Change of Status Application College of Education Graduate Programs

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Wayne State University Graduate Education Office 489 Education Detroit, MI 48202

Change of Status Application (313) 577‐1605 College of Education Graduate Programs (313) 577‐7904 FAX

Are you adding an additional program to your current program? No Yes

Selecting “yes” is a request to be enrolled in two programs simultaneously. Note that courses cannot be used to meet degree requirements in two master programs and courses completed for a master’s degree may not be used in an Education Specialist program, i.e. double counting of courses is not permitted. Some programs do not permit students to be enrolled in more than one program at one time.

Name (first, middle initial & last) WSU ID Number (9 digits) Gender: Male Female E‐mail Address Date of Birth (DD/MM/YYYY)

Address: (number, street, and apartment‐if applicable) City State Zip Code

Home Phone (include area code) Work Phone (include area code) Cell Phone (include area code)

Current Status at WSU (degree or program, major and college) Last Registration at WSU (term & year)

Term and Year Requested for Change of Status: Fall Winter Spring/Summer Year:

Program Desired: List Major & Concentration (if applicable) ‐ See Pages 4 & 5

Non‐Degree (pre/post Master’s or post Doctoral) Note: Non‐Degree is not a program and therefore this status in not eligible for financial aid. Please indicate a reason for applying for this status:

Graduate Certificate (GC) Major:

Master of Arts (MA) Major: Concentration:

Master of Arts in Teaching (MAT) – Select Major: Elementary Secondary Teaching Major: Teaching Minor:

Master of Education (MEd) Major: Concentration:

Education Specialist Certificate (ESC) Major: Concentration:

Doctor of Education (EdD) Major: Concentration:

Doctor of Philosophy (PhD) Major: Concentration:

Previous Education: If you have a degree from Wayne State University, please indicate the college or school. Degree: BA, Date Earned University/College Major BFA, MBA, etc. (MM/DD/YYYY) Bachelor’s Degree Master’s Degree Ed. Specialist Certificate Other

Current & Previous Employment: Telephone Dates of Name of Employer Position Number Employment

Do you plan to be employed while in school? No Yes If yes, how many hours per week?

Present School Certification/License Status (check all that apply)

Michigan Other State: None

Elementary Secondary Administrator School Counselor License School Psychologist Certificate

Provisional Professional Continuing Other:

If you have completed any of the following examinations, check all that apply (test scores are not accepted over five (5) years old:

Graduate Record Examination (GRE) Date of Exam:

Which sections of the GRE were completed? Verbal Reasoning Quantitative Reasoning Analytical Writing

Miller’s Analogies Test (MAT) Date of Exam:

Race: Please identify your racial/ethnic background (check one box only). This information is voluntary; it is requested to fulfill reporting obligations of the University and will remain confidential. American Indian, Eskimo, or Aleut Asian or Pacific Islander Black (non‐Hispanic)

Hispanic Multiracial White (non‐Hispanic)

Master of Arts in Teaching – Additional Requirements (Place check in box to confirm attachment of required documentation to this application) Applicants to the Master of Arts in Teaching (MAT) must provide the following with this application: 1) Successful completion of the Michigan Basic Skills Test (attach a copy of your test results). If your examination scores were NOT released to Wayne State University, please request an original score report from Evaluation Systems Group of Pearson. Indicate the date(s) when the Michigan Basic Skills Test was taken: 2) A recent statewide Criminal History Check from http://apps.michigan.gov/ichat/home.aspx 3) Anyone convicted of an offense must provide certified copies of all documents related to his/her conviction, including the “Judgment of Sentence”. This document may be obtained from the court where the matter was adjudicated. In addition, a narrative describing the incident(s) from the perspective of the applicant is submitted for review by a college committee. 4) Successful completion of 40 hours of Group Work with Children (form and letter) 5) A completed WSU Transcript Evaluation for teaching major/minor at the Elementary or Secondary level 6) An Art Portfolio Review (if applicable) 7) Successful completion of the Oral Proficiency Interview and/or the Writing Proficiency Test (if applicable)

Revised October 1, 2009 Page 2

Advanced Degree Applicants (Education Specialist Certificate, Doctor of Education and Doctor of Philosophy): Complete the following section regarding Professional and Learned Societies. In addition, prepare and attach a descriptive statement regarding your writing, research, and publications (check box to confirm attachment).

Memberships and Offices in Professional and Learned Societies:

Organization or Society Membership or Office Years

Personal Statement – Attach additional pages as necessary: Describe your plans for graduate study and a professional career as they relate to your personal and educational background. Please indicate if there are special circumstances or factors you wish to have taken into consideration in connection with your application. This statement is not the same as an autobiographical statement.

I certify that the information given in this application and in any attached document, is complete and accurate, and I understand that the College of Education reserves the right to deny admission or revoke any admission granted if the information provided herein proves untruthful. I also understand that the submission of fraudulent academic records by a student for admission, transfer of credit, or any other purpose shall be cause for the student’s dismissal from the College of Education. If admitted, I agree to comply with the regulations of the College of Education and Wayne State University.

Signature Date Revised October 1, 2009 Page 3

Master of Arts in Teaching (MAT)

Master Degree Majors and Teaching Majors/Minors Elementary Major

Elementary ‐ Option 1 Elementary ‐ Option 2 Master of Arts (MA) A teaching major and the The Comprehensive Major Counseling Planned Program* and a Student‐Centered Marriage and Family Psychology Major/Minor* Rehabilitation Counseling and Community Inclusion Integrated Science School and Community Psychology Language Arts Bilingual‐Bicultural Ed. Sports Administration with concentrations in: Mathematics Early Childhood Education Interscholastic Athletic Administration Social Studies English as a Second Lang. Intercollegiate Athletic Administration Special Education Professional Sports Administration World Languages:

Commercial Sports Administration Chinese

French

Italian Master of Education (MEd) Spanish

Art Education with concentrations in: Additional Elementary Teaching Minors (may be added to

Art Education Option 1 or Option 2): Bilingual‐Bicultural Ed., Early

Art Therapy Childhood Education, English as a Second Lang., Integrated Bilingual/Bicultural Education with concentrations in: Science, Language Arts, Mathematics and World Languages Bilingual/Bicultural (Chinese, French, Italian and Spanish) English as Second Language

Career and Technical Education Early Childhood Education Master of Arts in Teaching (MAT)

Educational Leadership Secondary Major Educational Psychology Elementary Education Secondary Secondary English Education with concentrations in: Teaching Majors* Teaching Minors*

English: Secondary Biology Bilingual‐Bicultural Ed. English as a Second Language Career & Technical Ed Biology Evaluation and Research Chemistry Chemistry

Foreign Language Education with concentrations in: Chinese Chinese

Foreign Language: Secondary Earth/Space Science Computer Science English as a Second Language Economics Earth/Space Science Health Education English Economics Instructional Technology French English as a Second Lang. Kinesiology with concentration in: Geography English Exercise and Sport Science German French Physical Education Pedagogy Health Geography Wellness Clinician Research History German Mathematics Education Integrated Science Health Reading Italian History Science Education Kinesiology Pedagogy Italian Social Studies Education Latin Kinesiology Pedagogy Social Studies Education and MA in History (Joint Degree) Mathematics Latin Special Education with concentrations in Physics Mathematics Autism Political Science Physics

Cognitive Impairment Russian Political Science

Emotional Impairment Social Studies Russian

Learning Disabilities Spanish Spanish

Speech Speech * Teaching Majors and Minors are listed for purposes of Visual Arts Education state certification only. In the MAT program, students

have a University major of Elementary or Secondary only.

Revised October 1, 2009 Page 4

Advanced Certificate & Degree Majors

Education Specialist Certificate (ESC) Graduate Certificate (GC)

Counseling with concentrations in: College and University Teaching Counseling This certificate program is open to recent graduates of Rehabilitation Counseling and students currently enrolled in a Wayne State Curriculum and Instruction with concentrations in the University doctoral or terminal master's program and following: who plan to seek faculty positions upon completing their Bilingual Bicultural Education degree.

Career & Technical Education Advanced Graduate Studies in School Psychology Early Childhood Education This certificate program is open to students in good Elementary Education academic standing in the School and Community English Education Psychology M.A. program. K‐12 Curriculum Mathematics Education Online Teaching Science Education This certificate program is intended for individuals in or Secondary Education preparing for teaching positions in K‐12 schools and Social Studies Education higher education or those preparing for careers in General Administration and Supervision corporate training offices. The certificate provides Special Education Administration students with essential knowledge and skills in pedagogy, Instructional Technology course development, evaluation, instruction, and other Reading aspects of the educational process in online learning Special Education environments.

Doctor of Education (EdD) Doctor of Philosophy (PhD)

Counseling Counseling Curriculum and Instruction with concentrations in the Curriculum and Instruction with concentrations in the following: following: Art Education Art Education Bilingual Bicultural Education Career and Technical Education Career and Technical Education Early Childhood Education Early Childhood Education Elementary Education Elementary Education English Education

English Education Foreign Language Education

Foreign Language Education K‐12 Curriculum

K‐12 Curriculum Mathematics Education Mathematics Education Science Education Science Education Secondary Education Secondary Education Social Studies Education Social Studies Education Educational Leadership and Policy Studies Educational Leadership and Policy Studies Educational Psychology Evaluation and Research Evaluation and Research Instructional Technology Instructional Technology Reading, Language and Literature Kinesiology with concentrations in the following: Special Education Physical Education Pedagogy Exercise and Sport Science Special Education

Note: Most Advanced Degree programs have additional requirements for admission not included with this application. Details of the additional requirements are mailed to you after your application has been reviewed.

Revised October 1, 2009 Page 5