Delaware Alternate Route for Educators – Application
For 2016 – 2017 school year
Application deadline: April 1, 2016
Instructions
N.B., If you require this application in a different format, please contact Margie Trenary ([email protected]).
The DARE project is designed to recruit and select ten (10) candidates to participate in an alternative-route-tocertification pathway specifically designed to fill vacancies in secondary Special Education and World Languages, in
high-need secondary schools in Delaware. Recruiting will target traditionally underrepresented groups, including but
not limited to minorities, individuals with disabilities, and women.
To be considered for admission all candidates are required to:
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Provide transcripts from any regionally accredited colleges/universities
Submit a competed application with 2 professional and 2 personal references
Provide a current resume
Submit scores showing they have passed Praxis CORE® and appropriate Praxis II® tests
Undergo a State of Delaware and federal criminal background check
Undergo a State of Delaware Child Abuse Clearance check
Provide proof they are free of TB
Spend at least 10 hours in a school visit arranged by the DARE Coordinator
Attend two 4-hour Saturday workshops arranged by the DARE Coordinator
Participate in two screening interviews
Follow these steps to complete this application:
1.
2.
3.
I.
Download into Word.
Complete by typing directly into the form. Print when finished. Provide a signature (which can be typed).
Return this form with your resume and college transcripts to Frank Livoy, Coordinator DARE Project, by one of
the following methods:
a. mail to Delaware Center for Teacher Education, University of Delaware, 200 Academy Street,
Newark, De, 19716
b. email application and scanned documents to [email protected]
c. fax (302) 831-3137 att: Frank Livoy, DARE Coordinator
Personal Information
Name
Last four digits of SSN#
Address
City
Birthdate (mm/dd/yyyy)
State
Zip
Home e-mail
Work e-mail
Other e-mail (if applicable)
Home phone # (
)
Which number should we call first?
Cell # (
Home
Cell
)
Work # (
Work
)
II.
Professional Background
WORK EXPERIENCE-Please provide employment details beginning with your current or most recent
employer through your last three positions. If you held multiple positions with the same organization,
detail each position separately. Omission of prior employment may be considered falsification of
information. Please explain any gaps in employment. Include full-time military or volunteer commitments.
PLEASE DO NOT complete this information with the notation “See Resume.”
PLEASE NOTE: As an applicant to DARE, you give the Project Coordinator the right to contact all
current and former employers for reference information.
Dates Employed (most recent position)
From:
To
Full time
Part-time
Title:
If part-time, #
hrs./wk:
Organization Name and Address:
Supervisor’s Name, Title and Phone #:
Other Reference Name, Title and Phone #:
Contact my current
references:
At any time
Only if I am a finalist
candidate
Primary duties:
Reason for Leaving:
Dates Employed ()
From:
To
Full time
Part-time
Title:
If part-time, #
hrs./wk:
Organization Name and Address:
Supervisor’s Name, Title and Phone #:
Primary duties:
Reason for Leaving:
Other Reference Name, Title and Phone #:
Contact my current
references:
At any time
Only if I am a finalist
candidate
Dates Employed ()
From:
To
Full time
Part-time
Title:
If part-time, #
hrs./wk:
Organization Name and Address:
Supervisor’s Name, Title and Phone
#:
Other Reference Name, Title and Phone #:
Contact my current
references:
At any time
Only if I am a finalist
candidate
Primary duties:
Reason for Leaving:
III. Education Information
Highest Degree Earned:
Bachelor’s
Master’s
For each degree please list the institution and graduate date
Degree
Institution
Praxis Test Information Praxis Core
Test
Test Date
Reading
Writing
Math
Praxis II?
No
Yes
Score
Ph.D.
Other
Graduation Date
If Yes, please provide the following information:
Test Subject
Code #
Test Date
Score
What kind(s) of experience have you had teaching and/or working with children?

college instructor for

full-time public or private school classroom teacher for

public or private school substitute teacher for

paid classroom aide, tutor, or paraprofessional for

volunteer classroom aide or tutor for

school coach or extracurricular leader for

community youth program (i.e., scouts, little league, 4H, Sunday school) leader for

summer camp counselor for

teacher or workshop leader in business, industry, or the military for

other:
years
years
years
years
years
years
years
Are you a certified teacher in another state or country?
If Yes, date:
years
state or country:
No
years
Yes
area(s) of certification:
What university education courses have you completed? (check all that apply)?
None
Educational Psychology
Effective Teaching Strategies
Other:
Content-area Methods
Classroom Testing/Assessment
Reading in the Content Areas
Adolescent Development
At what college/university did you complete that/those course(s)?
IV.
Professional Goals and Priorities
What is your primary reason for wanting to become a teacher?
Classroom Management
History/Philosophy of Education
Special Education
Multi-Cultural education
V.
Additional Information
Have you (a) ever been convicted of a crime, other than a minor traffic offense; or (b) ever entered a plea
of guilty or a plea of “no contest” (nolo contendere), or has any court ever deferred further proceedings
without entering a finding of guilty and placed you on probation, for any crime other than a minor traffic
offense?
Yes
No
If you answered “Yes,” please explain in detail, including the date of the charge, the court action, the
offense in question, and the address of the court involved.
Protection of Human Subjects
As part of my participation in DARE, I understand that information will be collected about my involvement in
the project and my performance as an aspiring teacher. This includes observations of professional
development in which I participate and my teaching in assigned schools; interviews and/or surveys of my
coach/mentor and the administrator who supervises me in assigned schools; other information related to my
teaching performance; and interviews or surveys that I am asked to complete to provide feedback on the
program. If selected to participate in DARE, I consent to the above information being collected as part of the
DARE evaluation. I understand that all information will be kept confidential and will only be shared in
aggregate form.
I hereby declare and affirm under the penalties of perjury that the contents of the foregoing application are
true and correct to the best of my knowledge, information, and belief; and so I indicate by signing below. I
agree to supply any additional information needed in connection with this application.
Applicant Signature: ______________________________________ Date: ________________
The University of Delaware does not discriminate on the basis of race, color, national origin, sex, disability, religion, age, veteran
status, gender identity or expression, or sexual orientation in its programs and activities as required by Title IX of the Educational
Amendments of 1972, the Americans with Disabilities Act of 1990, Section 504 of the Rehabilitation Act of 1973, Title VII of the Civil
Rights Act of 1964, and other applicable statutes and University policies. The University of Delaware prohibits sexual harassment,
including sexual violence. The following person has been designated to handle inquiries regarding the Americans with Disabilities Act,
the Rehabilitation Act, and related statutes and regulations: Tom Webb, Director, Office of Disabilities Support Services, Perkins
Student Center, 325 Academy Street, Suite 161, University of Delaware, Newark, DE 19716, 302-831-4643. The following person has
been designated to handle inquiries regarding the non-discrimination policies and to serve as the overall campus coordinator for
purposes of Title IX compliance: Bindu Kolli, Chief Policy Advisor, Office of Equity and Inclusion, 305 Hullihen Hall, University of
Delaware, Newark, DE 19716, 302-831-8063. The following individuals have been designated as deputy Title IX coordinators: for
Athletics, Jennifer W. Davis, Vice President for Finance and Administration, 220 Hullihen Hall, University of Delaware, Newark, DE
19716, 302-831-2769; and for Student Life, Dawn Thompson, Dean of Students/AVP for Student Life, 101 Hullihen Hall, University of
Delaware, Newark, DE 19716, 302-831-8939. Inquiries concerning the application of anti-discrimination laws may be referred to the
Title IX coordinators or to the Office for Civil Rights, United States Department of Education. For further information on notice of
nondiscrimination, visit http://wdcrobcolp01.ed.gov/CFAPPS/OCR/contactus.cfm for the address and phone number of the U.S.
Department of Education office that serves your area, or call 1-800-421-3481.
Rev. Feb 2016