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* 1. First Name

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* 2. Last Name

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* 3. Address

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* 4. Phone number

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* 5. Email

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* 8. DOB

Date

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* 9. Are you a NYS Resident?

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* 10. Are you eligible to work in New York State? (The grant for this program precludes us from accepting international students without existing eligibility to work.)

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* 11. Are you a veteran?

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* 12. Are you a first-generation college student?

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* 13. Undergraduate Institution

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* 14. Undergraduate Major

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* 15. Undergraduate Degree

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* 16. Undergraduate Commencement Date

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* 17. Undergraduate GPA

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* 18. Unofficial transcript upload

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* 19. Additional institutions, degrees or coursework?

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* 20. Additional unofficial transcript upload

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* 21. Contact Information for Reference #1

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* 22. Contact Information for Reference #2

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* 23. Language Skills (Skills in languages other than English-List language and self-assess proficiency level--beginner, intermediate, advanced, bilingual)

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* 24. Do you currently hold a teaching license? If so, which license/state? (Note: This program is designed for individuals seeking their first teaching license.)

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* 25. Are you a career changer, recent graduate, or educator in a non-teaching capacity? (career changer-prior experience in a professional field outside of education; recent graduate-education would be your first professional career since graduation from an undergraduate program; educator in a non-teaching capacity might include prior experience in education, but not certified classroom teaching)

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* 26. In what field(s) have you previously worked?

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* 27. In what subject area are you seeking certification?

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* 28. How did you hear about the BPS Residency Program?

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* 29. Resume upload

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* 30. Prompt #1: Describe your interest and/or experiences within urban education. Describe the professional, personal, and educational journey that has led you to apply for the Teacher Residency program. Then, explain why you believe this program aligns with your background and professional goals. (500-700 words)

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* 31. Reflect on the qualities you believe are important for successful engagement with diverse communities and student populations. In what ways do(es) your own identity and/or background experiences, particularly experiences with people who have backgrounds and experiences that are in some ways different from your own (i.e. socioeconomic status, race, ethnicity, religion, culture, sexual orientation, ability, etc.), prepare you to teach in urban classrooms? (500-700 words)

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