Departmental Application for Admission(MS Ed., Special Education Degree Program)

Departmental Application for Western Illinois University Admission School of Graduate Studies (MS Ed., Special Education degree program)

NAME: WIU #

ADDRESS: DOB:

PHONE: EMAIL:

WORK ADDRESS:

HAVE YOU BEEN ACCEPTED IN TO THE WIU GRADUATE SCHOOL?

LIST CURRENT TEACHING CERTIFICATIONS, ENDORSEMENTS, AND APPROVALS (INCLUDE TYPE, STATE AND DATE)

LIST COLLEGE EDUCATION (COLLEGE, DEGREE AND DATE DEGREE EARNED). (MOST RECENT FIRST)

LIST PROFESSIONAL WORK EXPERIENCE (MOST RECENT FIRST). INCLUDE POSITION, EMPLOYER AND DATES OF EMPLOYMENT.

LETTER OF INTENT. Please submit a formal, typed letter of intent that presents your reasons for seeking a Master’s of Science degree in Special Education at WIU and your expectations for how this degree would contribute to your professional career. Your letter will be reviewed with respect to your academic and professional writing skills, your knowledge of educational practices, and the match between your expectations and the WIU program.

IF YOU HAVE ANY QUESTIONS CONTACT THE SCHOOL OF GRADUATE STUDIES.

Western Illinois University School of Graduate Studies 1 University Circle, Sherman Hall 116 Macomb, IL USA 61455-1390 Return completed form to the Phone (309)298-1806; Fax (309)298-2345 School of Graduate Studies. www.wiu.edu/grad; Email: [email protected] 8-25-11