Fillable ADMISSION TO THE TEACHER PREPARATION PROGRAM (Harding University)

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ADMISSION TO THE TEACHER PREPARATION PROGRAM (Harding University)

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ADMISSION TO THE TEACHER PREPARATION PROGRAM
Students should apply to the Teacher Preparation Program BEFORE the end of their sophomore year
and should meet the following requirements at that time.
Required Grades
1. _____ Overall GPA of 2.70.
2. _____ "C" or better in English 1110 or 1130 (Composition I)
3. _____ “C” or better in English 2110 (Composition II).
4. _____ “C” or better in EdFd 2020 – Introduction to the Teaching Profession.
5. _____ “C” or better in EdFd 2030 – Child & Adolescent Development.
6. _____ “C” or better in COMM 1010 – Speech Communication.
7. _____ “C” or better in MATH 1330 – College Algebra or Quantitative Reasoning.
Required Assessments
Praxis Core Test OR ACT Equivalent OR SAT Equivalent. Be sure to have your scores sent to Harding
University. (Residual ACT exam can be taken in the Harding University Office of Testing and
Evaluation in Searcy, AR).
Praxis Core Score
ACT Score
SAT Score
Math
162
19
533
Reading
168
19
543
Writing
165
7
5
Application Packet - Complete the checklist below for Teacher Education Program.
1. _____ Application for Admission to the Teacher Preparation Program. Return to the Harding
University Northwest Arkansas office. (Form A)
2. _____ Student Reference Request and Family Educational Rights and Privacy Act (FERPA)
Release Form (Form B)
3. _____ “Cause” for Non-Issuance of a Teaching Certificate Statement. (Form C)
4. _____ Recommendation for Admission forms. Fill out the top and give to four of your previous
NWACC or HU_NWA instructors. (Send stamped envelopes with the following address:
ATTN: Meredith Young, Harding University Northwest Arkansas, 901 S. 52
nd
St., Rogers,
AR 72758 or ask instructors to email the form to mryoung@harding.edu) (Form D)
5. _____ Advising Grid for Admission to Teacher Preparation Program. Have Dr. Meredith Young
sign this form. Return to Harding University Northwest Arkansas office.
6. _____ Complete Federal Background Check & Fingerprinting
PLEASE NOTE:
Understand that, in the final analysis, it is YOUR responsibility to become acquainted with the
requirements of the Cannon-Clary College of Education published in the Harding University catalog and
to comply with those requirements. Nevertheless, we are pleased to assist you in planning your program
and receive much personal satisfaction in seeing your progress through your academic career at Harding.
901 S. 52nd Street Rogers, AR 72758
Updated 03.30.2020  phone: 479.268.5813, fax: 479.268.5818 1
TEACHER PREPARATION PROGRAM ADMISSION APPLICATION
Name: ________________________________________ Preferred: _________________________________________
Social Security #: _______________________________ Harding ID # _________________Date: ________________
Email: _________________________________________ Phone Number: ____________________________________
Address: ____________________________________________________________________________________________
Street City State Zip
Classification (Check): ____ Junior ____ Senior Major (Check): ____ K-6 Elementary OR ____ 4-8 Middle Level
Check Licensure Area: ____ K-6 Elementary OR ____ 4-8 Middle Level (If ML, check two subjects below.)
____ English Language Arts ____ Mathematics ____ Science ____ Social Science
Faculty Academic Advisor: _Dr. Meredith Young____________________________________________________________
____________________________________________________________________________________________________
FOR OFFICE USE ONLY FROM THIS POINT FORWARD:
Federal Background Checking and Fingerprinting Approval Date: ___________________________________________
Curriculum Plan Date:
Cumulative Overall GPA:
Required
Courses
Grade
Praxis Core
Score
Score
SAT
Score
ENG 1110/1130
Math (162)
Math (533)
ENG 2110
Reading (168)
Reading (543)
MATH 1330
Writing (165)
Writing (6)
COMM 1010
EDFD 2020
EDFD 2030
Recommendations Received:
1. _______________________________________________ 2. ________________________________________________
3. _______________________________________________ 4. ________________________________________________
Date Admitted to TPP
Cum GPA at TPP Admittance
Major at TPP Admittance
Date Admitted to Internship II
Cum GPA at Internship II
Major GPA at Internship II
Form A
901 S. 52nd Street Rogers, AR 72758
Updated 03.30.2020  phone: 479.268.5813, fax: 479.268.5818 2
Instructions: Fill in all information required, date and sign the form and return to Harding University Northwest
Arkansas if you want the University to release reference information as specified in this authorization.
Student Reference Request and FERPA (Family Educational Rights & Privacy Act) Release Request
I, (Student Name) ______________________________, request the Cannon-Clary College of Education at Harding
University to serve as reference for me. The purpose(s) of the reference are: (initial all selected purposes)
_____application for employment
_____all forms of scholarship or honorary award
_____admission to another education institution
The reference may be given in the following form(s): (initial one or both spaces)
_____written _____oral
Authorization
I authorize the Cannon-Clary College of Education at Harding University to provide references, release information and
education records, and provide an evaluation about any and all information from my education at Harding University and
at other institutions I have previously attended which are part of my education records at Harding University. (initial all
applicable spaces)
1._____ all prospective employers OR _____ specific employers
(list on reverse side)
2._____ all educational institutions OR _____ specific educational institutions
to which I seek admission (list on reverse side)
3._____ all organizations considering OR _____ specific organizations
me for an award or scholarship (list on reverse side)
Release
I understand I have the right to consent to the release of my education records and I have a right to receive a copy of any
written reference upon request. This consent shall remain in effect until revoked by me, in writing, and delivered to the
Cannon-Clary College of Education at Harding University, Searcy, White County, Arkansas, but that any such
revocation shall not affect disclosures previously made by Harding University prior to receipt of any such written
revocation. I have reviewed the above information and understand this is the information to be released should my
references be checked. In consideration and return for the Cannon-Clary College of Education issuing the information
authorized under this authorization, I release the Cannon-Clary College of Education, Harding University and its
governing board, employees and agents from any and all liabilities, claims and actions that may arise pursuant to this
release, disclosure pursuant to this release, and any consequences of such disclosure. I understand that this authorization
covers liability claims and actions caused entirely or in part by the acts or failures to act of the Cannon-Clary College of
Education, Harding University or its governing board, employees or agents, including but not limited to negligence,
mistake or failure or other conduct.
Student’s Signature__________________________________ Date_______________________________
Harding ID# ________________________
Form B
901 S. 52nd Street Rogers, AR 72758
Updated 03.30.2020  phone: 479.268.5813, fax: 479.268.5818 3
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“CAUSE” FOR NON-ISSUANCE OF A TEACHING CERTIFICATE
Certificates will not be issued or renewed for individuals who have committed acts that constitute
“cause” for revoking certificates as specified in ACT 866 of 1989. Section One of Act 866 defines
“cause” as:
1. Conviction of a felony.
2. The acknowledged or admitted commission of an act which would constitute a felony under
the Arkansas Criminal Code.
3. Holding a teaching certificate obtained by fraudulent means.
4. Revocation of a certificate in another state.
5. Intentionally compromising the validity of security of any student test or testing program
administered by and/or required by the Arkansas Department of Education.
6. Knowingly submitting, through the superintendent or directly to the Arkansas Department of
Education, falsified information which is requested or required by the Arkansas Department
of Education.
An individual will not be admitted to the teacher education program/professional field experiences at
Harding University if they have committed any of the acts listed above which constitute “cause” for the
non-issuance of a teaching certificate.
In the event a student who has been admitted to the teacher education/professional field experiences
program is cited, indicted, or arrested for a criminal offense which may reasonably impact their fitness
to teach, immediate suspension from the teacher education/professional field experiences program will
result. A plea of guilty, nolo contendere or a judgment of guilty will result in the student being dropped
from the teacher education/professional field experiences program.
I (Student Name), ___________________________________________, verify that I have not
committed any act which would impact my fitness to teach or would constitute “cause” for non-issuance
of a teaching certificate under Act 866 of 1989.
Student’s Signature__________________________________ Date_______________________
Harding ID# ________________________
Form C
901 S. 52nd Street Rogers, AR 72758
Updated 03.30.2020  phone: 479.268.5813, fax: 479.268.5818 4
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EVALUATION OF TEACHER CANDIDATE’S PROFESSIONAL DISPOSITIONS
Student Name (Please Print): _____________________________________________ H#: ________________________
I (the student) have signed the Student Reference Request and FERPA (Family Educational Rights & Privacy Act) Release.
However, I have waived _______ not waived _______ my right of access to this recommendation form.
______________________________________________________________ ____________________________________
Teacher Candidate (Student) Signature Date
Classification (Check): ____ Junior ____ Senior Major (Check): ____ K-6 Elementary OR ____ 4-8 Middle Level
Check Licensure Area: ____ K-6 Elementary OR ____ 4-8 Middle Level (If ML, check two subjects below.)
____ English Language Arts ____ Mathematics ____ Science ____ Social Science
I was enrolled in your class entitled ______________________________________ during ___________________________
(Semester & Year)
__________________________________________________________________________________________
Please complete this form by placing a check in the appropriate box and return to Meredith Young at Harding
University Northwest Arkansas, 901 S 52
nd
St, Rogers, AR 72758.
Professional Dispositions
Exceptional
4
Satisfactory
3
Needs Improvement
2
Unsatisfactory
1
Professionalism
Arrives punctually and prepared for classes and
required activities, dresses appropriately,
communicates professionally with others
Reflection
Seeks and uses feedback to change ineffective
processes
Curiosity
Asks questions, shows curiosity and enthusiasm
for content, seeks a deep understanding
Honesty
Exhibits honesty and integrity in coursework
with other students and teachers
Dedication
Actively participates in class, is consistent in
attendance, exhibits a positive attitude, is prompt
with work
Writing Skills
Oral Skills
Comments: __________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Based on your interactions with this candidate, what is your recommendation regarding this person’s continuation in the
teacher education program?
_____ Fully Support _____ Support With Reservation _____ Do Not Support
Signature: ______________________________ Print Name: ___________________________ Date: _________
Form D
901 S. 52nd Street Rogers, AR 72758
Updated 03.30.2020  phone: 479.268.5813, fax: 479.268.5818 5
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EVALUATION OF TEACHER CANDIDATE’S PROFESSIONAL DISPOSITIONS
Student Name (Please Print): _____________________________________________ H#: ________________________
I (the student) have signed the Student Reference Request and FERPA (Family Educational Rights & Privacy Act) Release.
However, I have waived _______ not waived _______ my right of access to this recommendation form.
______________________________________________________________ ____________________________________
Teacher Candidate (Student) Signature Date
Classification (Check): ____ Junior ____ Senior Major (Check): ____ K-6 Elementary OR ____ 4-8 Middle Level
Check Licensure Area: ____ K-6 Elementary OR ____ 4-8 Middle Level (If ML, check two subjects below.)
____ English Language Arts ____ Mathematics ____ Science ____ Social Science
I was enrolled in your class entitled ______________________________________ during ___________________________
(Semester & Year)
__________________________________________________________________________________________
Please complete this form by placing a check in the appropriate box and return to Meredith Young at Harding
University Northwest Arkansas, 901 S 52
nd
St, Rogers, AR 72758.
Professional Dispositions
Exceptional
4
Satisfactory
3
Needs Improvement
2
Unsatisfactory
1
Professionalism
Arrives punctually and prepared for classes and
required activities, dresses appropriately,
communicates professionally with others
Reflection
Seeks and uses feedback to change ineffective
processes
Curiosity
Asks questions, shows curiosity and enthusiasm
for content, seeks a deep understanding
Honesty
Exhibits honesty and integrity in coursework
with other students and teachers
Dedication
Actively participates in class, is consistent in
attendance, exhibits a positive attitude, is prompt
with work
Writing Skills
Oral Skills
Comments: __________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Based on your interactions with this candidate, what is your recommendation regarding this person’s continuation in the
teacher education program?
_____ Fully Support _____ Support With Reservation _____ Do Not Support
Signature: ______________________________ Print Name: ___________________________ Date: _________
Form D
901 S. 52nd Street Rogers, AR 72758
Updated 03.30.2020  phone: 479.268.5813, fax: 479.268.5818 6
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EVALUATION OF TEACHER CANDIDATE’S PROFESSIONAL DISPOSITIONS
Student Name (Please Print): _____________________________________________ H#: ________________________
I (the student) have signed the Student Reference Request and FERPA (Family Educational Rights & Privacy Act) Release.
However, I have waived _______ not waived _______ my right of access to this recommendation form.
______________________________________________________________ ____________________________________
Teacher Candidate (Student) Signature Date
Classification (Check): ____ Junior ____ Senior Major (Check): ____ K-6 Elementary OR ____ 4-8 Middle Level
Check Licensure Area: ____ K-6 Elementary OR ____ 4-8 Middle Level (If ML, check two subjects below.)
____ English Language Arts ____ Mathematics ____ Science ____ Social Science
I was enrolled in your class entitled ______________________________________ during ___________________________
(Semester & Year)
__________________________________________________________________________________________
Please complete this form by placing a check in the appropriate box and return to Meredith Young at Harding
University Northwest Arkansas, 901 S 52
nd
St, Rogers, AR 72758.
Professional Dispositions
Exceptional
4
Satisfactory
3
Needs Improvement
2
Unsatisfactory
1
Professionalism
Arrives punctually and prepared for classes and
required activities, dresses appropriately,
communicates professionally with others
Reflection
Seeks and uses feedback to change ineffective
processes
Curiosity
Asks questions, shows curiosity and enthusiasm
for content, seeks a deep understanding
Honesty
Exhibits honesty and integrity in coursework
with other students and teachers
Dedication
Actively participates in class, is consistent in
attendance, exhibits a positive attitude, is prompt
with work
Writing Skills
Oral Skills
Comments: __________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Based on your interactions with this candidate, what is your recommendation regarding this person’s continuation in the
teacher education program?
_____ Fully Support _____ Support With Reservation _____ Do Not Support
Signature: ______________________________ Print Name: ___________________________ Date: _________
Form D
901 S. 52nd Street Rogers, AR 72758
Updated 03.30.2020  phone: 479.268.5813, fax: 479.268.5818 7
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signature
click to edit
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signature
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EVALUATION OF TEACHER CANDIDATE’S PROFESSIONAL DISPOSITIONS
Student Name (Please Print): _____________________________________________ H#: ________________________
I (the student) have signed the Student Reference Request and FERPA (Family Educational Rights & Privacy Act) Release.
However, I have waived _______ not waived _______ my right of access to this recommendation form.
______________________________________________________________ ____________________________________
Teacher Candidate (Student) Signature Date
Classification (Check): ____ Junior ____ Senior Major (Check): ____ K-6 Elementary OR ____ 4-8 Middle Level
Check Licensure Area: ____ K-6 Elementary OR ____ 4-8 Middle Level (If ML, check two subjects below.)
____ English Language Arts ____ Mathematics ____ Science ____ Social Science
I was enrolled in your class entitled ______________________________________ during ___________________________
(Semester & Year)
__________________________________________________________________________________________
Please complete this form by placing a check in the appropriate box and return to Meredith Young at Harding
University Northwest Arkansas, 901 S 52
nd
St, Rogers, AR 72758.
Professional Dispositions
Exceptional
4
Satisfactory
3
Needs Improvement
2
Unsatisfactory
1
Professionalism
Arrives punctually and prepared for classes and
required activities, dresses appropriately,
communicates professionally with others
Reflection
Seeks and uses feedback to change ineffective
processes
Curiosity
Asks questions, shows curiosity and enthusiasm
for content, seeks a deep understanding
Honesty
Exhibits honesty and integrity in coursework
with other students and teachers
Dedication
Actively participates in class, is consistent in
attendance, exhibits a positive attitude, is prompt
with work
Writing Skills
Oral Skills
Comments: __________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Based on your interactions with this candidate, what is your recommendation regarding this person’s continuation in the
teacher education program?
_____ Fully Support _____ Support With Reservation _____ Do Not Support
Signature: ______________________________ Print Name: ___________________________ Date: _________
Form D
901 S. 52nd Street Rogers, AR 72758
Updated 03.30.2020  phone: 479.268.5813, fax: 479.268.5818 8
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ADMISSION TO THE TEACHER PREPARATION PROGRAM (Harding University)

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Completed 23 July 2020

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