Post-Baccalaureate Licensure Program Application
Applicants for any of the Post-Baccalaureate Residency License programs must submit the following: (1) completed application; (2) official transcripts for all post-secondary institutions, including verification of an earned bachelor's degree; (3) evidence of content-area knowledge with either 24 hours of relevant coursework as noted on the transcripts or passing scores on the state-approved content exams; and (4) evidence of current employment as a Residency Teacher. Applicants may be admitted provisionally pending receipt of content exam scores and verification of employment, but these conditions must be removed prior the first day of class.
Last Name *
Your answer
First Name *
Your answer
Preferred Name
Your answer
Address *
Your answer
Primary Phone *
Your answer
Email *
Your answer
NC Resident *
US Resident *
SSN (optional)
Your answer
Gender (optional)
Race (optional)
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Emergency Contact Name and Phone Number *
Your answer
Anticipated Semester to Begin *
Required
Anticipated Year *
Required
Program Applied for: Choose the program that is most closely aligned with your current Residency Teaching position. *
Please list below all post-secondary institutions previously attended, state in which they are located, and date of graduation. (You must submit one official transcript from each academic institution beyond high school via email to Dr. Charlesa Hann at c.hann@wingate.edu or mail it to 102 W Wilson St. Wingate, NC 28174 Attn: Dr. Hann.) *
Your answer
Please list your current employer, location, and position title with grade levels and/or content areas. *
Your answer
How did you hear about our program? *
Your answer
Comments or Questions
Your answer
Employment Verification
Please email employment verification (on letterhead signed by school or district official) to Dr. Charlesa Hann, at c.hann@wingate.edu.
Submit
Never submit passwords through Google Forms.
This form was created inside of Wingate University. Report Abuse