Special Education Internship Application 2021-22 Question Title * 1. Last Name OK Question Title * 2. First Name OK Question Title * 3. Address (Please put the address where you will be living if chosen for the internship) OK Question Title * 4. Phone Number OK Question Title * 5. Email Address (Where you can be reached daily) OK Question Title * 6. What college or university do you currently attend? Brenau University Clark Atlanta University Florida State University Georgia Gwinnett College Georgia Southern University (Armstrong, Liberty, Statesboro Campuses) Georgia State University Kennesaw State University Liberty University Mercer University Piedmont College University of Central Florida University of Georgia University of North Georgia University of Phoenix Valdosta State University Walden University Other (please specify) OK Question Title * 7. I am currently a .... College Senior College Junior Other (please specify) OK Question Title * 8. What is your anticipated graduation date? November 2021 December 2021 May 2022 Other (please specify) OK Question Title * 9. Are you interested in teaching in a Title I school? Yes No OK Question Title * 10. Please rank in order your preference for which level you are most interested in teaching. 1 2 3 4 Elementary 1 2 3 4 Middle 1 2 3 4 High 1 2 3 4 No preference OK Question Title * 11. Why have you chosen the field of education as your career? OK Question Title * 12. Briefly explain your reasons for applying to the GCPS Special Education Internship Program. Please include specific objectives and expected benefits of the internship. OK Question Title * 13. Where do you see yourself in five years? Include your long-term and short-term goals. OK Question Title * 14. Briefly describe your experiences with students with disabilities. OK Question Title * 15. Select the 2 special education programs you are most interested in teaching. Please share why. Autism (ASD- I, Severe) Autism (ASD-II, Moderate) Autism (ASD-III, Mild) Emotional Behavior Disorder (EBD) Interrelated (Resource and/or Co-teaching) Moderate Intellectual Disabilities (MOID) Severe and Profound Intellectual Disabilities (SID/PID) Visual Impairments Why? OK Question Title * 16. Please share any additional information about you and/or experiences you would like the Internship Review Team to consider. OK DONE