Preparing Intervention Specialists for Multilingual Multicultural Settings (PrISMS)
Application for Scholar Support for Graduate Program in Communication Disorders
Name: Click or tap here to enter text.
Address: Click or tap here to enter text.
Telephone: Click or tap here to enter text.Email: Click or tap here to enter text.
Name and location of the high school that you graduated from: Click or tap here to enter text.
Language Background
What is your native language? Click or tap here to enter text.
Do you speak a second language? If yes, please indicate the language. Click or tap here to enter text.
Were you ever identified as an English Language Learner? Click or tap here to enter text.
If so, at what age? Click or tap here to enter text.
What coursework have you taken to develop your second language?Click or tap here to enter text.
What other experiences have supported your development of a language other than English? Click or tap here to enter text.
Preference will be given to applicants who are proficient in a second language, including American Sign Language. You may be asked to complete an assessment of second language proficiency.
Academic Status
What is your overall GPA? Click or tap here to enter text.
How many course hours have you completed? Click or tap here to enter text.
Career Plans
What are your plans upon program completion? Click or tap here to enter text.
This support requires employment in an Early Childhood Special Education Setting or pediatric setting for 2 years for each year of support received, IDEA 662(h). Repayment of all or part of the support will be required if this requirement is not met.
Please attach your resume or curriculum vitae. Include your experience working with young children and their families, and specify experience with children who have disabilities. Please email application materials to: . Indicate “PrISMS Application” in the subject line. Applications are due by March 22, 2018.
PrISMS Application Form, Year 1
Revised 1/29/2018