SAM HOUSTON STATE UNIVERSITY APPLICATION FOR ADMISSION TO CANDIDACY FOR THE MASTER'S PROGRAM IN EDUCATION AND/OR TO THE SCHOOL COUNSELOR CERTIFICATE PROGRAM Name
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I wish to apply for admission to the program of preparation approved for this university by the State of Texas to qualify for Master of Education Degree and/or the School Counselor's Certificate. I understand that in order to qualify for the certificate, I must satisfactorily complete the program as outlined in the Graduate College Bulletin and by the Counseling Program at Sam Houston State University. 

 
 

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I am seeking:

Master's Degree and Certification
Certification Only (already hold a Master's Degree)

Signature Date

Degrees Held
Institution(s) Granting - Date
Major
Minor
       
       
       

Certificates Held  I anticipate employment as a(n):
Provisional  Elementary School Counselor
Professional    Middle or Intermediate School Counselor
Vocational    Junior or Senior High School 
Other    Other

List below teaching and/or administrative experiences with most recent experience first:
  Date 
Subject and Grade of Position
School/District 
County 
Principal 
Superintendent 
           
           
           

Give name and address of a fellow teacher and a certified school counselor who would be acquainted with your professional work:  
Teacher: 

Counselor: 
 

To be admitted, students must be unconditionally admitted to graduate studies. Attach an up-to-date transcript of all graduate level work. This transcript must show 15 hours of counseling core coursework.

Revised 11/2002 mae