Transition to Teaching Program Application

Kentucky Department of Education

Transition to Teaching Program Application

Last updated on Friday, January 26, 2007

I am interested in applying for the Kentucky Department of Education Transition to Teaching program. To be eligible to apply for the Transition to Teaching program you must:

a) be accepted into an alternative certification program at one of the four partner universities
b) be employed as a full time teacher in one of the nine partner districts

For a complete brochure, click here.

Personal Information
Today's Date	, 2007
First Name
Middle Initial
Last Name
Home Address
City
State
Zip Code
Home Phone Number (with area code)
Cell Phone Number (with area code)
E-Mail Address
Gender	Male Female
Ethnicity	Caucasian African-American Hispanic/Latino Asian/Pacific Islander American Indian/Alaskan Native Other
Undergraduate Degree(s)
Date Awarded
Granting College or University
Have you been awarded any other degrees?	Yes No
If Yes, please list them:
List former career/profession?

Alternative Certification Information
Are you currently enrolled in an Alternative Certification Program?	Yes No
If yes, where are you enrolled?
When did you begin the program?
Have you participated in KTIP?	Yes No
Where have you applied for an Alternative Certification program for 2007-08? (check all that apply)	Eastern Kentucky University Northern Kentucky University Murray State University Morehead State University
Have you been accepted into an Alternative Certification program for 2007-2008?	Yes No
If Yes, please list them and the name of a program contact:
What is your intended subject area and grade level for certification?
	Elementary School Middle School High School
What is your projected completion date?
How did you find out about the Transition to Teaching Program?	Kentucky Department of Education (KDE) web site Other web site Transition to Teaching Brochure Word-of-Mouth Job Fair Festival Other Source
Please describe in 250 words or less your reasons for pursuing a second career as an elementary, middle or high school teacher.

Employment Information
Were you employed as an emergency certified teacher prior to the 2007-2008 school year?	Yes No
If yes, where?
At what grade level?
In what subject?
Where have you applied for a teaching position for 2007-08? (check all that apply)	Ashland Independent Berea Independent Covington Independent Fulton Independent Fulton County Hart County Hopkins County Jackson County Jenkins Independent Lewis County Lincoln County Mercer County (Harrodsburg Campus) Monticello Independent Morgan County Newport Independent Paris Independent Robertson County
Have you been offered a full-time teaching position for 2007-08?	Yes No

If yes, please provide the name, address and district of the school where you will be teaching.
School Name
School Street Address
City
Zip Code
District

For more information contact:

Candace Souder
500 Mero Street, 17th Floor CPT
Frankfort, KY 40601

Phone: (502) 564-1479

Candace.Souder@education.ky.gov