ACCEPTANCE TO THE TEACHER EDUCATION PROGRAM
Last Name First Name Initial /Birthday (xx/xx/xx) /
SSN (xxx-xx-xxxx)
Requirements for Acceptance into the Teacher Education Program
1. A minimum of 2.50 cumulative G.P.A.
2. A total minimum of 2.50 GPA in University Seminar, College Writing and Quantitative Reasoning (Core) with no grade lower than a ‘C’ (a grade of ‘C-’ or lower is not acceptable).
3. A 2.5 grade-point average in the teaching major, minor, professional area, and “Prerequisites for Elementary Methods Courses” with no grade below a “C” in any of these areas.
4. A record free of, “conviction of, entry of a guilty verdict, a plea of guilty, or a plea of no contest to a criminal offense involving moral turpitude in this state or any other state or country,” (Montana Annotated Code, Sec. 20-4-110).
In order to meet the requirement for question #3 (above), you need to answer the following questions:
a. Have you ever been convicted of a crime more serious than a minor traffic violation? This disclosure must be made irrespective of whether the record was sealed or expunged, you served a sentence and had your civil rights restored, the sentence was deferred or suspended, or the charge was dismissed after conviction.
Yes No
If your answer to the above question is a “Yes”, explain fully below, specifying the nature of the offense(s), the date(s) it/them occurred, the name and location of the court (s), and the sentence(s) imposed. This disclosure must be made irrespective of whether you served a sentence and had your civil rights restored. Use additional pages if necessary.
b. Are you currently on probation, deferred prosecution, suspended sentence?
Yes No
If your answer to the above question is “Yes”, explain the circumstances and include the restrictions imposed by the courts. Use additional pages if necessary.
Schools will require a criminal records check before placement in public schools. MSU will receive your complete criminal record before placing students.
I hereby certify that the above information is true and correct, and I understand that any misrepresentations on this application may be grounds for denial of the application. By signing below, I acknowledge that all the information is accurate, and I give the Montana State University Education Department permission to verify any information provided.
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Signature Date
Catalog: 2004-2006 / Agricultural Education BroadfieldMontana State University
Secondary Teacher Education Preparation Program
ID: / Name: / Date:Social Security # / Last Name First Name Initial / m/d/yr
Local Address: / Phone:
Street City State Zip
Degree:
College Degree Completed / College Degree Sought
Academic Courses / Substitution Courses
Subject / # / Course Title / CR / Grade / Subject / # / Course Title / CR / Grade
AGED / 105 / Microcomputers in Agriculture / 3
AGEC / 210 / Econ of Ag Business / 3
AGED / 333 / Construction Technology / 3
AGED / 355 / Teaching Practices / 1
TE / 406 / Curriculum & Facilities Planning / 3
AGED / 251US / Leadership Dev for Agribusiness / 3
AGED / 253 / Ag Ed in Public Schools / 3
AGED / 314 / Power Systems Oper Control / 3
AGED / 316 / Agricultural Trans Systems / 3
AGED / 400 / Seminar / 1
ARNR / 100 / Intro Animal Science / 3
ARNR / 101 / Principles of Range Management / 3
ARNR / 102 / Principles of Range Mgmt. Lab / 1
ECON / 101IS / Economic Way of Thinking / 3
MET / 315 / Welding I / 3
LRES / 201 / Soil Resource / 3
VTMB / 271 / Func Anatomy of Dom Animals / 4
PS / 102CS / Plant Sci, Resources & Environ / 3
ARNR / 320 / Animal Nutrition / 4
PSPP / 234 / Hort Sci and Technology / 3
TE / 207 / Materials & Processes / 4
Take One of the Following:
PS / 318 / Biometry / 3
STAT / 216Q / Elementary Statistics / 3
Electives:
Subject / # / Course Title / CR / Grade / Subject / # / Course Title / CR / Grade
Take One of the Following:
HDCF / 150IS / Lifespan Human Development / 3
HDCF / 160 / Hum Dev: Conception to Adol / 3
Secondary Professional Preparation
EDCI / 102 / In-School Experience / 1
EDCI / 209 / Ed Psych & Adolescent Dev / 3
EDCI / 320 / Found of Instruct Computing / 2
EDCI / 360 / Foundations of Assessment / 2
HDHL / 106 / Drug/Health Issues for Educ / 1
EDSD / 363 / Multicultural Education / 1
EDSD / 452 / Methods of Teach AG & TE / 3
AGED / 4XX / Sp-Profess in Agric / 2
HDCF / 356 / Exceptional Needs (0-21) / 3
EDSD / 410 / Student Teaching / 10-12
EDSD / 413C / Professional Issues / 2
MATH
ENGL / 121W / College Writing I / 3
COM* / 110US / Intro to Public Communication / 3
*May take approved courses with the letters US for University Seminar Core.
For Office Use Only:
First Aid with CPRParaprofessional Experience
Disclosure Statement
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Student's Signature Date
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Advisor’s Signature Date
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Certification Officer's Signature Date
For Use When Completing Student Teaching Application:
* Taking this course Spring Semester
** Taking this course Fall Semester or Summer Semester