Office Use:
GPA ______________
Rec ______________
Trans _____________
Adm Date __________
5th Year Program: Elementary Education
Application for Admission
Applicant Information
Full Name:
Date:
Last
First
M.I.
Address:
Street Address
County
City
Phone:
State
Home (
)
Student ID:
5th Year
Concentration:
Work (
)
Cell (
Email:
Literacy
ZIP Code
)
Date of Birth:
Content
STEM
*Choose one
Ethnicity:
(Black, Caucasian, Hispanic, Native American, Other)
Yes
No
Are you a citizen of the United States?
Yes
Are you a legal resident of NC?
Female
Male
Yes
No
Gender:
Have you ever been convicted of a felony?
If yes, explain:
Student Organizations
Organization:
From:
Please list all the HPU student organizations that you have been or are currently involved.
Leadership
Positions Held
To:
Leadership
Positions Held
Organization:
From:
To:
To:
To:
To:
Comments:
Leadership
Positions Held
Organization:
From:
Comments:
Leadership
Positions Held
Organization:
From:
Comments:
Leadership
Positions Held
Organization:
From:
Comments:
Leadership
Positions Held
Organization:
From:
Comments:
To:
Comments:
No
Recommendation
Please list the individuals who will be completing your recommendation. The recommendation form that should be used can
be found at the end of this application. Please print and provide a copy to each individual.
Elementary Education Majors: Two recommendation letters must be submitted on the forms attached. One should be
from an Elementary Education professor and one can be from an Academic Advisor, a professor outside of education,
pastor, current employer, etc.
Special Education Majors: Two recommendation letters must be submitted on the forms attached. One should be
from a Special Education professor and one from an education faculty member outside of special education.
*Note: Please be sure to complete the top portion of the recommendation form before providing to your reference.
Relati
onship
Full Name:
:
Relati
onship
:
Full Name:
Previous Employment
List part-time or full-time work experiences in chronological order beginning with most recent.
Company:
Position &
Responsibilities:
From:
City/State:
To:
Comments:
Company:
Position &
Responsibilities:
From:
City/State:
To:
Comments:
Company:
Position &
Responsibilities:
From:
City/State:
To:
Comments:
Disclaimer and Signature
I certify that the statements made in this application are true and accurate:
Signature:
Date:
HIGH POINT UNIVERSITY
SCHOOL OF EDUCATION
5th Year Program: Elementary Education
Application for Admission
ESSAY
Essay Prompt for Elementary Education Majors:
As a future 21st Century elementary teacher, what is your responsibility in helping to prepare
students to be future-ready and globally-competitive?
Essay Prompt for Special Education Majors:
As a future 21st Century educator use your Special Education background and discuss your
responsibility in helping to prepare students to be future-ready and globally competitive.
HIGH POINT UNIVERSITY
SCHOOL OF EDUCATION
5th Year Program: Elementary Education
Application for Admission
Confidential Letter of Recommendation
Applicants, please complete the top portion, including your signature. Please provide a stamped
addressed envelope for your letter to be returned to High Point University.
_______________________________________ has applied to the 5th Year Program in the School of
Education at High Point University to pursue a Master’s degree and has requested your letter of
reference. Please answer the questions in as specific and candid a manner as possible. Your
comments will be available only to those involved in the admission decision process. Your signature
across the seal of the envelope ensures confidentiality. Please return, in the stamped envelope
provided by the applicant to:
High Point University
School of Education
833 Montlieu Avenue
High Point, NC 27262
Applicant’s signature: I waive my right to see this letter of recommendation:
______________________________________________ Date ____________________
Name of individual completing this form: ________________________________________________
Position and/or relationship to applicant: ________________________________________________
1. How long have you known the applicant?
2. Under what circumstances have you known the applicant?
3. What do you consider to be the applicant’s most outstanding talents or
characteristics?
4. Are there any notable weaknesses that might hinder the candidate’s
success in graduate studies? If so, please explain.
5. In what ways have you observed the applicant demonstrate originality and
independence in thinking?
6. Please add any additional information that would be helpful for us in
evaluating the candidate’s application.
Outstanding
Very
Good
Average
Below
Average
Poor
Not
Observed
Intellectual
Ability
Leadership
Potential
Maturity Level
Disposition
Ability to work
with others
Organization
and time
management
Ability to work
independently
Ability to
communicate
orally
Ability to
communicate in
writing
____strongly recommend
_____recommend
____recommend with reservations
_____do not recommend
_____________________________________________
(Signature)
________________________
(Date)