NAME:_________________________________________________ DATE:_____________________________________

Student ID#:_____________________________________ ACADEMIC ADVISOR:______________________________________

CLAST SCORES:  MAT_______ READ_______WRITE: _______ ESSAY:_______ TEST DATE:______________________

GRADE OF C OR HIGHER ON ED. COURSES: Y______    N______

CUMULATIVE GRADE POINT AVERAGE:________

ACT (COMPOSITE SCORE) __________________ SAT (COMBINED SCORES) _____________________

REQUESTED INTERNSHIP DATE:___________________ INTENDED GRADUATION DATE:______________________

This is to affirm that I have been fully apprised concerning the requirements for my intended major and have a copy of the checklist of courses to be completed. I am familiar with the standards for admission to and continuation in the Education Department which include:

1. Making formal application;
   

2. Attaining and maintaining a GPA of 2.5 with no grade lower than a C in any education course;
   

3. Achieving an acceptable score according to State and Flagler College requirements on the American College Test (ACT) or the Scholastic Aptitude Test (SAT) AND College-Level Academic Skills Test (CLAST);

4. Demonstrating an aptitude for and commitment to the teaching profession.

I understand that course selection and course completion to meet the requirements of the State-approved program are my responsibility.

SIGNED:_____________________________________________________________________________________________

PLEASE COMPLETE AND RETURN THIS FORM TO THE EDUCATION DEPARTMENT in room K-308, or to Campus Box #1380

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If you are not accepted, the reason (or reasons) are given below:

_________________________________________________________________________________________________
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_____________________________________
Dr. Michele Gregoire, Chair
Education Department, Flagler College

STUDENTS ONCE ACCEPTED, WHOSE CUMULATIVE GPA DROPS BELOW 2.5, WILL AUTOMATICALLY BE REDUCED TO A PROVISIONAL STATUS OF ACCEPTANCE UNTIL THE GPA IS BROUGHT UP TO AN ACCEPTABLE LEVEL. IN ORDER TO INTERN IN EDUCATION, A STUDENT MUST HAVE A GPA OF 2.5.