The University of North Carolina at Pembroke Teacher ...

[Pages:1]The University of North Carolina at Pembroke Teacher Education Program

Request for a Plan of Study (Licensure Only/Residency)

Please print the following information: First Name: _____________________ Middle/Maiden Name: _________________ Last Name: _____________________ Social Security Number:_______-______-_______ Cell Phone: (____)_______________ Address: _____________________________________ City: _____________________ State: _____ Zip: _____________ E-mail address: ______________________________________________________________________________________

Educational Background:

College/University*

Dates Attended

Degree

_____________________________________________________ ______________ _________________ _____________________________________________________ ______________ _________________ _____________________________________________________ ______________ _________________ _____________________________________________________ ______________ _________________ *Before processing can begin on your request, official transcripts of ALL college/university work and any North Carolina licensure areas now held must be on file in this office.

*Residency candidates with an admission GPA below 2.7 will be admitted provisionally and must complete the Residency Education Core with a 3.0 GPA at completion of the core to be recommended for full admission to UNCP's residency licensure programs. Program Coordinators will review transcripts and qualify candidates based on prior relevant degree or 24 hours in the licensure area or passing scores for all NCSBE licensure exams.

Request ONE area from the following:

Academically and Intellectually Gifted (AIG) Add-On (K-12) (If you currently hold a clear license) Art (K-12) Birth-Kindergarten (B-K) English as a Second Language Add-On (K-12) (If you currently hold a clear license) Middle Grades Science (6-9) Music (K-12)

Pre-School Add-On (If you hold a clear license in Elementary Education, Family or Consumer Sciences or Special Education.) Science ? (9-12) Circle one (1): Biology

Chemistry Earth Science Physics Spanish Education (K-12)

Current LEA (Local Education Agency) (If applicable):_________________________________________________ Current School and Grade (If applicable):_____________________________________________________________

__________________________________________________

Signature

UNC Pembroke School of Education

Licensure Office Post Office Box 1510 Pembroke, NC 28372

(910) 521-6397 uncp.edu/soe

_____________________________ Date

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download