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UNIVERSITY OF HAWAI`I AT HILO Application Form Academic Year - Fall PLEASE TYPE OR PRINT CLEARLY IN INK. COMPLETE THIS FORM AND SUBMIT IT TO THE ADMISSIONS OFFICE. Social Security # Legal Name: Family/Last First/Given Full Middle Any Other Names Used Spring Gender Male Female Birthdate (MM/DD/YY) / / Birthplace (State or Foreign Country) Citizenship Non-US Citizenship--Visa Type (Attach copy-greencard) Name of High School Graduated / Will Graduate From State / Country of High School Graduation Date Current Mailing Address: Street City/Province State/Country Zip/Postal Code Until (M/D/Y) Phone Number(s) USA Other Student Visa Immigrant - Date Rec Other / Permanent Address: Street City/Province State/Country Zip/Postal Code Email Address(es) Were any of your ancestors Hawaiian? Yes No Ethnicity (Select One) Hispanic or Latino Race (Select One or more) African or Black (AA) Japanese (JP) Native Hawaiian / Part-Hawaiian / Mixed-Hawaiian (HW) Not Hispanic or Latino American Indian (AI) Korean (KO) Samoan (SA) Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. Caucasian / White (CA) Asian Indian (IN) Chinese (CH) Filipino (FI) Laotian (LA) Thai (TH) Vietnamese (VI) Other Asian (OA) List your choice of Campuses and Academic Program you are seeking Campus Academic Program Tongan (TO) Guamanian / Chamorro (GC) Micronesian (MC) Other Pacific Islander (OP) University of Hawai`i at Hilo List every College, University, Business and Post-Secondary School Attended, including any UH Campus, and the one you are currently attending, if any Name of Institution City / State Attended / Attending Name of (Do not use initials) Attach additional sheet or From To Degree, Diploma List most recent first if necessary City / Country (MM/YY) (MM/YY) Major or Certificate -- -- -- -- MM / YY Expected/ Received Complete this section if you are currently enrolled in a College or University (attach additional sheet if necessary) Name of College or University currently attending Credit Hours Location (City / State) Term/Year Currently Enrolled APPLICANT's CERTIFICATION I certify that the answers and responses provided for all of the items on the University of Hawai`i at Hilo Application Form are complete and true to the best of my knowledge and belief. I understand that providing incomplete, incorrect, or false information may result in the recision of my admission and subject me to the requirements and/or disciplinary measures as provided under the University's Student Conduct Code. Furthermore, I understand that I may be required to produce certified documents relative to the determination of my residency status and that the provision of incorrect information regarding my residency declaration will also subject me to the requirements and/or disciplinary measures provided for in the University's rules and regulations governing the determination of residency for admission and tuition purposes. Date Signature (By entering your last name on the line above, you agree that it is the same as your signature) RESIDENCY: Do you wish to claim residency in the State of Hawaii? Yes (submit Residency Declaration) No

A Guide to Completing the Application for the University of Hawai i at Hilo Master of Arts in Teaching MAT Application Checklist UH Hilo application form $50 Application fee Statement #1: Interest in the Teaching Profession Statement #2: Beliefs about Student Learning Completed chart: Experiences Working with Children or Young People (please see attached form) Minimum 40 hours (more preferred) of previous experience working with school-aged (P-20) youth. Three letters of recommendation from people who have observed your performance teaching students at your desired grade level and can address your potential in the education field (please see attached form) Official transcripts from all colleges and universities attended (must be received in an envelope sealed by the institution) Baccalaureate degree transcripts from international institutions must be submitted to an independent transcript evaluation service Official report, PRAXIS II scores (UH Hilo code: 4869) Mandatory advising prior to submission of application (please see contact information, School of Education, next page) For International Applicants: Official TOEFL or IELTS score report, if required International Graduate Student Supplemental Information Form Copy of passport Early Bird Deadline: December 15 (Submit all documents directly to the Graduate Division) Program Purpose and Goals The primary purpose of the MAT program is to prepare teachers who demonstrate the knowledge, skills, and dispositions needed to build strong curriculum, pedagogy, assessments, and the relationships that bring about significant changes to improve schools, support learners and their development, and positively impact student achievement. Program completers will be able to: Create supportive environments based on their knowledge of learner development and learning differences. Demonstrate subject matter knowledge and apply this knowledge to engage students in learning content. Plan instruction that supports student learning through the use of multiple instructional and assessment strategies including technology. Demonstrate professional attributes, engage in critical reflection, and collaborate to ensure learner growth. 1. Students who complete the first year of the MAT program will be able to apply for initial teacher licensure with the Hawaii Teacher Standards Board. 2. Students who complete the second year will be able to engage in action research, a critical and reflective analysis that enables teachers to integrate and apply a variety of research-based methods in their classrooms and earn a Master of Arts in Teaching degree. Application Process Applications will be reviewed beginning December 15 for cohorts beginning in the following Summer semester. Incomplete application packets will not be reviewed. The UH Hilo Graduate Division receives all applications and supporting documents and maintains the applications through final notification. If you do not hear from us within 30 days of submitting your application, please contact the Graduate Division at 808-932-7926. Applications that meet the requirements will be forwarded to the School of Education Admissions Committee where they are subjected to a comprehensive review. Admission decisions made by the committee will be forwarded to the Graduate Division which sends the final notification to the applicant. Admission Status: The applicant s admission status is valid only for the semester to which the applicant is accepted. Applications from students who do not register or who withdraw from the University are voided but retained for a period of one (1) year. Students may reapply for admission to the next cohort by reapplying to the Graduate Division and submitting a $50 application fee. Note: Admission to the MAT program is competitive. Not all applicants who meet the qualifications are accepted. The UH-Hilo MAT program leads to teacher licensure in the State of Hawai i

Eligibility Criteria for Admission: An applicant must: 1) have earned a baccalaureate degree from an accredited institution or from a nationally recognized foreign institution. 2) have a GPA of 3.0 on a 4.0 scale in the last 60 sem. cr. 3) take the PRAXIS II: Content Area Examinations. 4) have a minimum of 40 hours (more preferred) of previous experience working with school-aged (P-20) youth. 5) submit two professional statements detailing interest in the teaching profession and beliefs about student learning. Additionally, 6) School of Education interview may be required. 7) for applicants seeking elementary licensure, these courses must be completed, each with a grade of C or better, and in combination passed with a GPA of 2.75 or above: ED 341 (4) Literacy Development in the Elementary School, ED 343 (3) Math for Elementary School and ED 347 Integrated Science and Social Studies for Elementary School. 8) for applicants seeking licensure at the secondary level, the baccalaureate degree should be related to the content area of licensure. 9) for applicants seeking licensure in English or Social Studies, there may be additional prerequisite coursework. 10) applicants for whom English is not the native language must obtain a score of 550 (paper based test), 213 (computer based) or 79 (internet based) on the TOEFL, or a 6.0 on the IELTS. Students with bachelor s degrees from English-speaking institutions do not need to submit TOEFL scores. Course* Cr Title First year, for licensure: ED 640 (2) Learner Development ED 641 (1) Learning Differences I ED 642 (2) Learning Differences II ED 643 (1) Learning Environments I ED 644 (1) Learning Environments II ED 645 (2) Learning Environments III ED 650 (1) Teaching in Hawai`i s Schools ED 651 (2) Elem Instructional Practice ED 652 (2) Elem LA/SS Pedagogy ED 653 (2) Elem MT/SC Pedagogy ED 654 (2) Tech Instruction & Assessment ED 655 (2) Sec Instructional Practice ED 656 (2) Sec LA/SS Pedagogy ED 657 (2) Sec MT/SC Pedagogy ED 658 (2) Sec Content Literacy ED 659 (3) Professional Practice ED 660 (1) Professional Responsibility I ED 661 (1) Professional Responsibility II ED 662 (1) Professional Responsibility III ED 670 (1) Field Experience I ED 671 (2) MAT Field Experience II ED 672 (3) Clinical Practicum Second year, to complete the MAT: ED 680 (3) Teacher as Researcher I ED 681 (3) Teacher as Researcher II Some courses are specific to the elementary track and others to the secondary track. Some courses are common to both tracks. The first three semesters in the MAT program prepare the student to become licensed to teach. Continuation in the program for 2 more semesters (6 more credits) leads to the Master of Arts in Teaching degree. Frequently Asked Questions Time: 1 year (30 credits) for teaching license (Summer, Fall, Spring) 1 year (6 credits) to complete the Masters Degree (Fall, Spring) Tuition, 2018-2019 academic year: $484 per credit hour, resident $1,102 per credit hour, non-resident Total Credits: 36 credits 1. What are the minimum entrance requirements? Completion of a relevant bachelor s degree, 3.0 GPA in the last 60 credits, 3 recommendations, professional statements, PRAXIS II scores. 2. Do I have to take the GRE? No. The PRAXIS II exam is the only required exam. 3. Will the MAT help me earn a teaching license? Yes, the MAT is a licensure preparation program. 4. Can I transfer credits? No, transfer credits are not accepted. 5. When will the program start? The MAT begins in Summer Session, and is 3 semesters in length (summer/fall/spring) for teacher licensure, and 2 additional semesters to complete the master s degree. 6. Is financial aid available? Contact the UHH Financial Aid Office for information (808-932-7449). 7. How many credits do I take? Students must take the prescribed courses in sequence. 8. Do I need a computer? Yes, or at least daily access to one. For program information and mandatory advising, please contact: UH Hilo School of Education sehna@hawaii.edu (808) 932-7102 For questions related to submission of your application, please contact: UH Hilo Graduate Division 200 W. Kāwili Street Hilo, Hawai i 96720-4091 (808) 932-7926 hilograd@hawaii.edu Revised: 5/19/2017

Master of Arts in Teaching (MAT) Supplemental Application Elem. Sec. (check one box) I have been advised by the School of Education advisor and given information regarding financial aid. Yes No I waive my right to advising by the School of Education. Yes No Complete and return this form to the UHH School of Education, 200 W. Kawili Street, Hilo, HI 96720-4091 by the early bird application deadline of December 15. Applicants must be aware that completed applications are necessary for consideration and applications received after this date will receive less priority for admission. Personal Data Name Last First Middle Student I.D.# Mailing Address Zip Code P.O. Box/Street City State Phone Number: (H) (W) (C) Email Address: Primary Secondary Are you a resident of the State of Hawaii? Yes No If not, state of residency Gender: Male Female Application: Students must submit a UH Common Application form for admission into UH Hilo before submitting this Supplemental Application form for the Master of Arts in Teaching Program. Completion of Prerequisite and Content Preparation Courses: All prerequisite and content preparation courses must be completed prior to entering the Master of Arts in Teaching Program. Recommendation Form: Three (3) recommendation forms are required for each applicant. The forms should be obtained from someone who has directly observed your performance and can address your potential in the education field. Other Documents Needed: Statement of Interests and Beliefs On a separate sheet, please respond in your most polished and professional prose to the following. Each response should be approximately 250 words, typed, double spaced, and submitted with this application. The statement should include two separate components as described below. 1. Why do you want to be a teacher? Please describe what experiences motivated you to choose teaching as your profession over another career. 2. Please describe your beliefs about student learning. What has influenced you in those beliefs? Experiences Working with School-Aged (P-20) Youth. Describe your experiences working with school-aged (P-20) youth with emphasis on the target age level appropriate to the program for which you are applying. Examples of such experiences include volunteer tutoring, summer fun programs, substitute teaching or employment as a teacher's aide. Where appropriate, include the name of the organization, supervisor, dates of experience or employment and your duties. Please list experiences in chronological order starting with the most recent experience first. We reserve the right to verify this information. The Hawai'i State Department of Education requests information of applicants for teacher licensure and employment in the public schools of Hawai'i. The DOE also verifies information through law enforcement agencies regarding sex-related offenses, child abuse/neglect/neglect offenses, substance/drug abuse offenses, or any violation of the law (felony or misdemeanor) other than minor traffic violations. Applicants to the Master of Arts in Teaching Program Cohort with concerns in any of these areas are encouraged to contact the Hawai'i DOE. Results of the background check may impact field placement in schools which is a requirement of the Master of Arts in Teaching Program Cohort. (Admission to the Master of Arts in Teaching is non-discriminatory. Due to various laws requiring statistical reports on ethnic origins of students, we ask the above questions) Signature: Date: Revised 7/1/16