Information and Experience Profile
BACHELOR OF EDUCATION
The Faculty of Education recognizes that each candidate brings previous experiences or training that
enriches the program and influences current and future career paths.
This form may be submitted electronically to Jill Ross, BEd Administrative Assistant,
jbross@upei.ca
You may add additional items in each section if the space allotted is not sufficient.
Name: __________________________________
1.
I have been conditionally accepted into the
Primary/Elementary (Grades K - 6)
2.
Date of Birth _______________________
Day/Month/Year
ENGLISH
FRENCH program in the
Intermediate/Senior (Grades 7 – 12) cohort
What degrees or diploma will you have obtained by the beginning of the B Ed Program?
______ 3 year degree _____ 4 year degree ______ Diploma ____ Graduate degree
Please give details of each degree or diploma (year received, major and minor areas of study).
Part A: REFERENCES
Complete the chart below (in full) listing three people who have agreed to be contacted as a reference for
you. Referees are not required to send letters. No personal references or references from family members
will be considered.
FULL NAME: ________________________________________________________________
TITLE: _____________________________________________________________________
TEL. NUMBER: __________________________________
EMAIL: ____________________________________________________________________
Your relationship to referee: _____________________________
FULL NAME: ________________________________________________________________
TITLE: _____________________________________________________________________
TEL. NUMBER: __________________________________
EMAIL: ____________________________________________________________________
Your relationship to referee: _____________________________
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September, 2015
FULL NAME: ________________________________________________________________
TITLE: _____________________________________________________________________
TEL. NUMBER: __________________________________
EMAIL: ____________________________________________________________________
Your relationship to referee: _____________________________
Part B: Experiences with Young Children and Youth
This section is to acknowledge any experience you may have with young children and youth, either in a
volunteer or paid capacity. You may include experiences gained in secondary school and through
subsequent life experiences. For each experience noted, please estimate the length of time committed to
this activity in weeks and include a concise statement of your responsibilities.
These experiences may include but are not limited to: teaching overseas or in Canada; working in
schools, camps, recreation facilities or early childhood programs; volunteering and/or coaching in youth
programs; teaching or involvement in music, artistic or dramatic activities; extra-curricular involvement
and volunteer work with organizations, clubs, groups or individuals.
LEADERSHIP NOTE: Teachers are in positions of leadership not only in their classroom but also as staff
members within their schools and within the profession and community. Leadership experiences may
include being elected as team leader, a member of an executive, providing leadership in work settings,
directing drama or musical productions, representing a group in provincial, national or international
activities, designing, initiating or implementing new programs, organizing others, etc.
Experience 1
Length of involvement
Name of organization or supervisor
Approximate dates of involvement
Name of organization or supervisor
Approximate dates of involvement
Describe your
responsibilities for each
experience, including any
leadership role you
assumed.
Experience 2
Length of involvement
Describe your
responsibilities for each
experience, including any
leadership role you
assumed.
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September, 2015
Experience 3
Length of involvement
Name of organization or supervisor
Approximate dates of involvement
Describe your
responsibilities for each
experience, including any
leadership role you
assumed.
(Add more sections as needed)
Part C: Experiences with Diversity
Indicate any experience living or working in contexts or cultures that are considered diverse. Diversity
may include (but is not limited to) involvement with: people with special needs; people who may be
chronically ill; multi-cultural experiences; cross generation activities; substance abuse awareness and
healing programs; poverty; gender and sexual orientation groups; or course work relating to diversity.
Describe your experience(s) with diversity
Part D: Awards and Special Recognition
List any awards or special recognition received in high school, college, university, or the community.
The list may include (but is not limited to) recognition in the areas of academics, sports, the arts,
volunteer activities, or community service.
Date Received
Name of Award
Reason for Recognition
Part E: Employment History
All work experiences help to develop aspects of a person. These may include summer/part-time positions,
full-time careers, as well as unpaid employment such as parenting and childcare.
Dates of
Involvement
Total length
of time in
this work
Name of Organization
(Contact person, phone
or email)
Responsibilities
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September, 2015
Part F: Skills, Talents, Interests, Hobbies
Teachers need to be well-rounded, well-informed individuals. It is important that educators not only be
able to teach well, but also that they contribute to staff activities, school life, and assist youth in
developing their interests and abilities.
Describe your other interests or hobbies.
Part G: OTHER INFORMATION (OPTIONAL)
This section gives you an opportunity to share information about any challenges or obstacles that you
have overcome in your effort to become an educator. Applicants may choose to self-declare a special
status, (e.g. Indigenous ancestry, immigrant), a learning / physical challenge, or any other example of
personal diversity. (This application is confidential and the information will not be used for any purpose or
by anyone outside of the Admissions Committee.)
Part H: PERSONAL DECLARATION
I certify that the statements in this profile are true and complete to the best of my knowledge.
I understand that erroneous information in this application could result in my disqualification
from the program. The B ED Committee may contact any person or organization listed in the
application for further information or for verification of information. Candidates may be
requested to attend an interview.
_____________________________________
UPEI ID number
________________
Name (Print clearly)
___________________________________________
Signature
__________________________
Date
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September, 2015