Lehman Urban Transformative Education-Teachers Opportunity Corps (LUTE-TOC) Graduate Scholar

Application for Admission for Spring 2017

Application Directions

Use this Application for Admission to apply to The TOC program if you are:

A: A graduate student who are currently enrolled in a teacher education program.

B: An applicant who are interested in applying for a teacher education program leading to certification.

Call the Lehman College TOC Office at 718-960-5137 with any questions.

Please complete the application form along with two completed recommendation forms and send to:

Ms. Traci Palmieri, Director

The Lehman College TOC Program

School of Education

Carman Hall Room 176

Lehman College

250 Bedford Park Blvd. West

Bronx, NY 10468

Section 1: Applicant Information (please print or type)

Name: Last ______First ______MI ______

Address: ______City State Zip Code

Phone(s): ______

E-Mail Address: ______

Date of Birth: ______Gender: M F New York resident: Yes No

I am a: □ US Citizen □ Permanent Resident

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Section 2: Please indicate which of the following categories you identify with. You may check more than one.

□ Alaskan Native (Eskimo or Aleut) □ Hispanic or Latino

□ American Indian □ Native Pacific Islander

□ Asian □ White

□ Black or African American □ Other ______

□ Decline to State

Section 3: List all colleges and the dates attended (attach separate sheet if needed).

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Section 4:

Undergraduate: ______GPA: _____ Date a BA degree awarded: ______

Undergraduate Major (e.g., mathematics, chemistry, etc): ______

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Section 5: Complete Section 5 if it is applicable.

Graduate ______GPA: ______Date a Master’s degree expected: ______

Graduate Program Leading to Certification ______

Academic Advisor ______

List courses you still need to satisfy graduation requirements (attach a separate sheet if needed).

Note: Non-Lehman Applicants must submit their official copy of transcript along with the application.

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Section 6:

Name of Recommender One: ______

Name of Recommender Two: ______

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Section 7: Personal Statements

Short Essay: Becoming a Teacher

In 500 words, explain why you would like to be a teacher. Tell us what you would do differently from teachers you have known. Tell us what you would emulate from teachers who have inspired you.

Please tell us any additional information about yourself that you believe would help the Admissions Committee for The TOC Program in reviewing your application.

The information that I have provided in this application is correct to the best of my knowledge.

______

Applicant’s Signature Date

The City University of New York does not discriminate on the basis of race, religion, sex, age, creed, color, national origin, physical or mental disability, sexual orientation, marital status, citizenship status, or veteran status.

Please be aware that all documents submitted in support of an application for admission become the permanent possession of CUNY and will not be returned.

Please be certain that all of the information requested in the application is answered fully and correctly.

The CUNY policy regarding fraudulent documents can be viewed on our website at www.cuny.edu.

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