Southern University and A & M College



Southern University and A & M College

College of Education

Application for Certification-Only Alternate Program

Semester/Year Applying For: Spring____________ Fall __________

|Name |Home Telephone |

|______________________________________ (Last, First, Middle Initial) |( ) _______________________________ |

| |Work Telephone |

|Former Name(s) |( )_______________________________ |

|______________________________________ | |

| |E-Mail __________________________________ |

|Social Security Number: |Date of Birth: ______________________________ |

|______________________________________ | |

| |Sex: Male ____ Female________ |

|Current Mailing Address: |Permanent Address: |

| | |

|______________________________________ |__________________________________________ |

| | |

|_____________________________________ |__________________________________________ |

| | |

|______________________________________ |__________________________________________ |

|Country of Birth: |Citizenship: |

|______________________________________ |___________ U. S. |

| |___________Other ___________________________ |

|Non-US citizens: Indicate Present Visa Status |College/University Attended (Ex. B.A. - SUBR) |

|_____ Permanent |Undergraduate Degree: |

| | |

|Resident/Immigrant/Refugee | |

|_____ Other, please specify |Graduate Degree: |

| | |

|High School : |Ethnicity |

| | |

|Name:__________________________________ |______Black/African American |

| |______Hispanic |

|City/State:______________________________ |______Caucasian |

| |______Asian |

|Parish/County ___________________________ |_____ Other______________________ |

| |This information is voluntary and will be used in a non-discriminating manner, |

|Graduation Date: ________________________ |consistent with applicable civil rights laws. |

If you have a disability and would like to request academic accommodations, please contact the Office of Disability Services at 225-771-3950.

Are you presently employed as a teacher? _______Yes ________ No If yes, where?

______________________________________________________________________________

If teaching, what subject/grade ____________________________________________________

Have you been admitted to our certification only program before? Yes_____ No_______

If yes, which program: 0ld_____________ New ___________

(Prior to Spring 04) (Spring 04)

Are you working towards initial certification ______certification renewal_______ add-on _____

(Please check appropriate area)

If renewal or add-on, please attach a copy of your current Louisiana Teacher’s Certificate, Type A,B,C or Level 1, 2, 3.

Please indicate the area in which you desire to seek certification:

____Elementary Education (1-5)

Middle School (Grades 4-8) ____Mathematics ____Science ____Social Studies

Please submit this application and required documents along with a non-refundable money order payable to Southern University: Application Fee ($35.00) + ($25.00) if past the deadlines

For initial certification

• 3 professional letters of recommendation

• Typed essay addressing “Why I want to be a teacher?” (500 words)

• Official transcript from all universities attended

• Original PRAX IS I and Content Area Scores

Note

An interview is required prior to acceptance.

For add-on/renewal certification

• Copy of teaching certificate

• Official transcript

I certify that the information that I have submitted with this application is correct and complete and

that I have read and understand the application instructions attached to this form and the policies of the College of Education.

_______________________________________ __________________________

Signature Date

Southern University and A & M College

College of Education

Certification-Only Alternate Program

To be admitted, individuals should provide original documentation for items 1-4.

1. Possess a baccalaureate degree from a regionally accredited University;

2. Have a 2.20 GPA, or higher, on all undergraduate coursework.

3. Pass the PRAXIS Pre-Professional Skills Tests (PPST) (An ACT composite score of 22 or a SAT combined verbal and math score of 1030 may be used in lieu of Praxis I exams).(applicants with the master’s degree are exempt)

4. Pass the PRAXIS content-specific subject area examination:

a. Candidates for PK-3 pass the Elementary Education Content Knowledge (10014) specialty

examination.

b. Candidates for Grades 1-5 pass the Elementary Education Content Knowledge (10014)

specialty examination.

c. Candidates for grades 4-8 pass the Middle school subject specific examination(s) in the

content area(s) to be certified.

d. Candidates for grades 6-12 pass the Secondary subject specific examination(s) in the content area(s) to be certified. If no examination has been adopted for Louisiana in the certification area, candidates must present a minimum of 31 semester hours of coursework specific to the content area.

e. Candidates for All-Level, K-12 area of Health and Physical Education: pass the subject- specific examination(s) in the content area(s) to be certified. If no examination has been adopted for Louisiana in the certification area, candidates must present a minimum of 31 semester hours of coursework specific to the content area. Providers must develop a process to assure that candidates demonstrate necessary performance skills in the all-level certification area.

Completed Application Package must include:

Application for Admission

3 professional letters of recommendation

Typed essay on “Why I want to be a teacher?” (500 words)

Official transcript from all universities attended

Original PRAX IS I and Content Area Scores

Copy of Louisiana Teacher’s Certificate (if add on or renewal)

Appropriate Application Fee ($35.00) + ($25.00) if past the deadlines listed below

Completion Requirements

1. Pass the PPST components of the PRAXIS (Note: Required for Admission)

2. Complete all coursework with an overall grade point average of 2.50 or higher. A grade of “C” or higher is required for all courses.

3. Pass PRAXIS specialty examination for certification area (Note: Required for Admission).

4. Pass the PRAXIS Principles of Learning and Teaching (PLT) examination:

a. Pre-K-3 candidates should take Early Childhood Education test (30521)

b. Elementary candidates should take test (20522)

c. Middle School candidates should take test (20523)

d. Secondary candidates should take test (20524)

e. K-12 candidates should take either (20522), (20523) or (20524)

5. All candidates who enter certification only program after May 1, 2004

will be required to demonstrate proficiency in the Reading Competencies as adopted by the State Board of Elementary and Secondary Education through either (1) completion of the same amount of semester hours in reading as required for undergraduate teacher preparation programs, or (2) a reading competency assessment, prior to receiving a Level 1 or higher professional teaching certificate.

Incomplete applications will not be processed.

APPLICATION DEADLINES (must be postmarked by the deadlines listed below)

Fall Semester June 30 (deadline with late fee July 12)

Spring Semester November 20 (deadline with late fee December 14)

For additional information and/or questions, you may contact or visit our website at subr.edu →Academic Affairs → College of Education → Certification-Only Alternate Program

Southern University

College of Education

Office of Student Services

P.O. Box 9983

Baton Rouge, LA 70813

-----------------------

Office Use Only

_____New

_____Readmit

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_____Add-On

_____Renewal

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