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Name: Social Security #: / /
LAST FIRST MI MAIDEN (if applicable)

Mailing Address: Home Phone: ( )

CITY STATE ZIP
Primary E-mail Address: Date of Birth (optional):

ADMISSION INFORMATION
• Return completed form and attachments to St. Petersburg College (SPC), Central Records, P. O. Box 13489, St. Petersburg, FL 33733-3489.
• Official transcripts from the institutions you list below (not including SPC) and CLAST/FTCE scores not included in official transcripts must be sent to
St. Petersburg College, Central Records, P. O. Box 13489, St. Petersburg, FL 33733-3489.
• Currently enrolled SPC students must complete this application.
• New students must complete the SPC general application form and this College of Education Application Supplement.
• Former SPC students, who have not attended St. Petersburg College, College of Education in the past year, must submit an updated SPC general application and
this Application Supplement.
• Former SPC students who are uncertain of their admission status should call (727) 341-4772.
BACCALAUREATE DEGREE SEEKING (Select a Program)

B.S. Education, Elementary Education (K-6) ELED-BS
B.S. Education, Exceptional Student Education(K-12) ESED-BS
B.S. Education, Secondary Math (6-12) MTSED-BS
B.S. Education, Secondary Science (6-12) BSCED-BS
B.S. Business Technology Education (6-12) BTEED-BS
B.S. Technology Education (6-12) TECED-BS

PREFERRED LOCATION for Education
Tarpon Springs Campus
St. Petersburg/Gibbs Campus
West Campus of Pasco-Hernando Community College - New Port Richey
Hillsborough County School District Paraprofessionals TTT

NON-DEGREE SEEKING (Post- Baccalaureate Students)
IMPACT (Educator Preparation Institute Alternative Certification Program)
Initial Certification (teacher certification)
Recertification (previously certified teacher)
Industrial Technical Education (Certificate only)

COLLEGE/UNIVERSITY RECORD (must list all previous institutions attended)
Postsecondary Institutions Attended City and State Degree/Certificate Received Credits Completed G.P.A.
(A.A.,A.S.,B.S.,Diploma) Alternative Certification Program

I certify that the answers given herein are true and correct. I further understand that a false statement in this application or any admission document will
subject me to penalties pursuant to §837.06, Florida Statutes; and is grounds for denial of admission or, upon further discovery, grounds for dismissal and
invalidation of college credit or degree based on such credit.

I authorize St. Petersburg College to request, and consent to the release of my educational records. I authorize those persons within the above postsecondary
institutions, to disclose information regarding my educational records and to release and provide copies of my educational records to the College Registrar,
St. Petersburg College. I understand that “educational records” include, without limitation, any and all records maintained that relate to me. I release,
acquit, discharge and exonerate the above postsecondary institutions (its trustees, officers and employees) from all liability in connection with the release of my
educational records as provided herein.

SOCIAL SECURITY NUMBER ACKNOWLEDGEMENT
I acknowledge by my signature I understand the College is collecting my social security number for the purpose of complying with federal and state statutes
related to employment, financial and academic assistance, and inter-institutional articulation or transfer, and that the College may disseminate that
information in some communications with outside organizations, while taking precaution to safeguard use of the number. I also understand that should I
choose not to have my social security number transmitted to the Internal Revenue Service (IRS) in response to Hope/Lifetime Learning Tax Credit reporting,
I face the possibility of a fine of $50.

Applicant’s signature (in ink) Date

St. Petersburg College
Office use only
Baccalaureate Application Supplement
College of Education

Expected Term of Attendance
Term Month Year
Term I August
Term II January

2) A.A. Degree: General education courses plus Florida-mandated prerequisites. (Students with at least 60 semester credit hours of postsecondary education, but
who do not hold an A.A. degree, may be admitted by the Dean on a case-by-case basis.)

3) Cumulative grade point average of 2.5 on a 4.0 scale in all postsecondary coursework (including common prerequisite coursework).
4) Students are required to disclose, on a COE form after admitted to the College of Education, any information that may be revealed through the FDLE and FBI
background check each semester they enroll in a course with school-based hours. This form is completed through New Student Orientation.

5) Completion of all lower-division state mandated common prerequisites, including the following three Education prerequisites with grades no lower than a “C”:
EDF 1005, EDG 2701 & EME 2040.

Non-Degree Student Admission Information:
1) IMPACT: (Educator Preparation Institute Alternative Certification Program) Post-baccalaureate students who apply to the IMPACT program must submit
official transcripts from all previous institutions attended and the Florida Department of Education Bureau of Educator Certification Statement of Eligibility.

2) Initial Certification: Post-baccalaureate students who wish to enroll in an upper-division course must provide proof of an earned bachelor’s degree (unofficial or
official transcripts) and the Florida Department of Education Bureau of Educator Certification Statement of Eligibility.

3) Recertification: Post-baccalaureate students who wish to enroll in an upper-division course must provide proof of an earned bachelor’s degree (unofficial or
official transcripts) and verification of teacher certification or employment in a school district.

4) Industrial Technical Education: Candidates must submit a copy of a completed high school transcript stating that the student received a standard high school
diploma, college ready diploma or GED transcript with date of graduation.

St. Petersburg College is dedicated to the concept of equal opportunity. The college will not discriminate on the basis of race, color, religion, sex, age, national origin
or marital status, or against any qualified individual with disabilities, in its employment practices or in the admission and treatment of students. Recognizing that sexual
harassment constitutes discrimination on the basis of sex and violates this rule, the college will not tolerate such conduct. Should you experience such behavior, please
contact the director of EA/EO at (727) 341-3257 or (727) 341-3261 or by mail at PO Box 13489, St. Petersburg, FL 33733-3489.

(727) 341-4772 www.spcollege.edu
St. Petersburg College

SPC

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