As an undergraduate student, I understand a qualifying ACT Composite score of 22 or verification that all portions of the MoGEA have been passed is required. As a graduate student, I understand I am not required to take the MoGEA, but I am required to take and pass the Missouri Content Assessment prior to applying for student teaching.* I understand. I understand a favorable recommendation (Dispositions Assessment: Early Clinical Placement form) from one of my field experience cooperating teachers is required. This requirement is completed as a part of coursework in HLGU's Field Experience I or II Students transferring credit for Field Experience I or II must supply a favorable recommendation from a previous field experience’s cooperating teacher to the Teacher Education Division using the Dispositions Assessment form linked above.* I understand. Name* First Last Campus*HLGU's Hannibal Main CampusHLGU's Three Rivers College CampusHLGU's Online CampusAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Campus Box NumberCell Phone*Email* Projected Graduation Date* Date Format: MM slash DD slash YYYY HLGU Advisor*Colleges you have attended and degrees earned, if any:Certification Area*Early Childhood (Birth – 3rd Grade)Elementary (1st – 6th Grade)Elementary with Early Childhood Add-On (Birth – 6th Grade)Art (K-12th Grade)Music Vocal Concentration (K-12th Grade)Music Instrumental Concentration (K-12th Grade)Physical Education (K-12th Grade)Special Education (K-12th Grade)Middle School English (5th - 9th Grade)Middle School Math (5th - 9th Grade)Middle School Science (5th - 9th Grade)Biology (9th – 12th Grade)Business (9th – 12th Grade)English (9th – 12th Grade)Mathematics (9th – 12th Grade)Social Studies (9th – 12th Grade)Speech & Theatre (9th – 12th Grade)Unified Science with Biology Concentration (9th – 12th Grade)Degree*Bachelor's at main HLGU CampusBachelor's at TRC CampusMaster's OnlineInformationPlease provide the name and email address for a college/university instructor you have had for a general education course.Instructor Name First Last Instructor Email* Enter Email Confirm Email InformationPlease provide the name and email address for a public school teacher you have worked with during a field experience placement.Public School Teacher Name First Last Public School Teacher Email* Enter Email Confirm Email InformationPlease provide the name and email address for an HLGU instructor you have had for an education course.Instructor Name First Last Instructor Email* Enter Email Confirm Email InformationPlease provide the name and email address for a TRC instructor you have had for an education course.Instructor Name First Last Instructor Email* Enter Email Confirm Email InformationPlease provide the name and email address for an HLGU instructor you have had for an education course.Instructor Name First Last Instructor Email* Enter Email Confirm Email Current Grade Point AveragesThe Department of Elementary and Secondary Education has established minimum GPA requirements as listed below. If you need help calculating each GPA, feel free to use this online GPA calculator.Cumulative GPA (min. of 2.75)*This GPA is automatically calculated for you on your unofficial student transcript. Professional GPA (min. of 3.0)*Calculate this GPA using all classes with EDU, ECE, EED, or SED course numbers. *Content GPA for K-12 and SED only (min. of 3.0)Calculate this GPA using classes under the content area heading on your Graduation Checklist.Convicted of a Felony?*YesNoIf yes, explain.Upload a photograph of yourself.*The photo is not evaluated as part of entrance requirements. It is used for a student teaching display in the Education Department office that highlights upcoming graduates. *Upload a typed letter.Upload a typed letter, demonstrating professional writing skills, to the Teacher Education Committee requesting admittance into the Teacher Education Program. This letter should include a brief autobiographical sketch, and an explanation of your desire to become a teacher.By submitting this form, you agree to the following:* I understand that in order to enter, remain in, and exit from the HLGU Teacher Education Program, I must comply with all institutional and state requirements. My failure to comply with any institutional requirement (including HLGU student conduct regulations) or state requirement could result in my being dismissed from the program, making me ineligible to be recommended for certification. I understand that by virtue of my enrollment in teacher education courses at Hannibal-LaGrange University and by participation in various classroom activities (i.e., educational field experiences and student teaching), I may have access to records which contain individually identifiable information. The disclosure of this information is prohibited by the Family Education Rights and Privacy Act of 1974 (Buckley Amendment). I acknowledge that I fully understand that the intentional disclosure by e of this information to any unauthorized person (i.e. talking about a particular student or teacher to a friend) could subject me to criminal and civil penalties imposed by law. I further acknowledge that such willful or unauthorized disclosure could constitute just cause for disciplinary action and/or removal from the teacher education program by Hannibal-LaGrange University's Teacher Education Division regardless of whether criminal or civil penalties are imposed. I agree to the above confidentiality statement.