International
Students
Application for admission to Master of
Arts
program focusing on teaching, learning and
assessment
Fill out this application completely, typing or
printing
all responses. If you have any questions about it or the admissions
process at Alverno, please call 1-800-933-3401,414-382-6104 or e-mail:
Sarajane Kennedy.
When
you have completed the application, mail it
and the $20
application fee to:
Admissions Office
Alverno College
3400 S. 43rd St.
P. O. Box 343922
Milwaukee, WI 53234-3922
Note: Please notify the Admissions Office if any
of the following information should change.
Personal
History
1.Name:_____________________________________
Last/ First/ Middle/ Other Last Name(s) Used
2.Address: __________________________________
Number/ Street/ Apartment
__________________________________________________
City/ State/ Zip
3.Home Phone: ( )_______Work Phone: ( ) ______
Ext. _____
4.Citizenship: [ ] U.S.A. [ ] Resident Alien [ ]
Foreign
5.Social Security Number:_______________________
6.Gender: [ ] Male [ ]Female
7.Date of Birth:_______Place of Birth: ____________
8.Are you related to an Alverno student? [ ] Yes
[ ] No
If yes, name:___________Relationship:____________
9.Are you related to an Alverno graduate? [ ] Yes
[ ] No
If yes, name:_____________ Relationship:__________
Emergency Contact
10. Name:________________Relationship:__________
Telephone: ( ) _______Work Phone: ( ) ___________
11. Program intent:
____ I am applying for admission as a candidate
for the
Master of Arts degree
____ I have a master's degree and seek licensure only
____ I do not have a master's degree, but seek
graduate-level licensure only
12. Area(s) of specialization or licensure desired:
____ Adaptive Education (for K-12 teachers who want
to extend their licenses to develop their skill in working with
inclusion classroom)
____ Administrative Leadership (Principal's License)
____ For practitioners in business, government and
non-profit agencies:
___
Adult Education and Instructional Design
___ Adult Education and Instructional Technology
___ Adult Education and Organizational Development
____Alternative
Education (for K-12 teachers who want to work in alternative school
settings)
___ Director of Instruction (for K-12 teachers who
want
to prepare to work as learning coordinators, staff
development directors, assessment center directors and related roles)
___ Instructional Technology for K-12 Settings (for K-12 teachers
who want to strengthen their knowledge and
pedagogical skill in the application of technology in
teaching)
___ Professional Development (for K-12 teachers who
want to improve their teaching practice)
___ Reading (for K-12 teachers who want the #316 Reading Teacher
license and #317 Reading Specialist)
___ Science Education (for licensed teachers of grades 5-9
who want to strengthen their knowledge and pedagogical skill in
the teaching of science)
13. I am applying for admission for the:
[ ] Fall 20 ___ [ ] Spring 20___ [ ] Summer 20___
14. I expect to take: 3___ 6___ 9___ credits /semester.
15. I intend to apply for financial aid. Yes ___ No ___
Academic and Professional Work History
16. Educational Background: List chronologically,
all
current and previous colleges and universities attended,
including Alverno College.
Undergraduate:
Institution/ City/ State/ Dates of Attendance/
Degree Conferred/ Date
____________________________________________
__________________________________________________
__________________________________________________
Graduate:
Institution/ City/ State/ Dates of Attendance/
Degree Conferred/ Date
__________________________________________
__________________________________________
___________________________________________
NOTE: Request official transcripts from all institutions
listed above to be sent to:
Alverno College
P.O. Box 343922
Milwaukee, WI 53234-3922
17. (For international students only)
TOEFL Score:__________
Date taken:_______________
18. Work Experience and Professional Activities:
Beginning with your current position, list all
professional work experiences; for each experience, indicate relevant
professional activities. Use additional pages as needed.
Name of Employer/ Position/ Supervisor's Name/
Dates
____________________________________________
____________________________________________
____________________________________________
19. If a teacher, what type of license do you hold?__________________
Licensing State? __________________________________
20. List the names and positions of the individuals
whom you have asked to submit letters of recommendation on your
behalf. Three recommendations are required. At least one of them
should be from college or university professors; at least one of
them should be from supervisors or professional colleagues. Your
application will not be complete until all are received.
Name:____________________________________ Title:___________________
Name:____________________________________ Title:___________________
Name:____________________________________ Title:___________________
21.Where did you first learn of Alverno College's
graduate program:
_________________________________________
22. What is the key factor which caused you to
decide to apply to Alverno College?
_________________________________________
_________________________________________
Philosophy
and Goal Statement
Please respond to the following questions in a typewritten
format that does not exceed a total of 500 words.
What is your philosophy of education and how does
it
guide your work as a teacher (in K-12 schools or
organizational settings), instructional designer (in
organizational or educational settings), and as a learner?
What are your goals for improving your practice
and
how does your participation in a master's program fit with those
goals?
In evaluating your response, the Admissions Committee
will use the following criteria: - Does the applicant clearly state
his or her beliefs, values, and goals related to learning? - Does
the applicant provide clear examples of his or her philosophy of
learning? - Does the applicant
indicate an ability to assess his or her own professional
practice? - Does the applicant recognize his or her
own strengths and areas to develop as a learner?
Communication Samples
As a demonstration of your ability to engage in effective
practice in a professional setting, please submit two to
five samples of communication, written or oral, that
you have produced for use in your work, e.g., memos or
other correspondence, training plans and materials,
course plans and materials, grant proposals, feedback
to students or participants, videos of presentations,
publications, and promotional materials. For each sample, attach
a half sheet with information about the context of the sample and
why you chose it.
In evaluating your communication samples, the
Admissions Committee will use the following criteria:
- Do the samples reflect a range of communication
settings?
- Do they express clear and effective relationships among ideas?
- Do they effectively engage the audience by using
appropriate conventions and style?
23. To the best of my knowledge, all statements
on this application form and in accompanying documentation
are complete and accurate.
Signature:_______________________________
Date:____________________
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