Morningside College Continuing Education for Teachers
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Application for Supervised Externship
(this is not the Master of Arts in Teacher Education Application)
Teacher Name:
Teacher Email Address:
School/Employer:
School/Employer Address:
City:  State:  Zip:
US Home Address:
City:  State:  Zip:
US Home Phone:
Complete the admission application and submit with a $25.00 non-refundable application fee (U.S. dollars) made payable to Morningside.

A. Please list colleges and universities attended.

College/University
State
Start Date
(Mo/Yr)
End Date
(Mo/Yr)
Major
Degree
GPA
B. Citizenship Status

 United States Citizen      Temporary Resident      Permanent Resident

 Nonresident Alien*

* If you are a Nonresident Alien, please complete the following:

Country of Birth:    Country of Citizenship: 

Is English your native language?    Yes    No    (If no, documentation of English literacy is required.)

Do you currently have a US visa?     Yes    No    If yes, what type: 

What is the visa expiration date?  (mmddyy)

Do you require an I-20?     Yes    No

C. Required Courses:

     1. Behavior is Language: Strategies for Managing Disruptive Behavior
     2. Advanced Classroom Management: Children as Change Agents

D. Elective Courses:
Note: If you are registering for only the Required Courses listed above, you may leave this section blank.

 
Course
Term
3.
4.

I will provide Morningside College with copies of my transcripts, diploma, evaluations, and visa approval.

I have read and understand the requirements, policies, and procedures that are published by Morningside College, including course description, fees and costs for the courses and information regarding graduate credit. I agree to abide by all rules and regulations of Morningside College.

I hereby grant permission to make any necessary inquiries. I voluntarily and knowingly authorize any former school, government agency, employer, person, firm, corporation, its officers, employees and agents, or any other person or entity to make a written or oral response to such information request. I understand and agree that this application including all information submitted will be forwarded to Teachers Council and to VESi.

 

Applicant's Signature:   Date: