APPLICATION TO TAKE EDUCATOR PREPARATION/DEVELOPMENT COURSEWORK
(Teacher, School Administrator, or School Pupil Services)
BOWLING GREEN STATE UNIVERSITY
Please complete the form electronically, print, and mail or fax the paper copy along with the Guest (Undergraduate) or the NonDegree Graduate Application form to the Office of Registration and Records on the BGSU main campus or on the Firelands
campus. The form will be forwarded to the Office of Accreditation and Licensure in the College of Education and Human
Development (main campus) for processing.
Name:
ID#:
Current Date:
Desired Enrollment Term/Year:
Phone #1:
Phone #2:
Email Address:
Section A: Please place an “X” in the box next to either statement #1 OR #2 to indicate your current educator
licensure status; Under #1 OR #2, place a “X” in front of a, b, c, d, or e (select one only) to indicate your primary
purpose for taking educator preparation coursework at BGSU
1.
I hold a current or expired teacher, administrator, or pupil services certificate/license in
(indicate content area;
box will expand) from the following state(s):
a. I wish to take educator preparation coursework for personal development purposes only
b. I wish to take educator preparation coursework for certificate/licensure renewal purposes only
c. I wish to take educator preparation coursework as a guest undergraduate student or a non-degree graduate
student while my admission to a graduate certificate or degree program is pending. I have applied to the
following program:
d. I wish to take educator preparation coursework as a guest undergraduate student or a non-degree graduate
student to add a new license or a new endorsement. Please proceed to Section B to indicate desired license or
endorsement
e. Other (please indicate)
2.
I DO NOT hold a current or expired teaching, administrator, or pupil services certificate/license
a. I wish to take educator preparation coursework for personal development purposes only
b. I wish to take educator preparation coursework as a guest undergraduate student or a non-degree graduate
student while my admission to a graduate certificate or degree program is pending. I have applied to the
following degree program (box will expand):
c. I wish to take educator preparation coursework as a guest undergraduate student or non-degree graduate
student to pursue initial licensure. Please proceed to Section B to indicate desired license or endorsement
d. Other (please indicate)
Note: If you marked “1d.” or “2c.” and have non-BGSU coursework that should be reviewed for eligibility consideration, please
send official transcripts to the Office of Accreditation and Licensure, 455 Education Building, BGSU, Bowling Green, OH 43403.
+Transcripts may be anticipated from the following Institution(s):
Section B: If an “X” was placed by #1d OR #2c above, please place a “X” beside your desired licensure or
endorsement area in the chart below:
TEACHING LICENSES—Unless otherwise indicated, all teacher licensure programs are at the undergraduate level;
*Programs with asterisks (i.e., “*”) following the title require graduate program admission :
ADOLESCENT/YOUNG ADULT (GRADES 7-12)
Adolescent/Young Adult (Secondary) Education—Select one area of specialization below:
Earth Sciences
Integrated Science (pending)
Life Sciences and Physics
Earth Sciences and Chemistry
Integrated Social Studies
Physical Sciences: Chemistry
Earth Sciences and Physics
Life Sciences
Physical Sciences: Chemistry and
Integrated Language Arts
Life Sciences and Chemistry
Physics
Integrated Mathematics
Life and Earth Sciences
Physics Physical Sciences: Physics
CAREER TECHNICAL (VOCATIONAL; GRADES 4-12)
Business Education (Integrated)—
Marketing Education—
Undergraduate level
Undergraduate level
Business Education* (Integrated)—
Marketing Education* (must
Graduate level
register under Business
Education)—Graduate level
Work Force Development (formerly,
Route B, 24-Hour Program)—Select
program area(s):
Business
Marketing
To pursue this program at BGSU, an individual must
have been offered an applicable teaching position and
have a CTE-37 form signed by the employing
superintendent or designee. In addition, the individual
must already hold a teaching certificate or license.
*Programs with asterisks (i.e., “*”) following the title require graduate admission
11.02.2011
2
APPLICATION TO TAKE EDUCATOR PREPARATION/DEVELOPMENT COURSEWORK
EARLY CHILDHOOD (GRADES PREK-3)
Early Childhood Education
INTERVENTION SPECIALIST (UNLESS OTHERWISE INDICATED, GRADES K-12)
Deaf/Hard of Hearing—
Mild/Moderate—Undergraduate
Undergraduate level (PreK-12)
level
Mild/Moderate—Graduate level
Moderate/Intensive Intervention
Specialist—Undergraduate level
Moderate/Intensive Intervention
Specialist—Graduate level
MIDDLE CHILDHOOD (GRADES 4-9) Individuals pursuing first/initial licensure must select two concentrations; individuals holding
Ohio certificates/licenses may select one or two concentration areas (please indicate desired concentration[s]).
Middle Childhood
Mathematics
Science
Reading/Language Arts
Social Studies
MULTI-AGE (GRADES PREK-12)
Music Education—Select one area of specialization:
Choral
Classroom/General Music
Physical Education
Visual Arts—Art Education—Select one area of specialization:
Three-Dimensional Studies
Two-Dimensional Studies
World Language—Select one area of specialization:
French
Latin
German
Russian
Instrumental
Spanish
TEACHING ENDORSEMENTS—Please indicate desired endorsement and enrollment status: U = Enrolled as a Guest
(Undergraduate) or a Guest pending undergraduate degree program admission ; PB = Enrolled as a Guest (Undergraduate) or Non-Degree
Graduate pursuing post baccalaureate licensure; GC = Enrolled as a Non-degree Graduate pending Graduate Certificate program
admission; G = Enrolled as a Non-Degree Graduate pending graduate program admission
Adapted Physical Education
Limited to physical education license
U
GC
Middle Childhood Generalist 4-6
Limited to middle childhood license
with two areas
U
PB
Language Arts/Reading
Mathematics
Science
Social Studies
Reading*
GC
Classroom Technology*
(Computer/Technology)
G
P-6 Mathematics Specialist*
Limited to pre-kindergarten,
elementary, early childhood, middle
childhood, high school, or AYA
mathematics licenses
GC
Early Childhood Generalist (4-5)
Limited to Early Childhood license
U
PB
GC
P-6 Science Specialist*
Limited to kindergarten-primary,
elementary, early childhood, middle
childhood, high school, or AYA
science licenses; 3 years experience
GC
Transition to Work
PB
G
Limited to intervention specialist or
career-technical licenses
ADMINISTRATIVE LICENSES—All administrative licensure programs are at the graduate level only
ADMINISTRATIVE SPECIALIST
Curriculum, Instruction, and
Professional Development*
Educational Research*
PRINCIPAL—Mark all that apply
Principal, ages 3-12; Grades PK-6*
SUPERINTENDENT
Superintendent*
Educational Staff Personnel
Administration*
Pupil Services Administration*
School Community Relations*
Principal, ages 8-14; Grades 4-9*
Principal, ages 10-21; Grades 5-12*
PUPIL SERVICES LICENSES—All pupil services licensure programs are at the graduate level only
School Counselor*
School Psychologist*
School Speech-Language
Pathologist*
*Programs with asterisks (i.e., “*”) following the title require graduate admission
Comments:
11.02.2011