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TEAM Model Residency Program Application 2020-2021
Application for Residency
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* Indicates required question
Option 1
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Option 1
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Last Name
*
Your answer
Middle Name
*
Your answer
First Name
*
Your answer
Student ID# (Ex. 000-00-000)
*
Your answer
Social Security Number (Ex. 000-00-000)
*
Your answer
Tech Email
*
Your answer
Preferred Email
*
Your answer
Phone Number (Ex. 000-000-0000)
*
Your answer
Address
*
Your answer
City
*
Your answer
State
Your answer
Zip code
Your answer
Major/Certification
*
Your answer
Have you been accepted into the teaching program?
yes
no
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What Praxis Exams have you passed?
*
ACT 22/Praxis I(Reading, Math and Writing)
Praxis II/Content Area
PLT
SPED/1-5 (Elementary majors only)
Required
District Choice of Residency (Choose top 3)
*
A.E. Phillips Laboratory School (K-8)
Early Childhood Education Center (Pk-3 majors only)
Bienville
Bossier
Caddo
Claiborne
De Soto
Jackson
Lincoln
Monroe City
Ouachita
Richland
Webster
Winn
Required
Grade level Interests:
*
Pk/K
Primary grades
Upper elementary
Middle school
High school
Required
Check every grade you have observed/taught during your Pre-Residency experience.
Pk
K
1
2
3
4
5
6
7
8
9
10
11
12
I understand Tech must receive passing scores on all required Praxis and PLT exams by June 1, 2020. Comments below and type your name.
Your answer
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