Interest Form : Department of Curriculum and Instruction : Texas State University

First Name *

Last Name *

Email *

Please enter an email that you have access to and check regularly.

Phone Number *

School District *

Please enter the district where you are currently employed.

Certification Pathways *

Chose one or more:

Early Childhood Through Grade Six Core Subjects with English as a Second Language

EC-6 ESL

Early Childhood Through Grade Six Core Subjects with Bilingual - Spanish

EC-6 Bilingual

Special Education Early Childhood Through Grade Twelve

Special Education (EC-12)

How long have you been an Instructional Aide? *

Describe Your Current Instructional Aide Assignment *

How did you hear about our program? *

From school district

(i.e. HR, Principal, Superintendent, Colleague)

From online marketing advertisement

Other

If other was selected in the field above, use this line to tell us how you heard about our program:

Any other questions, concerns, or information you would like to share:

Interest Form