Susquehanna University Graduate Application

Fields marked with an asterisk (*) are required.

Program Information

To which graduate program are you applying?*

Master of Education

Teacher Intern Program

What semester do you intend to begin your graduate studies?*

Desired certification area*

Contact Information

First Name*

Preferred Name

Middle Name

Last Name*

Email Address*

Mobile Phone*

I give permission to Susquehanna University to send me important updates via text messaging. (Standard message rates apply)*

Yes

No

Birthdate*

Mailing Address*

Country

Street

City

Region

Postal Code

Student Information

Gender*

Please specify

Citizenship*

Please upload a proof of citizenship below (valid birth certificate or passport)*

Second citizenship

Have you previously been enrolled at Susquehanna?*

Yes

No

Dates of enrollment when enrolled.*

Has your last name changed since you were enrolled at SU?*

Yes

No

What was your last name when you attended Susquehanna?*

Are you currently receiving veteran's benefits?*

Yes

No

Do you have a valid Pennsylvania Teaching certificate?*

Yes

No

School district affiliation

PDE PPID number

Content area(s) and grade range(s) of PA teaching certification.

Please upload a copy of your valid PA teaching certificate here.*

Are you interested in also applying to SU's Teacher Intern Program?*

Yes

No

Do you currently hold a Pennsylvania teacher certification?*

Yes

No

Please list the certification:*

Personal Statement

Why do you want to pursue an advanced degree?*

You may upload a word or PDF document or cut and paste your statement into the field below.

Or, type or copy-and-paste your document here:

Why do you wish to become a licensed educator?*

You may upload a word or PDF document or cut and paste your statement into the field below.

Or, type or copy-and-paste your document here:

References

For application to our graduate programs, three references from former professors or recent employers are required. Upon submission of your application, emails with reference questionnaires will be automatically sent to the references listed below.

Reference #1

Reference #1 name*

Reference #1 email address*

Reference #1 phone number*

Reference #2

Reference #2 name*

Reference #2 email address*

Reference #2 phone number*

Reference #3

Reference #3 name*

Reference #3 email address*

Reference #3 phone number*

Educational Background

Educational Background & Employment History

Please name all previously attended postsecondary institutions. Please include:*
- Institution name
- Degree sought
- Dates enrolled
- Major(s)/concentration(s)
- If a degree was earned

You may upload a word or PDF document...

Or, type or copy-and-paste your document here:

Please name all previous employers. Please include:*
- Position/title
- Employer
- Dates of employment

You may upload a word or PDF document...

Or, type or copy-and-paste your document here:

To better understand your past experence with children in the K-12 setting, please list below all places in which you have worked with children in the past 5 years with the number of hours worked.*
Examples:

Sunday school teacher for ages 7-10 - 30 hours
After school math tutor for 11 year old - 15 hours
Soccer coach for ages 5-7 - 25 hours

Review & Submit

Following application submission, you will receive an email to log in and view your application status portal. There, you can view and submit outstanding documents. Items needed to complete your Susquehanna graduate application include:

Act 24 clearance
Act 34 clearance
Act 114 clearance
Act 151 clearance
Act 126 clearance (within last three years)
TB Test results (not more than one year old)
Official transcripts from former college(s)
Three letters of recommendation from former professors/recent employers

Following application submission, you will receive an email to log in and view your application status portal. There, you can view and submit outstanding documents. Items needed to complete your Susquehanna graduate application include:

Act 24 clearance
Act 34 clearance
Act 114 clearance
Act 151 clearance
Act 126 clearance (within last three years)
TB Test results (not more than one year old)
Official transcripts from former college(s)
Three letters of recommendation from former professors/recent employers

I acknowledge that my application is not considered complete until I have submitted the documentation listed above.*

In place of your signature, please type your full legal name:*