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TEACHER EDUCATION SCREENING COMMITTEE
INTERVIEW CHECKSHEET

The applicant for admission to the USAO Teacher Education Program        brought the following materials to the interview with the Screening Committee:

              1._____           Degree/Certification Program Checksheet

              2._____           Professional Portfolio Notebook includes two

                                      critique/reflection essays and a copy of the admission

                                      essay.

              3._____           Professional Portfolio Personal File Box includes two

                                      artifacts corresponding to the critique/reflection essays.

              4._____           A tentative graduation plan (optional) indicating when

                                      he/she anticipates his/her Professional Trimester.

                        The applicant provided a satisfactory oral definition/description of at least

 one of              the following term(s).

             1._____            Interdisciplinary Instruction

             2._____             Liberal Arts Curriculum

             3._____             Effective Teaching Research

             4._____             Standards-based model

             Evidence of working with children:

            ____    Field Experience OR

             ____    Other  ______________________________________

             ____    The applicant received information concerning Teacher Shortage

                         Areas.

             ____    Application file is complete: application, essay, disposition statement,

                         four recommendations, program checksheet, transcript, oral English

                         screening, field evidence.

            Upon concluding the interview, the applicant was told:

                        _____  All requirements appear to have been met and that his/her name will

                                    be submitted to the Teacher Education Committee this month to be

                                    recommended for admittance to the USAO Teacher Education

                                    Program.

            _____  His/Her name will be submitted this month upon the completion of

                        the following requirement(s):

           _____  Rewrite/make corrections to application essay and return it to

                       the Teacher Education Office by next Monday.

           _____  Obtain required recommendations/signature(s) and return to

                       the Teacher Education Office by next Monday.

                                   _____  ________________________________________

                                  (Other)

                        _____  One or more of the requirements has NOT been met.  Therefore,

                                    his/her application will be held until the end of the semester.  At that

                                    time, if all requirements have been met, his/her name will be

                                    submitted to the Teacher Education Committee with a

                                    recommendation to admit.  If requirements have NOT been met,

                                    then the Committee will recommend that he/she be denied

                                    admittance to the Teacher Education Program.

            _____  The Committee recommends that he/she be denied admission to

                        Teacher Education for the following reason(s): 

                      __________________________________________

___________________________________

(Signature of Screening Committee Interviewer)