Office of Graduate Studies 186 High Street Farmington, ME 04938
Version Created Fall 2020
Master of Science in Education
in Mathematics Education
Application
Last Name __
___________________________________ First Name ___________________________ Middle________________
Preferred First Name _________________ Name on previous records ___________________________ Date of Birth __________
Student ID (if known) __________________________
Personal Email Address_______________________________________ Home Phone Number _________________________
Home mailing address _________________________________________________________________________
Country of Birth: ________________________________________________________ Are you a US citizen? Yes No
If you are a US Permanent Resident, indicate alien registration number and submit a copy (front & back) of your Permanent
Resident Card. A# _______________
(Optional) Universities are asked by the federal government, accrediting associations, and college guides, among others, to describe
the racial/ethnic backgrounds of our students. To fulfill these requests, we ask you to answer the following questions:
Language(s) spoken at home ________________________________ Are you of Franco-American heritage? Yes No
Please indicate if you are Hispanic/Latino Yes No
Please select one or more of the following racial categories to describe yourself: American Indian or Alaska Native
Asian Black or African American Native Hawaiian or other Pacific Islander White Other
District/School _______
____________________Position ___________________________ Number of years _____
District/School ___________________________Position ___________________________ Number of years _____
For Office Use Only Date Received: ___________
___________ Application Essay
___________ Official undergraduate transcript
___________ For consideration of transfer credits, official graduate transcripts and syllabi
___________ Copy of Maine teaching certification ___________ Recommendation 1 ___________ Recommendation 2
Preferred start Date _________________ Specialization _________________________________________________________
Education and Experience (check one)
I am currently enrolled as an undergraduate student
I have a bachelor’s degree from UMF
I have a bachelor’s degree from another institution
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-- Do you have a current criminal history record check (CHRC) with the Maine Department of Education? (please include a copy with
your application) ______ Are you currently employed in a PreK-12 school setting?____________(if no, skip to next section)
Number of Years Teaching ______ Current Employer
Current Position______________________________________________________________________________________
Do you hold a current Maine Department of Education certificate? Yes No
Please provide a copy of your
My endorsements are in the following areas ___________________________________________
Maine DOE certification.
Other PreK-12 experience:
