evaluation instructions for application by ib3kJV4


									                                          Instructions for Requesting an Evaluation
A. Who should complete this application?
   Graduates of Purdue University or another accredited institution who are interested in completing a teacher education
   program at Purdue University West Lafayette (whether they are seeking original licensing, an addition to an existing
   license, or a professional license) should complete this form. Note: If you are interested in the "Transition to
   Teaching" program, please visit the Office of Professional Preparation and Licensure web site at
   http://www.education.purdue.edu/licensure/ for admission requirements.
    Non-U.S. Graduates: You must obtain an official evaluation report which translates your non-U.S. course
    work into U.S. equivalents. Contact the Educational Credential Evaluators (http://www.ece.org) or World
    Education Services (http://www.wes.org) to obtain a course-by-course report. Please provide the original
    report with this request form. The Office of Professional Preparation and Licensure cannot evaluate your
    credentials without this report.
B. Who should not complete this application?
   Graduates who wish to obtain a second baccalaureate degree should not complete this form. If a second baccalaureate
   degree is desired, contact the Office of Admissions at (765) 494-1776.
C. When does one request an evaluation?
   Evaluation requests are accepted at any time during the year. Individuals seeking admission to the Graduate School
   of the College of Education for an advanced degree or to complete graduate course work, however, should submit all
   materials to the Office of Professional Preparation and Licensure prior to June 1 for the Spring Semester and prior to
   November 1 for the Summer and Fall Semesters in order to meet Graduate Studies Office deadlines.
D. What happens to the request form once it has been submitted to the Office of Professional Preparation and
   When the items below have been submitted, the transcript evaluation will be conducted by a Licensing Advisor. After
   all materials are reviewed, a letter indicating any deficiencies will be issued. This evaluation is valid for one year. If
   courses are not initiated within this period, the evaluation is considered void. (A student taking course work before
   an evaluation is received does so at his/her own risk. Please note prerequisites, corequisites, and the sequence
   of professional education classes in course catalogs.)
   Allow three to four weeks for processing the evaluation.
E. Whom do I contact if I have questions regarding completing this evaluation form?
   Contact the Office of Professional Preparation and Licensure at (765) 494-5486 or licensure@purdue.edu.
F. Where should the completed request form be returned?
   Office of Professional Preparation and Licensure, Beering Hall of Liberal Arts & Education, Room 3229,
   100 North University Street, West Lafayette, IN 47907-2098
Please include the following items in your evaluation request packet:
    1. Official transcripts from institutions attended other than Purdue University (West Lafayette, Calumet or North
       Central), if course work pertains to the program area. Please request that the transcript be sent to you, and then
       enclose it with this packet. Note: You may wish to order an additional set of transcripts to use at the time of
    2. A cashier's check or money order made payable to Purdue University for the amount due. (Minimum amount due
       is $35.00.) See page four. No personal checks or cash will be accepted.
    3. The completed evaluation request form.
    4. Verification of teaching experience. See #10 on page 3.
    5. Non-Purdue graduates should complete the self-assessment form. Please follow the order of courses as they
       appear on the approved program sheets.
    6. Attach a course description from a course catalog or a syllabus for each course that you wish to substitute for a
       Purdue course. Grades received from courses not taken at Purdue must be a grade of “C” or higher.
NOTE: * Return all items listed above in one mailing. Incomplete application packets will be returned.
      * An academic or faculty advisor is unable to officially advise a student for licensure until the Office of Professional Preparation
         and Licensure has completed an evaluation.
      * Due to sequencing and the availability of some of the professional education courses, it may not be possible to complete a
         program in less than two years unless a person is admitted through the Transition to Teaching Program (see A. above).
      * If an evaluation is not requested before course work is completed for licensure, the individual will be charged the evaluation fee
         before the license application will be processed.

                                   Request for Evaluation
                      for Purdue University Teacher Education Programs
                                            Please type or print (in ink).

Date of request                                   Date received by office

1. Name (include all names ever held)

    Last                                          First                                     Middle Initial


2. Social Security Number                                     Telephone Number (_____)

3. Current Address and E-mail Address

                                                              E-mail Address
4. List degree earned, date, university, and grade point average (GPA). In order to be eligible for an
   evaluation, an overall GPA of 2.50/4.00 or 4.50/6.00 (2.67/4.00 or 4.67/6.00 for foreign language
   education; 2.80/4.00 or 4.80/6.00 for early childhood, elementary, and special education;
   3.00/4.00 or 5.00/6.00 for social studies) at the time of graduation is required.
   Note: Please verify Special Education GPA requirements with the Office of Professional
   Preparation and Licensure before submitting this evaluation request.

   Degree                Date            Institution                                                GPA ______

   Degree                Date            Institution                                                GPA ______

5. Other universities attended and grade point average(s)

    a.                                                     b.
    c.                                                     d.

6. Do you wish to obtain a graduate degree or complete graduate courses? Yes ____ No ____

7. Do you plan to apply to the Transition to Teaching program? Yes ____ No ____
   (See www.education.purdue.edu/licensure for admission requirements.)

8. If currently enrolled at Purdue, please list School/College of enrollment.

9. Have you requested an evaluation from this office in the past? Yes ____ No____
   If so, complete the following:

    a. Area(s) requested

    b. Month/Year of receipt of evaluation

    c. Name held when request was made
10. If applicable, list licenses currently held, indicating state and level. Attach a copy of each.
   Note: If you have taught during the past ten years, please submit a letter verifying teaching experience on
   school corporation letterhead signed by the personnel office. This documentation will be reviewed as part of
   the “Professional Education” assessment of each program.

11. Please check the area(s) below in which you are requesting an evaluation.

 INSTRUCTIONAL:                                                                               Charge
 _____ Generalist: Early Childhood Education/Exceptional Needs: Early Childhood                35.00   $_______
 _____    Generalist: Early and Middle Childhood (Elementary Education)                        35.00   $_______
          Early Adolescence and Adolescence/Young Adulthood (Senior High/Junior
          High/Middle School):
 _____       Agriculture                                                                       35.00   $_______
 _____       Family and Consumer Sciences                                                      35.00   $_______
 _____       Health                                                                            35.00   $_______
 _____       Language Arts (English)                                                           35.00   $_______
 _____       Mathematics                                                                       35.00   $_______
 _____      Reading                                                                            35.00   $_______
 _____       Science (one or more areas):
             ___ Chemistry                                                                     35.00   $_______
             ___ Earth/Space Science                                                           35.00   $_______
             ___ Life Sciences (Biology Education)                                             35.00   $_______
             ___ Physics                                                                       35.00   $_______
 _____       Social Studies (three or more areas are required):                                35.00   $_______
             ___ Historical Perspectives/Economics/Government and Citizenship
             ___ Historical Perspectives/Economics/Psychology
             ___ Historical Perspectives/Economics/Sociology
             ___ Historical Perspectives/Government and Citizenship/Psychology
             ___ Historical Perspectives/Government and Citizenship/Sociology
             ___ Historical Perspectives--For Transition to Teaching (see A on page 2),
                 the Historical Perspectives area may be a stand alone license only if the
                 candidate has a bachelor’s degree with a history major. All other
                 individuals interested in Social Studies licensing must complete a
                 minimum of three social studies areas.

 _____    Technology Education                                                                 35.00   $_______
          Adolescence/Young Adulthood (Secondary):
 _____       World Language:
             ___ French                                                                        35.00   $_______
             ___ German                                                                        35.00   $_______
             ___ Spanish                                                                       35.00   $_______

          Early Childhood, Middle Childhood, Early Adolescence, and Adolescence/Young
          Adulthood (All Grade):
 _____           Computer Education (Educational Technology) *                                 35.00   $_______
 _____            Exceptional Needs (Special Education) This program is not available
                  under Transition to Teaching. See A on page 2.
                         ___ Mild Intervention**                                               35.00   $_______
                         ___ Mild and Intense Intervention**                                   35.00   $_______
                         ___ Intense Intervention (for those holding a teaching license)**     35.00   $_______
 _____           Fine Arts
                          ___ Visual Arts                                                      35.00   $_______
                          ___ Visual Arts/Design Emphasis                                      35.00   $_______
 _____           Gifted and Talented Education *                                               35.00   $_______
 _____           Interdisciplinary Cooperative Education (can only be added to Bulletin 400    35.00   $_______
                                                          or Rules 46-47 license)
 _____           Physical Education                                                            35.00   $_______
            * If not already licensed, another license area must be selected.
          ** Offered as a graduate program only.

_____ Counselor **                                                                                          35.00    $_______

_____  District Administrator **:
       ___ Superintendent                                                                                   35.00    $_______
       ___ Director of Exceptional Needs                                                                    35.00    $_______
       ___ Director of Career/Technical                                                                     35.00    $_______
       ___ Director of Curriculum and Instruction                                                           35.00    $_______

_____     Building Level Administrator **                                                                   35.00    $_______

          ** Offered as graduate program only.

       Area(s) on license _______________________________________________                                   35.00    $_______

TOTAL DUE (money order or cashier’s check payable to Purdue University)                                              $_______
The minimum charge for an evaluation is $35.00.

                                            NON-PURDUE GRADUATE
                                              Self-Assessment Form
   Purdue course:         Non-Purdue course I would like to substitute:                                University:
   (subject/number)       (subject/number)                        (title)                                (name)
   ____________          ___________         __________________________________                      ____________

   ____________          ___________         __________________________________                      ____________

   ____________          ___________         __________________________________                      ____________

   ____________          ___________         __________________________________                      ____________

   ____________          ___________         __________________________________                      ____________

   ____________          ___________         __________________________________                      ____________

   ____________          ___________         __________________________________                      ____________

   ____________          ___________         __________________________________                      ____________

   ____________          ___________         __________________________________                      ____________

   ____________          ___________         __________________________________                      ____________

   ____________          ___________         __________________________________                      ____________

   ____________          ___________         __________________________________                      ____________

   ____________          ___________         __________________________________                      ____________

   ____________          ___________         __________________________________                      ____________
   NOTE: Please include a course description from a course catalog (from the year you attended) or a
   syllabus for each non-Purdue course that you wish to substitute for a Purdue course. A grade of “C” or
   higher is required for any non-Purdue course to be substituted for a Purdue course.

                      Once all materials have been received, please allow three to four weeks for processing.



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