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CREDENTIAL PROGRAM APPLICATION - CSU_ Chico by wuzhenguang

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									                                   CSU, Chico School of Education Application Packet for the
                                                Multiple Subject Program
Name: _______________________________________                                Student ID: _____________________________
Deadlines for Application: Due in Tehama 101, by 4:00 p.m. on March 1 or October 1 (or              Apply for a Certificate of Clearance
the next working day if those are non-working days). Please include this checklist with             (fingerprint check). Obtain the Clearance
your application                                                                                    packet at this link:
Use this application checklist form to help    2. Complete Credential Application                   http://www.csuchico.edu/soe/documents
complete and organize your application         Requirements                                         /coc-directions.pdf or in the SOE office.
materials. We suggest you keep a copy of                                                            Complete Steps 1 and 2. Include a copy
all documents submitted.                       Photocopy of confirmation sheet (one sheet         of the completed Request for Live Scan sheet
                                               only) from your online Graduate School               with your credential application. Clearance
1. Complete an application for                 application. (For post-baccalaureate applicants.)    by the CA Commission on Teacher
admittance to CSU, Chico                                                                            Credentialing is required by state law for
                                               $50 credential program application fee made        your school placement (student teaching).
If you are new to CSU, Chico, have been        payable to CSU, Chico.
out of school for a semester or more, or                                                            One copy of official transcripts
                                               Completed Credential Program                       from each college/university attended. In
are graduating at the end of the semester,
                                               Application (attached). (Complete information is
you must apply to the university. For                                                               addition, CSU, Chico students must also
                                               essential to the processing of your application.)
assistance, call the Graduate School office,                                                        provide an unofficial or portal transcript.
530-898-6880.                                  A copy of your professional résumé. For
                                                                                                    (Transcripts submitted elsewhere on
                                               assistance you may contact the Career Planning       campus are not available to the credential
If you are applying to the Graduate            and Placement Office (898-5253, Student Service      program.)
School for admission please do all of          Center 270).
the following (early application is                                                                Verification of Basic Education Skills
strongly recommended):                         Handwritten belief statement form                  Requirement. Proof of passing
                                               (attached).                                                CBEST
Apply online at: www.csumentor.edu                                                                Information: www.cbest.nesinc.com
                                               Handwritten experience statement form              OR if you have passed the Multiple
Submit a check or money order                (attached).
                                                                                                    Subjects CSET subtest I, II, and III
payable to CSU, Chico in the amount of
                                               Candidate Disposition Form (attached)                CSET Writing Skills Exam
$55 or Graduate School Fee Waiver Form
                                               should be given to the teacher in whose              Submit a copy of the individual scoresheet
http://www.csuchico.edu/graduatestudies/
                                               classroom your early school experience was done.     that is mailed to you.
prospective/admissions_forms
                                               The teacher should complete the form and return
                                               it to the School of Education. You must fill in      For other options, see pre-program
Submit one official set of transcripts
                                               the top portion before giving it to the teacher.     advisor.
from all colleges or universities previously
attended to the Graduate School.
                                               A letter of recommendation that attests to         CSET for Multiple Subjects
                                               the attributes you possess that will contribute to   (Subject Matter Competency)
If you are (or expect to be) a graduate of     effective teaching. The letter may be from a work    Passage of the CSET Multiple Subject
CSU, Chico, you do not need to submit          supervisor or a professor who can verify your        Examination is required prior to
transcripts to the Graduate School.            professional abilities. Letters should be current    application deadline for priority
                                               and on letterhead.                                   consideration. Information regarding the
                                                                                                    CSET-Multiple Subject exam can be
                                               Three (3) additional references. Provide           found at www.cset.nesinc.com
                                               the names and phone numbers of three people
                                                                                                    Submit a copy of the individual scoresheet
                                               who know you in an educational setting (college
                                                                                                    that is mailed to you.
                                               professor, teacher, school administrator, church
                                               school director, or work supervisor.)
                                                                                                    Verification of tuberculosis
                                                                                                    clearance (test must have been within the
                                                                                                    last 4 years).
                    M ULTIPLE S UBJECT P ROGRAM C REDENTIAL P ROGRAM A PPLICATION
                                              School of Education (SOE )
This form, along with your Graduate School Application, is used by SOE to certify that admission requirements are met for the
Multiple Subject program. Please fill out the form completely if you wish to be considered for the School of Education Credential
Program..


LAST NAME                             FIRST NAME              M.I            STUDENT ID #                     SOCIAL SECURITY #

CSET (Subject Matter Competence)
  Exam taken, individual scoresheet enclosed
  Exam to be taken or retaken on __________________________
CBEST (Basic Skills Tests)
  CBEST exam taken, individual scoresheet enclosed
  Exam to be taken or retaken on __________________________:

Certificate of Clearance (fingerprinting):
   Certificate of Clearance online application submitted on__________________ (date)
  Fingerprinting completed on ________________ (following LiveScan, online application must be submitted)
  Credential held:

Bachelors Degree:
Institution:
Major:                                                                 Graduation date or anticipated date:

Colleges/Universities attended (list all)
 CSU, Chico                                                                                        Unofficial transcript enclosed
                                                                                                       Official transcript enclosed
                                                                                                       Official transcript enclosed
                                                                                                       Official transcript enclosed
Prerequisite Courses Completed Courses in progress should be marked “IP” for grade received

     MS Program          Title of Course            Semester /          Equivalent Course # (must be            Institution
     Course                                         Grade               approved)
                        Introduction Classroom
     EDTE 255
                         Experience
                         Access & Equity in
 EDTE 302
                         Education
 HCSV 450               Health Education
                         Theory/Practice of
 ENGL 471               Second Language
                         Acquisition
                         Fundamentals of
 ENGL 520
                         Teaching Practice
Native English Speaker
          Yes _____ No ______
Ethnicity
           American Indian or Alaska Native
           Asian
           Black or African American
           Hispanic/Latino of any race
           Native Hawaiian or Other Pacific Islander
           White
           Decline to State

                                            (Used for demographic reporting purposes only)


        I certify that the above and all information submitted by me in conjunction with my application is accurate and complete.




Applicant’s Signature                                                                        Date



Local Mailing Address



Phone                                                                     E-Mail
               California State University, Chico –School of Education Credential Programs
                                    Belief and Experience Statements

_____________________________________________________ _____________________________________________________
LAST NAME                                                            FIRST NAME

Part 1: Belief Statement:
The mission of the School of Education includes the following: We believe in the power of education to create a diverse, democratic,
socially responsible society in which every student is valued.
Based upon the teaching philosophy that you have developed, describe specific teaching practices that would work towards meeting
the goals of the mission statement. Use the space provided below.
Note: This form will not be kept confidential. It will be read by university faculty and possibly by public school personnel.
                 California State University, Chico –School of Education Credential Programs
Part 2: Experience Statement:
Provide a handwritten description of an experience from your life and discuss how that experience would influence your work with
diverse populations of children (struggling learners, English Learners, children from low socioeconomic backgrounds, or children with
disabilities or exceptional needs). Include specific examples and use the space provided below.




Note: This form will not be kept confidential. It will be read by university faculty and possibly by public school personnel.




SIGNATURE:                                                                                             DATE:
California State University, Chico
School of Education
Chico, California 95929-0222
530-898-6421
                                            CANDIDATE DISPOSITION FORM
Candidate Name:

Candidate Program Level:        Early School Experience (EDTE 255)
                                    Teaching Practicum I  Teaching Practicum II

To the respondent: Effective credential candidates should enter our programs with certain dispositions and continue to develop those
dispositions through the experiences provided in our professional programs. Please mark an “x” in the box that represents your rating
of the dispositions, keeping in mind the candidate’s current program level. For explanations of each performance level and disposition,
please see the rubric on the back of this form to guide you in your ratings. The purpose of this form is to guide and inform program
faculty in their acceptance decisions and to monitor professional growth throughout the credential program. Please return this form
ASAP to the School of Education (address shown above).

                                Disposition                                   Needs            Developing          Acceptable
                                                                           Improvement

     Disposition #1
     Appreciates and values human diversity, recognizes community
     and cultural norms, shows respect for students’ varied talents and
     perspectives, seeks to foster culturally-appropriate
     communications and demonstrates best practices in his or her
     field.

     Disposition #2
     Believes that all children can learn, appreciates their varying
     abilities and persists in helping all children achieve success.

     Disposition #3
     Committed to continuous, self-directed learning, critical thinking
     and reflection in order to refine instructional practice and deepen
     knowledge in the academic disciplines.

     Disposition #4
     Demonstrates pride in the education profession and participates
     in collaborative relationships with colleagues, students, parents,
     and social and professional communities and agencies.

     Disposition #5
     Committed to the expression and use of democratic values and is
     committed to creating a learning environment that fosters active
     engagement in learning and encourages positive social
     interaction.

Signature ______________________________________ Print Name ___________________________________

Position _________________________________________________ Date _______________________________

School ___________________________________________________ Phone _____________________________

Total hours spent in your classroom: _____    Dates from_________ to _________ Diverse classroom  yes          no

Number of English Language Learners in your classroom:
Recommend for Credential Program acceptance:                    yes no (Early Field Experience only)
Additional comments are welcome.
                                                              Needs Improvement                                       Developing                                       Acceptable
               Disposition #1
Appreciates and values human diversity,            Unfairly interacts and responds to               Is aware of the need to interact and respond     Interacts and responds with all students fairly;
recognizes community and cultural norms,           students; is unaware of opportunities to         with all students fairly; responds to            looks for opportunities to enhance cross-
shows respect for students’ varied talents and                                                      opportunities to enhance cross-cultural          cultural understandings; invites and integrates
                                                   enhance cross-cultural understandings; is
perspectives, seeks to foster culturally-                                                           understandings; recognizes individual            students’ individual differences into the
appropriate communications and                     non-responsive to students’ individual
                                                                                                    differences; attempts to encourage cultural      classroom environment; encourages cultural
demonstrates best practices in his or her field.   differences; misses opportunities to             sensitivities and perspectives; is aware of      sensitivity and perspectives; models culturally
                                                   encourage cultural sensitivities and             culturally responsive pedagogical practices      responsive pedagogical practices
                                                   perspectives; is unaware of culturally
                                                   responsive pedagogical practices
               Disposition #2
Believes that all children can learn,              Not engaging with students at all levels of      Recognizes and engages all levels of student     Looks for and inquires about a variety of
appreciates their varying abilities and persists   student abilities: Easily frustrated when        abilities: Tries to help students that don’t     strategies to engage all levels of student
in helping all children achieve success.           students don’t understand; focuses on higher     understand; attempts to interact all levels of   abilities: Persists with students to try to help
                                                   level students only; isn’t aware of students     student abilities; seeks to help all students    them understand; encourages students at all
                                                   who need help                                                                                     levels; seeks strategies to be more effective
                                                                                                                                                     with all students.
               Disposition #3
Committed to continuous, self-directed             Rarely asks questions about classroom            Asks some questions about classroom              Often asks questions about and comments on
learning, critical thinking and reflection in      dynamics; passes by opportunities to discuss     dynamics; occasionally engages in thinking       classroom dynamics; shows a real interest in
order to refine instructional practice and         teaching practice; demonstrates inadequate       about and discussing teaching practice;          thinking about and discussing teaching
deepen knowledge in the academic                   knowledge of subject and curriculum, and/or      demonstrates knowledge of subject and            practice by initiating discussions often;
disciplines.                                       has few ideas to increase his/her knowledge      curriculum, but is less certain of ways to       demonstrates superior knowledge of subject
                                                                                                    increase his/her knowledge                       and curriculum; describes realistic and specific
                                                                                                                                                     workable plans for increasing his/her
                                                                                                                                                     knowledge.
               Disposition #4
Demonstrates pride in the education                Dresses inappropriately and/or exhibits          Dresses and conducts self appropriately;         Models professional dress and conduct; uses
profession and participates in collaborative       inappropriate and/or unprofessional behavior;    communicates effectively with students and       verbal communication that enhances
relationships with colleagues, students,           uses verbal communication that does not          colleagues; meets scheduled time/hour            interactions with students and colleagues;
parents, and social and professional               foster interaction; Attendance, punctuality,     commitment and is prepared                       meets or exceeds scheduled time/hour
communities and agencies.                          and/or preparation is problematic                                                                 commitments, arrives promptly and is well
                                                                                                                                                     prepared
               Disposition #5
Committed to the expression and use of             Unaware of the need for interdependent,          Aware of the need for interdependent,            Recognizes and values interdependent,
democratic values and is committed to              collaborative social interaction; unresponsive   collaborative social interaction; listens to     collaborative social interaction; values student
creating a learning environment that fosters       to student ideas; displays little interest or    student ideas; actively observes group work;     ideas; facilitates student group work, when
active engagement in learning and                  involvement in group work; limited               responsive to students                           asked; very responsive and respectful to all
encourages positive social interaction.            responsiveness to students                                                                        students, both verbally and nonverbally

								
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