Fill - Free fillable T Epacket T Epacket T Epacket (Wichita State University) PDF form

Teac

her Education Application Packet

Mail

or submit complete application packet to:

Teacher Education Admissions

College of Applied Studies Advising

Wichita State University

1845 Fairmount, Campus Box #131

Wichita, KS 67260-0131

Web site: www.wichita.edu/casadvising

Notice of Nondiscrimination:

Wichita State University does not discriminate in its employment practices, educational programs or activities on the basis

of age, color, disability, gender, gender expression, gender identity, genetic information, marital status, national origin,

political affiliation, pregnancy, race, religion, sex, sexual orientation, or status as a veteran. Retaliation against an individual

filing or cooperating in a complaint process is also prohibited. Sexual misconduct, relationship violence and stalking are

forms of sex discrimination and are prohibited under Title IX of the Education Amendments Act of 1972. Complaints or

concerns related to alleged discrimination may be directed to the Director of Equal Opportunity or the Title IX Coordinator,

Wichita State University, 1845 Fairmount, Wichita KS 67260-0138; telephone (316) 978-3187.

Wichita State University

Teacher Education Program, Admission Requirements

I. Thirty-Five (35) Hours of General Education,

A. Basic skills course requirements with grades that meet Wichita State University policy

1. English Composition I

2. English Composition II

3. Basic Public Speaking

4. College Algebra or higher level mathematics course

* Elementary, Early Childhood Unified, and Middle Level Math majors are required to have a 2.0 or better in

College Algebra in order to take Math 501. A grade of C- is not accepted.

B. Other general education course requirements

1. General Psychology

2. Elementary Statistics

** Secondary Math majors need Calc. I, instead of Elementary Statistics

II. Introduction to the Teaching Profession Course

Prospective candidates must complete an introductory to the teaching profession course (e.g., CI 270) with an earned

grade of B- or better in the course and a “satisfactory” grade in the corresponding field experience component.

(Beginning Fall 2019, not required for Art Education majors).

III. Standardized Test Requirement

A prospective teacher education candidate must meet only one of the following four standardized

test requirements. The basic skills test used to fulfill his or her admission requirements must have been

taken within ten (10) years from the date of the prospective candidate’s application to the teacher

education program:

A. American College Testing Program (ACT) - Composite score 21 or above.

Most scores are available for online viewing within 2 weeks after each national or international test

date. For specific information: http://www.act.org/content/act/en/products-and-services/the-

act/test-day.html. Cost is approximately $46.00

Test Date

Registration Deadline

(Late Fee Required)

October 26, 2019

September 20, 2019

September 21-October 4, 2019

December 14, 2019

November 8, 2019

November 9-22, 2019

February 8, 2020

January 10, 2020

January 11-17, 2020

April 4, 2020

February 28, 2020

February 29-March 13, 2020

June 13, 2020

May 8, 2020

May 9-22, 2020

July 18, 2020

June 19, 2020

June 20-26, 2020

If you are testing on a national test date and can't afford the registration fee for the ACT or ACT

with writing, you may be eligible for an ACT Fee Waiver.

http://www.act.org/content/act/en/products-and-services/the-

act/registration/fees.html#feewaivers

B. Praxis Core Academic Skills for Educators Tests.

Minimum required scores—Reading (exam code 5712) 152; Writing (exam code 5722) 162; and

mathematics (exam code 5732) 142

https://www.teacherstestprep.com/Praxis-

Core?utm_source=bing&utm_medium=cpc&utm_campaign=Praxis%20Core%20-

%20Search&utm_term=praxis%20core&utm_content=Praxis%20Core

C. SAT - Combined score 980 or above

https://collegereadiness.collegeboard.org/sat/register

D. The Coll

ege Assessment of Academic Proficiency (CAAP) was discontinued by ACT as of

December 2017. Scores from exams completed prior to this date will still be accepted for the next

10 years with the following scores:

a. Writing 55 b. Mathematics 53 c. Reading 56

IV. For Elementary and Early Childhood majors only

• “C” or better in Geography or History (OR) pass the CBASE in Social Studies with 235 minimum score

• “C” or better in a Science Course (OR) pass the CBASE in Science with 235 minimum.

V. Grade Point Average (GPA) Requirements

A. Overall GPA: 2.5

B. GPA in 35 hours of general education coursework: 2.75

C. WSU GPA: 2.5 (if applicable)

VI.

Signed Attestation of Eligibility

VII. Signed Grounds for Dismissal Regulations

VIII. Provide proof of a completed CERTIFICATION OF HEALTH FOR SCHOOL PERSONNEL (K.S.A. 72-

5213)

Submit to CASA, 107 Corbin. On this form you are responsible for Negative TB exam and physical, completed by your

family doctor, Wichita State Student Health Services, or another medical professional. Student Health also charges for

this service and an appointment is necessary. Cost is approximately $60

IX. Background check cleared. Cost is approximately $42

• Option #1: Provide a copy of current Substitute License (Applicant may also give SSN to Applied Studies

Advising Center staff to look up license on the KSDE website).

• Option #2: Provide a copy of recent background clearance with Validity or NATSB.

• Option #3: Validity Screening Solutions - Submit the Validity online background request form

Application for Teacher Education Admission

Candidate’s Name ______________________________________Program ______________________________________

Date of Birth _______________ WSU ID______________________ Email _______________________________

Mailing Address___________________________________________________ Phone ____________________________

Candidates must complete all columns which are not shaded

Course Requirements for Admission

Grade

WSU Advisor

Check

English Comp 1

English Comp 2

Public Speaking

College Algebra

General Psychology

Elementary Statistics (Calc I for Sec. Math majors)

Intro to the Teaching Profession course (grade of B- or better)

Beginning Fall 2019, CI 270 is not required of Art Ed majors.

*Must have a copy of all transcripts on file.

Choose one

Score

Date

Elementary/ECU majors

Course Grade

ACT Composite

(21 minimum) or

SAT Combined

(980 minimum)

CBASE Social Studies

(or) History or

Geography with “C” or

better

CORE Reading

(152 minimum)

CORE Writing

(162 minimum),

CORE Math

(142 minimum)

CBASE Science

(or) Science Course with

“C” or better

GPA Requirements for Admission

Requirement Met

GPA

2.75 GPA 35 hours general education course work

2.50 GPA Overall

2.50 GPA WSU (if applicable)

Signed Attestation of Eligibility

Signed Grounds for Dismissal Regulations

I give

permission to have my photo published in WSU publication such as newsletters,

websites,

etc…

underst

and

that

I must submit the “Certification of Health Form” to Applied Studies Advising Center and have a

background clearance on file before I am allowed to enroll in Core I classes.

Semester and Year Expecting to “Start” Core I at WSU______________________________________________________

Candidate’s Signature __________________________________________________________ Date__________________

Advisor’s Signature _________________________________________________________ Date__________________

Full Admit _____ Conditional ____ Reason: __________________________________________________

______

ATTESTATION OF ELIGIBILITY

The Kansas State Board of Education requires that individuals who have been convicted of, or pleaded guilty to, any act

punishable as a felony may not be certified to teach. Wichita State University is responsible for recommending individuals who

have completed the teacher education program for certification as a teacher. Given this responsibility, it is asked that you read

and sign the statement below.

If you are confident that you understand the standard, please answer the questions below and complete the "Attestation of

Eligibility."

1. Have you ever been convicted of a felony? _____ **

2. Have you ever been convicted on ANY crime involving theft, drugs, or a child? _____ **

3. Have you entered into a criminal diversion agreement after being charged with any offense described in Question 1 or 2

above? _____

4. Are criminal charges pending against you in any state involving any of the offenses described in question 1 or 2 above?

_____

5. Have you had a teacher’s or school administrator’s certificate or license denied, suspended or revoked in any state? _____

6. Is disciplinary action pending against you in any state regarding a teacher’s or administrator’s certificate or license? _____

7. Have you ever been terminated, suspended, or otherwise disciplined by a local Board of Education for falsifying or altering

student tests or student test scores? _____

8. Have you ever falsified or altered assessment data documents, or test score reports required for licensure? _____

**Note: Anyone who is ineligible to be employed according to KSDE regulations, or has been denied by Coop

because of an existing record, cannot be assigned a field placement in any of the Core classes.

ATTESTATION OF ELIGIBILITY

I, ________________________________________________, certify that the information on this application is true and

complete to the best of my knowledge. I understand that any misrepresentation of facts may result in the denial or revocation

of my certificate or license.

Signature:___________________________________________Date:______________

click to sign

signature

click to edit

Grounds for Dismissal from Field Experiences

Candidates in a teacher education program participating in a clinical experience as a part of their degree program are expected

to conduct themselves in accordance with the requirements and expectations of their degree program. Candidates in a teacher

education program should likewise not engage in unprofessional conduct or unlawful behaviors. In view of these expectations,

students in a teacher education program participating in a clinical experience who are unable to meet these academic

standards, as judged by faculty and cooperating teachers, may receive a failing grade and/or face possible removal from their

particular clinical/field experience:

1. Candidates may not engage in any inappropriate interactions with pupils, guardians of pupils enrolled in the school, or

school or university personnel during the clinical experience. If you feel you are under any pressure to engage in

inappropriate social activity, contact your university supervisor.

2. Candidates’ social interactions and communications, including use of cellular phones, Email, and the internet with

school pupils, or guardians of pupils enrolled in the school, or school or university personnel, should be limited to those

occurring in an official capacity at officially sponsored school events or sites.

3. Candidates may not be in the possession of or under the influence of alcoholic beverages, illegal drugs or dangerous

weapons or substances on school property, nor with or in the presence of any school pupil(s).

4. Candidates may not use sexually explicit, obscene, profane, abusive, or derogatory language on school premises or at

school sponsored events; nor may they suggest access to inappropriate material (e.g., on the Internet).

5. Candidates may not escort or transport pupils off school property unless accompanied by the cooperating teacher or

another full-time employee assigned by the principal.

6. Candidates may not leave school early, be late to school or seminars, or have absences on a consistent basis.

7. Candidates may not falsify, forge, or alter any documents pertaining to academic records, including evaluation reports.

In addition, if at any time your conduct causes the cooperating teacher, the principal, or the university supervisor to determine

that your presence in the classroom has become detrimental to the educational program of the pupils in the class, your actions

will be reviewed by a field experience review team comprised of school and university officials and/or you may be asked to

leave the school and your placement could be terminated by the University.

Should you be asked to leave the school based upon your behavior or your failure to perform at a satisfactory level, Wichita

State University is not obligated to reassign you to another school. Failure to abide by these regulations may result in any of the

following consequences: removal from field experiences, judicial action by Wichita State University, legal action, and/or failure of

course work.

I have read and am aware of WSU’s Guidelines for Professional Conduct during Field Experiences and Grounds for

Dismissal from Field Experiences.

Printed Name: ___________________________________________________

Signature: Date:

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CERTIFICATION OF HEALTH FOR SCHOOL PERSONNEL

K.S.A. 72-5213

Top portion of this form is to be filled out by Teacher Education Candidate. A completed copy of this form must be submitted to Applied Studies

Advising Center, 107 Corbin, Wichita State University. The candidate must keep the original documentation or a copy at all times during field

experiences and internships.

Name:_______________________________________________________________________________

WSU ID:_____________________________________________________________________________

Address: ________________________________________________Birthdate:_____________________

School: Wichita State University

Tuberculin Testing Results

(To be completed by Health Care Provider)

Tuberculosis has been ruled out by

Test Administered Read Result

Mantoux/PPD ___________ ________ ________ ________ mm induration

(Negative) (Positive)

Chest X-ray ___________ ________

(Negative / Positive)

Administered by ________________________________________________________________________

Read by _____________________________________________ ____________________________

(Signature) (Health Facility)

Provider’s Statement

I have, this date, examined _______________________________and find no evidence of any physical condition that would conflict with

the health, safety, or welfare of the pupils or would prevent the individual from working in a safe and healthful manner.

List limitations or restrictions, if any.

Comments______________________________________________________________________________________________________

_______________________________________________________________________________________________________________

___________

__________________________________________________________________________ _______

(Signature of Licensed Physician, Registered Physician’s Assistant or Advanced Registered Nurse Practitioner) (Exam Date)

(Address)

K.S.A. 72-5213. Certification of health; (a) Every board of education shall require all persons, whether employees of the school district or under the supervision thereof, who

come in regular contact with the pupils of the school district, to submit a certification of health on a form prescribed by the secretary of health and environment and signed by

a person licensed to practice medicine and surgery under the laws of any state, or by a person who is registered as a physician’s assistant under the laws of this state when such

person is working at the direction of or in collaboration with a person licensed to practice medicine and surgery, or by a person holding a certificate of qualification to practice

as an advanced registered nurse practitioner under the laws of this state when such person is working at the direction of or in collaboration with a person licensed to practice

medicine and surgery. The certification shall include a statement that there is no evidence of physical condition that would conflict with the health, safety, or welfare of the

pupils; and that freedom from tuberculosis has been established y chest x-ray or negative tuberculin skin test.

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Dear College of Applied Studies Student:

The Application to Teacher Education process includes completion of a background check with Validity

Screening Solutions within 10 business days of submitting the application to Teacher Education and have

on file a signed student acknowledgement and authorization form. Passing the criminal background

required at application to teacher education does not replace or ensure you will pass the Kansas State

Department of Education (KSDE) background check required when applying for licensure.

To complete the criminal background check required for admission to Teacher Education complete these

steps:

1. Go to the secure link: https://www.ejobapp-validityscreening.com/p/wsu3256

2. You will need to create a New User account by client link in the upper right hand corner (previous credentials

will not work for this updated site)

3. Create a User Registration by completing the required fields and clicking SAVE

4. An authentication message will be dispatched to your email. Follow the link within the email to set password

and begin application.

5. Locate your needed package by selecting the SUBMIT link

6. Complete each section of the screening profile

a) Review the screening profile to ensure all sections are complete and click NEXT (bottom right)

b) Read the “Notice” and check the confirmation box, click NEXT (bottom right)

c) Read the “Summary of Rights under the Fair Credit Reporting Act” and check the confirmation box,

click NEXT (bottom right)

d) Complete the Disclosure and enter your signature in the electronic signature box, click NEXT (bottom

right)

e) Complete the required fields in the Authorization and enter your signature in the electronic signature

box, click NEXT (bottom right)

f) Complete Credit Card payment options (AMEX, Discover, MasterCard or Visa)

i. Cost is $42.00 plus $2.00 administrative fee

ii. Receipt of payment will be emailed to you once submitted

g) Schedule Drug Test (if necessary, you will be prompted to select location)

h) Select SUBMIT to complete application

* Your results will not be released to WSU until you successfully submit your request and payment to Validity.

Results will be forwarded to Wichita State University. Instructions on how to access your completed report via your

profile page will also be sent via email once your profile has been submitted.

If you have any questions please feel free to contact Ashlie Jack at (316) 978-3589 or ashlie.jack@wichita.edu. You

may also contact Validity Screening Solutions with technical questions at 913.322.5995, toll-free at 866.920.5995 or

via email at students@validityscreening.co

……………………………………………………………………………………………………………………………...#

WICHITA#STATE#UNIVERSITY/#College&of&Applied&Studies/&1845#Fairmount#Street/#Wichita,#Kansas#67260-0028#

tele:#(316)#978-3301/fax:#(316)#978-3302/web:#www.wichita.edu/cas#

Wichita State University College of Applied Studies

Teacher Education Candidate

Guidelines for Professional Performance during Field/Clinical Experiences

The WSU Teacher Education Candidate (includes any WSU student engaged in a field experience as part of their

teacher preparation program) and Intern is responsible for:

1. Communicating with the cooperating teacher the university supervisor on a routine and timely basis;

2. Adhering to all placement school policies and procedures;

3. Demonstrating academic and professional integrity as outlined by WSU’s policies and procedures

regarding student conduct (visit http://webs.wichita.edu/inaudit/ch8_05.htm);

4. All Teacher education candidates (TECs) in a teacher education program participating in a field

experience as a part of their degree program are expected to conduct themselves in accordance with the

requirements and expectations of their degree program. TECs should not engage in unprofessional

conduct or unlawful behavior in accordance to KSDE's Kansas Educator Code of Conduct:

http://www.ksde.org/Portals/0/TLA/Licensure/KS_Ed_Code_Conduct_Brochure031014.pdf

5. Completing all assignments and projects as mutually agreed upon and assigned by the university

supervisor, cooperating teacher, and/or the Teacher Education Program (e.g., KPTP, reflection

evaluations, lesson plans);

6. Being punctual and regular in attendance;

a. If for any reason a teacher education candidate must be absent, he/she should notify the

university supervisor, the cooperating teacher, the building principal, and the school contact

person prior to the absence.

b. Absences should be limited to emergency situations only (e.g., illness or family

emergencies).

c. If a teacher education candidate is ill for an extended absence, he/she should provide the university

supervisor with documentation such as a confirmation from his/her doctor. Similarly, the teacher

education candidate must provide documentation reflecting the non-

illness related absences if

documentation is available (e.g., obituaries).

d. The field experience requirement may be extended when absences occur.

e. If a teacher education candidate is absent when he/she is scheduled to teach, he/she must provide a

set of detailed lesson plans for the teacher who will assume the classroom responsibilities

7. Demonstrating a sensitivity to students’ needs;

8. Demonstrating responsiveness to feedback;

9. Transporting him/herself to and from the placement school;

10. Maintaining the confidentiality of student information that must remain private in accordance with the

Family Educational Rights and Privacy Act (FERPA); and

11. Any other appropriate assignment(s) or request(s) made by the cooperating teacher, university supervisor,

or WSU faculty.

Student Fees as of December 2018:

Prices are subject to change

I. Application for Teacher Education Program/ Core I classes - Out of Pocket Expenses

1. Background: $42

2. TB skin test: $20 (price at WSU Student Health)

3. Physical: $38 (price at WSU Student Health)

4. Testing:

a. ACT (if needed): $46

b. CBASE (for Elementary and Early Childhood majors): $44

II. Core Program Fees – Charged to Student Account

1. Field Experience/Internship: additional $30/per credit hour

2. Final Semester: Kansas Performance Teacher Portfolio (KPTP): $60

III. Final Semester - Out of Pocket Fees:

1. Graduation: Cap and Gown (Regalia and Tassel): $36

2. Licensure:

a. Background/Fingerprint Process: $50 (some law enforcement agencies may charge a fee to take

your prints)

b. Initial Teaching License Application: $60 for each area

c. Praxis Test Fees:

• PLT - $90

• Content test(s) between $120-$146 for each area (Note: two subject areas in Middle Level -

between $240-292)

Fee waivers may be available for college students who meet all eligibility criteria. If you qualify for a fee

waiver, the test fees for up to three Praxis ® Core tests, or one Praxis ® Subject Assessment may be waived.

If you are requesting a fee waiver for all three Praxis Core tests, the voucher issued to you will be for the

combined test code (5751). https://www.ets.org/praxis/about/fees/fee_waivers/

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