Instructions to apply to the Field Based Teacher Education Program (Educational Aide): Complete the online application and print the Confirmation Page; Responsibility Framework Page; Degree Audit; and Completed Teacher Education Program Checklist ( EC-6, 4-8, or SED-All Level ); Manila File Folder (letter size). Return all items to : Teacher Certification Office, Texas A&M Commerce, Ed North, Room 202, Commerce, TX 75429.

 
*SSN: - -
*Date of Birth: - -
*Gender:
*U.S Citizen?:    *CWID:

*Ethnicity: *Race 1: *Race 2:

*First Name:
(Use proper capitalization)		 *Last Name:
(Use proper capitalization)		 Maiden:

*Address:
(Use proper capitalization)		 *City:
(Use proper capitalization)		 *State *Zip:

*Home Ph: ( )- - Work Ph: ( )- -

Cell Ph: ( )- - *Email:
   


Teaching Fields: 1 st 2 nd (if applicable)
(*For 4-8/8-12/Secondary/All-Level applicants only)

*Level:

*Type of Plan :


*Campus (indicate the campus where you are receiving instruction):

Basic Skills Reading: Basic Skills Math: Basic Skills Writing: Speech Class Grade:

NOTE: You must meet all Basic Skills requirements to be fully admitted to the Teacher Education Program.

___________________________________________________________________________________________________________________________
*Have you ever been convicted of a felony? If yes, please explain and give date of offense on separate sheet of paper and attach to application.

NOTE: Admission to the Field-Based Program requires a minimum grade of "C" in coursework, an overall GPA of 2.75, a minimum GPA of 2.75 in Teaching Field courses and in Pre-Internship courses. A grade of "C" or above in a speech class, satisfactory completion of Basic Skills Requirements and departmental approval.


Please indicate school district and campus. 
School District: (Do Not Abbreviate) Campus:
   
*Principal:

*Principal Email: 		*Phone: ( )- -
   
*Mentor Name: *Mentor Email:
   
*Grade Level: *School Address:
   
*School City, State, Zip :  


                         

*Required Fields
Note: Upon submission of this application, a confirmation page will be available for printing.
Please print the confirmation page and submit with the required documents.