APPLICATION FOR ADMISSION TO THE EDUCATOR PREPARATION INSTITUTE DATE (of this application) ___/___/_______ LAST NAME
FIRST NAME
MAIDEN NAME
MIDDLE NAME
*Valencia ID number (required) V_______________________ Telephone Number (
)
-
Alternate Phone Number (______)_________-_________
Address (Street)
Apt #
County
City, State, Zip Code
Atlas Email: Male
Female
Birth date: ___/___/_______
Ethnicity: (Please check one box) African-American/Black
Caucasian
Asian/Pacific Islander
Hispanic
American/Native Indian
Other
Background Information: Have you obtained a valid Statement of Eligibility from the Florida Department of Education?
Yes
No
Subject Area: _______________________________________________ Date Issued: ___/___/_______ Expiration Date: ___/___/_______ Note: You must attach a valid copy of your Statement of Eligibility with this application Have official transcripts been sent to the registrar?
Yes
No
Presently enrolled at Valencia College?
Yes
No
Date admitted to Valencia
____/____/_______
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Have you obtained a valid Temporary Certificate? (if applicable)
Yes
No
Subject Area: _______________________________________________ Date Issued: ___/___/_______ Expiration Date: ___/___/_______ *Note: If you have obtained a Temporary Certificate, you must submit a copy with this application AND a valid copy of your Statement of Eligibility Teacher Questionnaire: Are you currently employed as a teacher?
Yes
No
If yes, which school? _____________________________________ Grade level? ______________ Previous Occupation:_______________________________________________________________ Which age group(s) are you interested in teaching? (Check all that apply) Elementary School
Middle School
High School
List the experience you have had in any educational or training environment: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Please write a brief statement regarding your career professional goals as they relate to teaching: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________
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Criminal History: Pursuant to Florida Statute 1012.32 and as part of your employment record, you will be fingerprinted and a criminal history check will be conducted. A prior criminal record may or may not result in your disqualification for employment, but a failure to disclose your record WILL disqualify you from employment. You must list on your application for employment all adult and juvenile misdemeanors, felonies or other criminal offenses other than non-criminal traffic violations. (DUI and reckless driving are criminal offenses, not simply non-criminal traffic violations.) In Florida, the entire arrest record is revealed to school districts by the Florida Department of Law Enforcement and the FBI when fingerprints are supplied, including “sealed records,” “expunged records,” and “military court proceedings.” (Factors such as age at the time of the offense, type of offense, remoteness of the offense in time and rehabilitation will be taken into account in determining effect on suitability for employment.)
If you have additional concerns or questions, please contact the EPI office at 407-582-5473.
Application Deadlines: Fall Term: August 15th Spring Term: December 15th *Summer Term: May 15th * Summer ONLINE courses begin in early May and all required EPI paperwork must be submitted before online courses begin in the summer term. Once a course begins, you cannot register for the course. Summer INTENSIVE courses begin in mid June. All required EPI paperwork must be submitted by June 1st. All EPI courses are limited to a space available basis. Valencia College reserves the right to make changes in admission criteria and program information as circumstances require, and is an Equal Opportunity Institution.
I have read and understand the EPI student handbook and application to the EPI program. I affirm that all information on this application is true. I also understand that it is fraudulent to misrepresent any information on this form.
SIGNATURE
Date ___________________
Equal Opportunity Institution
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ADMISSION CRITERIA AND CHECKLIST Educator Preparation Institute The following criteria will be used for selection into the Educator Preparation Institute. Admission to the Educator Preparation Institute is limited to eligible applicants only. All students must have a Bachelor’s degree from a regionally accredited institution and a valid statement of eligibility and/or a valid Temporary Certificate from the Florida Department of Education. To complete the EPI program, students must pass and provide FTCE Exams scores and submit an EPI portfolio. Application Deadlines: Fall Term: August 15th Spring Term: December 15th Summer Term: May 15th
Application requirements: _____ 1. Obtain a Statement of Eligibility from the Florida Department of Education. You may request an eligibility statement at http://www.fldoe.org/edcert/steps.asp. The cost is $75 and is the responsibility of the student. This process will take approximately 4-6 weeks.
_____ 2. Submit a completed college application for admission by the College Application Deadline. Visit Valencia's Web site at www.valenciacollege.edu/admissions for specific information.
_____ 3. Attend a group enrollment session about the Educator Preparation Institute prior to submitting an EPI application to the program. Dates are posted on the EPI website, http://valenciacollege.edu/epi/about.asp
_____ 4. Complete the Brief Biographical Statement form and submit with your EPI application. A copy of the statement can be found at http://valenciaccollege.edu/epi/steps.cfm
_____ 5. Complete the FEAPs Pre-Assessment form and submit with your EPI application. A copy of the statement can be found at http://valenciacollege.edu/epi/steps.cfm
_____ 6. Complete the EPI Education Plan and submit with your EPI application. A copy of the statement can be found at http://valenciacollege.edu/epi/steps.cfm
_____ 7. After the checklist is complete, an EPI application must be submitted to the EPI office in building 1 room 255 (West campus) with all required documentation and a copy of your Statement of Eligibility and/or Temporary Certificate. EPI applications are located at http://valenciacollege.edu/epi/steps.cfm *After acceptance and prior to the start of the first term of field experience courses, students will be notified of the process required to complete a criminal background check and the deadline for the completion of the check. Applicants with a positive background check may be denied permission to continue in the Educator Preparation Institute. The fee is the responsibility of the student. Students will not begin the EPI field experience courses until we have the background check on file. Background checks are valid for one semester. *Applicants for Valencia's Educator Preparation Institute must be free of offenses that would disqualify them from a student field experience in an educational setting and must have their civil rights intact. This policy is in response to requirements by county school district regulations.
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