Ashland University
Dwight Schar College of Education Office of Fields and Partnerships
Undergraduate Application for Admission into the Teacher Education Program
This application should be completed when the student applies for EDCI 330, EDEC 330, EDIS 330, or EDCI 336.
Admission to the Teacher Education Program is necessary to enroll in Junior Field Experiences (Teacher Induction
Ceremony). The student is expected to complete all pre-professional requirements prior to admission. If a student
is currently enrolled in a course that is required, a copy of the student’s current course schedule must be attached.
Any student who fails to meet the requirements for admission into the Teacher Education Program may decide not
to enter the program, show improvement in the areas of deficiency and reapply, or make an appeal to the
Department Chair.
Name: ___________________________________________ Student ID Number: _________________________
Campus Box Number: ____________ Email Address: _________________________________________________
Home Address: __________________________________________________________________________________
City: ____________________________________________ State: ______________ Zip: ____________________
Cell Phone Number: _______________________________ Birthdate (MM/DD/YY): _________________________
Advisor: _________________________________________
Licensure Area Desired
Early Childhood PreK-3
Intervention Specialist K-12
Middle Childhood 4-9
Two Content Areas
(Mark Only One)
Early Childhood Education (PreK-3)
Intervention Specialist- Early Childhood
(Mark Only One)
Intervention Specialist (ISMM)
Intervention Specialist (ISMI)
Intervention Specialist Dual
(Mark Two)
Language Arts
Social Studies
Adolescent and Young Adult 7-12
One Content Area
Multi-Age PreK-12
(Mark Only One)
Language Arts
Social Studies
(Mark Only One)
Visual Arts