Profession and a Capacity to Meet its Standards 4. Provide a personal statement explaining your commitment to the teaching profession and your ability to meet its professional standards. (Consider describing any relevant work, volunteer, or practicum experiences with year-olds, transescent students.) As part of this personal statement, you may also include comments or quotes from someone who is completing a letter of recommendation for you. 5. Describe why it is important for you to teach at the Elementary Level and why you want to work with American Indian students.