ATP Provisional Graduate Student Application Updated on: June 1, 2016 A Provisional Graduate student is defined as a qualified student who has a Bachelors degree from Austin College or another institution. All applicants for the graduate program must complete undergraduate general education requirements as well as certification content courses required either by Austin College or the Texas State Board for Educator Certification. Date Date Format: MM slash DD slash YYYY Name* First Last Social Security NumberGender Male Female Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country PhoneEmail* Certification Level*Choose OneEarly Childhood through Sixth GradeGrades Four through EightGrades 7-12Grades 8-12All Level CertificationCertification Field*GeneralistCertification Field*Choose OneEnglish Lang Arts & ReadingEnglish Lang Arts & Reading/Social StudiesMathematicsScienceSocial Studies/ HistoryCertification Field*SpeechCertification Field*Choose OneEnglish Lang Arts & ReadingHistoryLife ScienceMathematicsPhysical ScienceCertification Field*Choose OneArtFrenchGermanLatinMusicPhysical EducationSpanishTheatreHave you ever been or are you currently enrolled in another teacher certification program? Yes No Name of the Program and Dates EnrolledDescribe why you are interested in pursuing a career in teaching.Describe why you are interested in pursuing teacher education at Austin College.Experiences Related to TeachingPlease include employer, dates of employment, specific nature of workAcademic HonorsBriefly describe any scholastic distinctions or honors you received in college.ATP General Education Requirements U.S. History I or II Writing/English Math (college algebra or higher) Life Span Psychology Educational Psychology or Cognitive Psychology Foreign Language to the Intermediate Level Education Courses Undergraduate coursework that may be considered to fulfill ATP requirements.U.S. HistoryInclude course title, course number, institution, grade, semester hoursWriting/EnglishInclude course title, course number, institution, grade, semester hoursMathInclude course title, course number, institution, grade, semester hoursLife SpanInclude course title, course number, institution, grade, semester hoursEd Psy or CognitiveInclude course title, course number, institution, grade, semester hoursForeign LangInclude course title, course number, institution, grade, semester hoursEduc Courses or Life ExperiencesInclude course title, course number, institution, grade, semester hours List life experiences you want considered for required coursework that have contributed to your ability to teach.Criminal History Check Acknowledgement* I acknowledge and understand that a criminal history check is required to teach in the state of Texas I understand that the state of Texas requires all applicants for a teaching certificate to be fingerprinted and to give permission for a nationwide criminal background check. I further understand that the State Board for Educator Certification (SBEC) can deny a teaching certificate to an applicant who has a criminal record. I am also aware that even if SBEC agrees to grant a teaching certificate to a person with a criminal record, a school district will conduct its own criminal background check and can decline to hire the applicant because of his or her record. I understand that if I do have a criminal history record and continue in the Austin Teacher Program, I am doing so at my own risk. I will hold Austin College and the Austin College Education Department harmless if I am denied a teaching certificate or am unable to find a teaching job because I have a criminal record. Educators Code of Ethics* I have read the "Code of Ethics and Standards Practices for Texas Educators" and agree to abide by the code as a pre-professional educator and/or student observer in classrooms. View the "Educators' Code of Ethics"