*Prefix:
*First Name:
*Last Name:
*Home Address:
Address Line 2:
*City:
*State/Province:
*Country:
*Zip/Postal:
*Home Phone:
*Work Phone:
*Email Address:
*What is your highest level of education?
*Years of full time work experience?
*Please select your year of high school graduation or GED.
*Please select your age range at the time of enrollment.
*Are you a U.S. citizen, national, or permanent resident? YesNo
*Will you have access to a computer to take your courses? YesNo
*Have you earned any of your credits outside the United States? YesNo
*What time zone do you live in?
*Best Time to Call? AMPM
*Please specify military affilliation (if any).
*Please select a projected start date.
*Do you have a current teaching certificate (Walden)? YesNo
*Do you possess a bachelor's degree from a regionally accredited institution or an institution accredited by an agency recognized by the Department of Education (Kaplan)? YesNo
*Do you possess or have you ever possessed a teaching license (Kaplan)? YesNo
*Do you possess a cumulative undergraduate grade point average (GPA) of 2.5 or higher (out of 4.0) (Kaplan)? YesNo
*Are you a currently practicing secondary (7-12) Teacher (Kaplan)? YesNo
*Do you plan on doing your field work in a school district in Iowa, Washington DC, or Florida? (Kaplan) YesNo
*Do you possess a cumulative undergraduate grade point average (GPA) of 2.75 (out of 4.0) (Kaplan)? YesNo
*Are you a currently practicing K-12 teacher (Kaplan)? YesNo
*Do you teach to a classroom/group of students (Kaplan)? YesNo

I understand that Admissions Advisors from each of my selected
       schools will contact me to discuss my specific goals.
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