MARYLAND COLLABORATIVE FOR TEACHER PREPARATION

TOWSON UNIVERSITY                   PROGRAM APPLICATION

 

PART I.                 PERSONAL INFORMATION  (All Potential MCTP Candidates complete Parts I-IV.)

 

NAME _____________________________________________________       SOC. SEC.# __________________________

                LAST                                     FIRST                                     M.I.

 

BIRTH DATE*________________________________________        E-MAIL______________________________

 

PERMANENT                                                                                      HOME

ADDRESS____________________________________________      PHONE______________________________

 

______________________________________________________  LOCAL______________________________

                                                                                                                                                (if different)

LOCAL                 

ADDRESS_____________________________________________

(if different)

______________________________________________________

 

PART II.                ACADEMIC INFORMATION

 

High School          ________________________________________                   YEAR GRADUATED _________

Cumulative high school grade point average  _____________

Post-secondary institutions attended:

Institution                                                                             Dates                                                                      GPA

_____________________________________________________________________________________________

_____________________________________________________________________________________________

 

PART III.               Please attach to this application a typed essay of 500 words or less explaining your interest in elementary or middle school science and mathematics teaching, and why you would like to be part of the Maryland Collaborative for Teacher Preparation.

 

PART IV.              Please arrange for official copies of all your high school or college (other than TU) transcripts to be sent to Katherine Denniston at the address below.

 

PART V.                STATISTICAL INFORMATION (OPTIONAL)

Race/ethnic origin and gender:

____ White – not of Hispanic origin                                ____Male____Female

____ African American (not Hispanic)                           

____ Hispanic

____ Asian or Pacific Islander

____ Native American

____ Other

 

APPLICANT’S SIGNATURE: ____________________________________________ DATE: ________________

PRINT THIS APPLICATION, COMPLETE, AND SEND TO:

Christian Bell, MCTP Project Coordinator

Center for Science and Mathematics Education

Towson University

8000 York Road

Towson, MD 21252

* Birth date is optional on this application; however students accepted into the program must

supply their birth date in accordance with National Science Foundation regulations.

 

 

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