School of Education and Teacher Preparation
November 24, 2015
Dear Pre-Education Majors:
To apply for admission to the Fall 2016 cohort in Early Childhood/Special Education, Middle Grades Education, or Secondary Education – Biology or Mathematics, you should attend one of the three mandatory orientation sessions on January 19 or 20, 2016.
Please follow the instructions below:
1. Print and complete the two-page Application for Admission to Teacher Education.
2. Attach three (3) CCGA Teacher Candidate Disposition Evaluations.
3. Attach a copy of your GACE Program Admission Assessment scores (or exemption).
4. Attach a copy of your Georgia Educator Ethics Assessment Certificate of Completion.
5. Complete the Pre-Service Certificate Application.
6. Submit the application and attachments on or before February 1, 2016, to Kathy Halliwell, 212F Correll Center.
If you have any questions, please contact Kathy Halliwell, School Coordinator, at 912-279-5843 or email her at .
On behalf of the faculty and staff,
Michael Hazelkorn, PhD
Dean, School of Education and Teacher Preparation
Professor of Special Education
College of Coastal Georgia
One College Drive
Brunswick, Georgia 31520
P: 912-279-5843
F: 912-264-7232
email:
One College Drive ׀ Brunswick, GA 31520-3632 ׀ P 912.279.5843 ׀ F 912.264.7232
Affirmative Action/Equal Opportunity/Access Institution
Due on or before February 1, 2016 to Kathy Halliwell, Office 212F, Correll Center.
Name ______9200______
Print Legibly Last First Middle Maiden Coastal ID Number
Mailing Address ______
Street City County State Zip Code
Home Address (if different from mailing address) ______
______
Cell Phone Number ______
If not currently a CCGA student, list your e-mail address______
Accreditation Information: Gender: □ Female □ Male
Race/Ethnicity: □ American Indian/Alaskan Native □ Hispanic or Latino □ White (not Hispanic origin)
□ Asian/Pacific American □Multiracial □ Black (not Hispanic origin)
Graduated High School from: ______
Name of School City County State
Teacher Education Program of Study (check one):
□ Early Childhood/Special Education (Grades K-5 dual certification program)
□ Middle Grades Education (Grades 4-8 certification program):
Concentrations (number 1st and 2nd): ___mathematics ___science ___social sciences ___ELA
□ Biology – Secondary Education (Grades 6-12)
□ Mathematics – Secondary Education (Grades 6-12)
Current Overall GPA: ______
(cumulative, including all transfer work)
Completion of GACE Program Admission Assessment Check one of the following:
___ GACE exempt based on SAT, ACT, GRE, CBEST, LLAST, or FTCE. [Please attach a copy of results]
___ GACE exempt based on Praxis passed prior to 3/06/07. [Please attach a copy of results]
___ GACE Program Admission Assessment passed. ____ [Please attach a copy of results]
___ GACE taken. I am awaiting the results.
___ GACE scheduled for ______(provide date).
___ GACE taken; but not all three tests were passed. [Please attach a copy of results]
Completion of Georgia Educator Ethics Assessment (Program Entry [350]) [Please attach a copy of the Certificate of Completion]
Fall 2016 Early Childhood/Special Education and Middle Grades Cohorts and
Biology and Mathematics – Secondary Education
Core Courses Remaining, including current semester (Subject and course number):
1. ______2. ______3. ______4. ______5. ______
6. ______7. ______8. ______
Disposition Evaluations: Attach three (3) Teacher Candidate Disposition Evaluations. One evaluation must be completed by an education instructor for EDUC 2110, 2120, or 2130. The other two evaluations may be completed by other instructors at CCGA or other institutions.
Remember to check your College of Coastal Georgia email for all future
correspondence about admission to the Fall 2016 teacher education program.
All correspondence will be sent to your CCGA account ()
To the best of my knowledge, all information on this application is accurate and complete.
Signature of Applicant ______Date ______
In Summer 2016, you will be contacted via your CCGA email regarding Liability Insurance.
Return this Application to Kathy Halliwell, School Coordinator,School of Education and Teacher Preparation, Office 212F Correll Center,
on or before February 1, 2016