Please indicate the status of completion or term planned for completion.

Academic and Employment Background

College and/or Universities Attended

You must submit copies of transcripts from all institutions by mail in addition to completing this application.

Employment Record (List most recent employment first)

Check those who may be contacted as references.

Obtain 3 letters of recommendation - send them to the following address:

Susan D’Aniello, Project SELECT Director
College of Education
Black Hills State University
University Center - Rapid City
4300 Cheyenne Blvd. 
PO Box 250
Rapid City, SD 57709

Please respond to the following questions:

6. Please list activities - organizations, volunteer work, service, etc. in which you have participated. Include dates.

7. Please explain what goals you have for when you become a certified teacher.