FT003
Future Teachers Scholarship
Application for 2016-17
Last Name
Fir st Name
Cit y
Mailing Address
(
)
Social Secur it y Number
Phone
MI
St at e
Zip Code
College St udent I D Number
Responses t o t he following quest ions ar e volunt ar y. The infor mat ion will be used for nondiscr iminat or y pur poses and may be used for civil r ight s r epor t ing pur poses.
Race/Et hnicit y
M ale
Cit y
H igh School
Female
St at e
During the fall 2016 semester, please indicate if you will be classified as:
Under gr aduat e
or
Gr aduat e
Full-t ime
or Par t -time
M ajor
Tot al number of hour s complet ed (under gr aduat e and gr aduat e) pr ior t o fall 2016
Please indicate the subject ar ea you plan to teach upon cer tification.
Eligible Critical Shortage Areas for the Future Teachers Scholarship
2016-17
Science
Special Education
Mathematics
Business
Foreign Languages
English/Language
Social Studies
Elementary Education
New Applicants
Early Childhood Education
School Counselor
Library
Sciences
Health
I n appr oximat ely
300 wor
ds, discuss what has influenced you t o pur
sue a Education
t eaching car eer in
your field of st udy.
Arts and Music
Humanities
Career and Technical Education
Computer Science
Previous Scholarship Recipients
I n appr oximat ely 300 wor ds, wr it e a st at ement in r esponse t o one of t he following:
1. Descr ibe how your commit ment t o t eaching been r eaffir med by t he pr ofessional pr ogr ess
you have made.
2. Descr ibe an accomplishment you have achieved in t he last year and explain why you view
it as such.
Transcripts
Please at t ach transcripts from any higher education institution you have attended.
Student Agreement
I f awar ded thi s schol arshi p, I agr ee to teach i n the publ i c school system of Okl ahoma for thr ee
consecuti ve year s upon gr aduati on and l i censur e as a teacher . I fur ther under stand that
fai l ur e to mai ntai n a mini mum cumul ati ve 2.5 gr ade poi nt aver age or changi ng to an ar ea of
study whi ch i s not a cr i ti cal shor tage ar ea shal l subject me to di squal i ficati on fr om thi s
pr ogr am. I her eby cer ti fy that the statements made her ei n ar e cor r ect and may be ver ifi ed by
r ecor ds of the i nsti tuti on(s) I have attended.
Applicant 's Signature
Dat e
Submit your completed application to the Futur e Teacher s Pr ogr am Coor dinator
at your institution. Please contact the institution that you plan to attend for
application deadline.