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Special Education Applications/Handouts/Forms

Please Note

1. Completed forms should be submitted to the department by the posted deadline.
2. Forms will not be accepted without all appropriate signatures and student ID number (not SS#).
3. All students must meet with their assigned advisors at least once a semester and keep an up-to-date program advisement form on file and available.
   

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General Documents

	Document Title	Type
	List of Important Numbers Across Campus
	Special Problems Petition (EDS 199, EDS 299) Contact the department for more details, (916) 278-6622. Deadlines:  Fall/Summer: April 1st                    Spring: November 1st
	Reservation Forms for EDS 297, 298, 500/501  PDF Version A separate reservation form must be submitted for each course and semester you intend to register. No exceptions. Deadlines:  Fall/Summer: April 1st                    Spring: November 1st
	Incomplete Grade Petition Contact the department for more details, (916) 278-6622.
	Prior Learning Assessment Form [with Narrative] Contact your assigned Advisor for more details.
	Changing Your Student Record Information Name, address, etc, (Must be done in person with photo ID through Outreach & Records) Change of Phone Number, Address, or Information Release Authorization (pdf)

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Preliminary - Educational Specialist Credential - New Applicants

	Document Title	Type
	How to Apply to the University and Level I (Preliminary) Credential Program
	Preliminary Level Credential Application [TPAC] For specific questions, call the Teacher Preparation Office at (916) 278-6403. Fall 2012: March 1, 2012 Spring 2012: October 3, 2011 Contact the department for more details (email eds@csus.edu).

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Preliminary - Educational Specialist Credential - Courses

Program Course Options

Preliminary Mild/Moderate & Multiple Subject Credential Preliminary Program Sequence Options OPTION A: No Other Credential Held 3-Semesters Core Program 1st Semester Units EDS 100A/B Educating Students with Disabilities 2+1 EDS 119 Legal and Social Found of Special Ed 3 EDS 220 Language and Literacy I 3 EDS 229A/B Strategies for Students with M/M Dis. 2+1 EDS 232 Seminar in Special Education: M/M (Required first semester course) 2 HLSC 136 School Health Education 2 Core Program 2nd Semester EDS 213A/B Mathematics Curriculum & Instruction 2+1 EDS 221 Language and Literacy II (EDS 220 Prerequisite - Passing RICA required for credential) 3 EDS 225A/B Assessment & Evaluation MM Dis 2+1 EDS 230A/B Positive Behavior Supports (EDS 229A/B - Prerequisite) 2+1 EDS 471 Phase I Field Exp. (Mild/Moderate) 4 Core Program 3rd Semester EDS 233 Final Mild/Moderate ST Teaching Seminar 1 EDS 237A/B Transition Strategies for Students with M/M 2+1 EDS 292A/B Teaching English Learners with Disabilities 2+1 EDS 472/473 Mild/Mod Student Teaching/Internship (CSET or equivalent must be passed prior to enrollment) 7 OPTION B: No Other Credential Held 4-Semesters Core Program 1st Semester Units EDS 100A/B Educating Students with Disabilities 2+1 EDS 119 Legal and Social Found of Special Ed 3 EDS 220 Language and Literacy I 3 EDS 232 Seminar in Special Education: Mild/Mod (Required first semester course) 2 Core Program 2nd Semester EDS 221 Language and Literacy II (EDS 220 Prerequisite - Passing RICA required for credential) 3 EDS 229A/B Strategies for Students with Mild/Mod Dis. 2+1 EDS 225 A/B Assessment & Evaluation Mild/Mod Dis 2+1 EDS 230A/B Positive Behavior Supports (EDS 229A/B - Prerequisite) 2+1 Core Program 3rd Semester EDS 213A/B Mathematics Curriculum & Instruction 2+1 EDS 292A/B Teaching English Learners with Disabilities 2+1 HLSC 136 School Health Education 2 EDS 471 Phase I Field Exp. (Mild/Moderate) 4 Core Program 4th Semester EDS 233 Final Mild/Moderate ST Teaching Seminar 1 EDS 237A/B Transition Strategies for Students with M/M 2+1 EDS 472/473 Mild/Mod Student Teaching/Internship (CSET or equivalent must be passed prior to enrollment) 7 OPTION C: Multiple or Single Subject Credential Already Held - RICA Passed 2-Semesters Core Program 1st Semester Units EDS 119 Legal and Social Foundations of Special Education 3 EDS 229A/B Strategies for Students with M/M Disabilities 2+1 EDS 232 Seminar in Special Education: M/M (Required first semester course) 2 EDS 292A/B Teaching English Learners with Disabilities 2+1 Core Program 2nd Semester EDS 225 A/B Assessment & Evaluation MM Dis 2+1 EDS 230A/B Positive Behavior Supports (EDS 229A/B - Prerequisite) 2+1 EDS 233 Final Mild/Moderate ST Teaching Seminar 1 EDS 237A/B Transition Strategies for Students with M/M 2+1 EDS 472/473 Mild/Mod Student Teaching/Internship (CSET or equivalent must be passed prior to enrollment) 7 OPTION D: Moderate/Severe Credential Already Held - RICA Passed 2-Semesters Core Program 1st Semester Units EDS 213A/B Mathematics Curric & Instruction 2+1 EDS 225A/B Assess & Evaluation M/M Dis. 2+1 EDS 229A/B Strategies for Students with M/M Dis. 2+1 Core Program 2nd Semester EDS 233 Final Mild/Moderate ST Tch Seminar 1 EDS 237A/B Transition Strats for Studs with M/M 2+1 EDS 472/473 Mild/Mod Student Tching/Internship (CSET or equiv must be passed prior to enrollment) 7 OPTION E: Mild/Moderate & Multiple Subject 4-Semesters Core Program 1st Semester Units EDS 100A/B Educating Students with Disabilities 2+1 EDS 119 Legal and Social Found of Special Ed 3 EDS 220 Language and Literacy I 3 EDS 229A/B Strategies for Students with M/M Dis. 2+1 EDS 232 Seminar in Special Education: M/M (Required first semester course) 2 HLSC 136 School Health Education 2 Core Program 2nd Semester EDS 213A/B Mathematics Curriculum & Instruction 2+1 EDS 214A/B Social Science Curriculum & Instruction 2+1 EDS 215A/B Science Curriculum & Instruction 2+1 EDS 221 Language and Literacy II (EDS 220 Prerequisite - Passing RICA required for credential) 3 EDS 230A/B Positive Behavior Supports (EDS 229A/B - Prerequisite) 2+1 EDS 421A , EDS 471, or Equivalent Initial Student Tchng 4 Core Program 3rd Semester EDBM 170 Intro. To Bilingual Education 3 EDS 292A/B Teaching English Learners with Disabilities 2+1 ED 300B PACT Scoring [Not a Course] 1 EDTE 317 Visual & Performing Arts (Spring Terms Only) 1 EDS 332 PACT Seminar: Assessment Center Lab 2 EDS 420B Final Student Teaching: Multiple Subject 7 Core Program 4th Semester EDS 225 A/B Assessment & Evaluation Mild/Mod Dis 2+1 EDS 233 Final Mild/Moderate ST Teaching Seminar 1 EDS 237A/B Transition Strategies for Students with M/M 2+1 EDS 472/473 Mild/Mod Student Teaching/Internship (CSET or equivalent must be passed prior to enrollment) 7 OPTION F: Mild/Moderate & Multiple Subject 5-Semesters Core Program 1st Semester Units EDS 100A/B Educating Students with Disabilities 2+1 EDS 119 Legal and Social Found of Special Ed 3 EDS 229A/B Strategies for Students with M/M Dis. 2+1 EDS 232 Seminar in Special Education: M/M (Required first semester course) 2 HLSC 136 School Health Education 2 Core Program 2nd Semester EDBM 170 Intro. To Bilingual Education 3 EDS 213A/B Mathematics Curriculum & Instruction 2+1 EDS 220 Language and Literacy I 3 EDS 230A/B Positive Behavior Supports (EDS 229A/B - Prerequisite) 2+1 EDS 292A/B Teaching English Learners with Disabilities 2+1 EDS 421A , EDS 471, or Equivalent Initial Student Tchng (May be taken in 3rd Semester) 4 Core Program 3rd Semester EDS 214A/B Social Science Curr & Instruct 2+1 EDS 215A/B Science Curr & Instruct 2+1 EDS 221 Language and Literacy II (220 Prerequisite - Passing RICA required for cred.) 3 EDS 225 A/B Assessment & Evaluation Mild/Mod Dis 2+1 Core Program 4th Semester ED 300B PACT Scoring [Not a Course] 3 EDTE 317 Visual & Performing Arts (Spring Terms Only) 2+1 EDS 332 PACT Seminar: Assessment Center Lab 2+1 EDS 420B Final Student Teaching: Multiple Subject 2+1 Core Program 5th Semester EDS 233 Final Mild/Moderate Student Teaching Seminar 1 EDS 237A/B Transition Strategies for Students with Mild/Moderate 2+1 EDS 472/473 Mild/Mod Student Teaching/Internship (CSET or equivalent must be passed prior to enroll) 7   Preliminary Moderate/Severe and Multiple Subject Coursework & Field Experiences Option A: Mild/Moderate Credential Already Held   Units EDS 205 Methods in Access & Inclusion in the Core Curriculum: Moderate/Severe 3 EDS 206 Collaborative Program Development: Moderate/Severe 3 EDS 207 Secondary, Post-Secondary, Transition Moderate/Severe Disabilities 3 EDS 208 Evidenced-based Assessment & Instruction: Moderate/Severe 3 EDS 209 Augmentative & Alternative Communication 3 EDS 216A/B Movement, Mobility, SHCN 2+1 EDS 218 Instructional Strategies: Low Incidence Disabilities 3 EDS 235 Fieldwork Seminar in Program & Instruction 2 EDS 236 Final Student Teaching Seminar: Moderate/Severe 1 EDS 414 Student Teaching I: Moderate/Severe 3 EDS 415 Student Teaching II: Moderate/Severe (or, EDS 421 Intern Teaching: Moderate/Severe 5)* 5 * Candidates must take EDS 421 Intern Teaching: Moderate/Severe if on an Internship. This is the only difference in the program for an Intern versus a traditional student teaching candidate. Option B: Multiple Subject Credential Already Held   Units EDS 130A/B Typical and Atypical Development Characteristics and Outcomes for Young Children with Disabilities 2+1 EDS 119 Legal and Social Foundations of Special Education 3 EDS 205 Methods in Access & Inclusion in the Core Curriculum: Moderate/Severe 3 EDS 206 Collaborative Program Development: Moderate/Severe 3 EDS 207 Secondary, Post-Secondary, Transition Moderate/Severe Disabilities 3 EDS 208 Evidenced-based Assessment & Instruction: Moderate/Severe 3 EDS 209 Augmentative & Alternative Communication 3 EDS 216A/B Movement, Mobility, SHCN 2+1 EDS 218 Instructional Strategies: Low Incidence Disabilities 3 EDS 230A/B Positive Behavioral Supports of Students with Mild, Moderate, and Severe Behavioral Challenges 2+1 EDS 235 Fieldwork Seminar in Program & Instruction 2 EDS 236 Final Student Teaching Seminar: Moderate/Severe 1 EDS 292A/B Teaching English Learners in General & Special Education 2+1 EDS 414 Student Teaching I: Moderate/Severe 3 EDS 415 Student Teaching II: Moderate/Severe (or, EDS 421 Intern Teaching: Moderate/Severe 5)* 5 * Candidates must take EDS 421 Intern Teaching: Moderate/Severe if on an Internship. This is the only difference in the program for an Intern versus a traditional student teaching candidate. Option C: Preliminary - Moderate/Severe Instructional Methods Core Units EDS 119 Legal and Social Foundations in Special Education 3 EDS 205 Methods in Access & Inclusion in the Core Curriculum: Moderate/Severe 3 EDS 206 Collaborative Program Development: Moderate/Severe 3 EDS 207 Secondary/Post-Secondary Methods, and Transition Planning: Moderate/Severe 3 EDS 208 Evidenced-Based Assessment & Instruction: Moderate/Severe 3 EDS 209 Developing Augmentative and Alternative Communication 3 EDS 216A/B Movement, Mobility, & Specialized Health Care 2 + 1 EDS 218 Instructional Strategies: Low Incidence Disabilities 3 EDS 220 Language and Literacy in Special Education - I 3 EDS 221 Language and Literacy in Special Education - II (EDS 220 Prerequisite) 3 EDS 230 A/B Positive Behavioral Supports of Students with Mild, Moderate, and Severe Behavioral Challenges 2 + 1 EDS 235 Fieldwork Seminar in Program & Instruction 2 EDS 236 Final Student Teaching Seminar: Moderate/Severe [Must be taken with EDS 415] 1 EDS 292A/B Teaching English Learners in General & Special Education 2+1 Multiple Subject Instructional Methods Core   EDS 213 A/B Mathematics Curriculum and Instruction in Inclusive Classrooms 2 + 1 EDS 214A/B Social Science Curriculum and Instruction in Inclusive Classrooms 2 + 1 EDS 215 A/B Science Curriculum and Instruction in Inclusive Classrooms 2 + 1 EDBM 170 Introduction To Bilingual Education 3 EDTE 317 Arts in K-8 Inclusive Classrooms 1 Moderate/Severe Student Teaching   EDS 414 Student Teaching I: Moderate/Severe 3 EDS 415 Student Teaching II: Moderate/Severe [Must be taken with EDS 236] 5 Employment & California Commission on Teacher Credentialing (CCTC) Preliminary Level Moderate/Severe Specialist Credential Achieved. Multiple Subject Student Teaching   (MSAT, CSET, or equivalent must be passed prior to the below student teaching) ED 300B TPA Multiple Subject - Literacy 1 EDS 332 Assessment Center Lab for Multiple Subject Student Candidates: (PACT) Seminar 2 EDS 420B Multiple Subject Student Teaching 5-7   Preliminary Early Childhood Special Education (ECSE) ECSE Preliminary   Units EDS 130A/B Characteristics and Outcomes for Young Children with Disabilities + Lab/Field Experience Section 2/1 EDS 201A/B Family/Professional Collaberation in ECSE + Lab/Field Experience Section 2/1 EDS 209A/B Developing Alternative and Augmentative Communication Systems 3 EDS 210A/B Assessment and Evaluation in ECSE + Lab/Field Experience Section 2/1 EDS 211A/B Curriculum, Intervention Strategies and Environments in ECSE: Infancy + Lab/Field Experience Section 2/1 EDS 212A/B Curriculum, Intervention Strategies and Environments in ECSE Pre-school + Lab/Field Experience Section 2/1 EDS 216A/B Movement, Mobility, Sensory, and Specialized Health Care + Lab 2/1 EDS 230 Positive Behavioral Supports of Students with Mild, Moderate, and Severe Behavioral Challenges 3 EDS 234 Directed Fieldwork Seminar: ECSE [Taken twice, concurrently with EDS 474/476 and EDS 475/477] 1 EDS 474 Directed Field Experience/Internship: Infants/Toddlers (or EDS 476) [Taken concurrently with EDS 234] 3-5 EDS 475 Directed Field Experience/Internship: Preschool (or EDS 477) 3-5 ECSE Certificate   Units EDS 130A/B Taracteristics and Outcomes for Young Children with Disabilities + Lab/Field Experience Section 2/1 EDS 201A/B Family/Professional Collaberation in ECSE + Lab/Field Experience Section 2/1 EDS 210A/B Assessment and Evaluation in ECSE + Lab/Field Experience Section 2/1 EDS 211A/B Curriculum, Intervention Strategies and Environments in ECSE: Infancy + Lab/Field Experience Section 2/1 EDS 212A/B Curriculum, Intervention Strategies and Environments in ECSE Pre-school + Lab/Field Experience Section 2/1 EDS 234 Directed Fieldwork Seminar: ECSE[Taken twice, concurrently with EDS 474/476 and EDS 475/477] 1 EDS 474 Directed Field Experience/Internship: Infants/Toddlers (or EDS 476) [Taken concurrently with EDS 234] 3-5 EDS 475 Directed Field Experience/Internship: Preschool(or EDS 477) 3-5

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Preliminary - Educational Specialist Credential - Advisement

Document Title	Type
Program Advisement Available from your assigned faculty advisor. A mandated Program Advisement form should be started your first semester of acceptance and updated each semester with your advisor. Candidate disenrollment from the program will result if this advisement does not occur. Please Note: A copy of your most recent Program Advisement form should be brought with you to every meeting with your advisor. It is strongly suggested that you maintain an updated version of this form as it is needed for many department and university processes.
Student Advisement Guide
Program Advisement Forms Preliminary Mild/Moderate Options Preliminary Mild/Moderate Credential [No Other Credential Held] Preliminary Mild/Moderate & Multiple Subject Credential (4 Semester Program) Preliminary Mild/Moderate & Multiple Subject Credential (5 Semester Program) Program Planning Form-Preliminary Mild/Moderate Credential [A California Multiple or Single Subject Credential already held - Passed RICA)] Preliminary Moderate/Severe Moderate/Severe Program Advisement Form Preliminary Early Childhood Special Education (ECSE) Early Childhood Special Education Program Advisement Form

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Level I [Preliminary] - Current Student Teachers

	Document Title	Type
	Student Teaching Applications Spring: November 1st Fall/Summer: April 1st
	Mild/Moderate and/or Multiple Subject Application Rvsd: 10/11
	Moderate/Severe Application
	Early Childhood Special Education (ECSE) Application
	Early Childhood Special Education (ECSE) Student Teaching Field Handbook   • Revision in process
	Early Childhood Special Education (ECSE) Competency Checklist   • Revision in process
	Teaching Performance Expectations (TPE) Candidates seeking a Multiple Subject Credential must meet the new CCTC requirements (SB 2042). Meeting the standards includes fulfilling all competencies as identified in the TPEs as covered in the EDS Teaching Seminar courses.
	Student Teaching Internship Handbook (Mild/Moderate, Moderate Severe, and Multiple Subject) Evaluation Pages of Handbook: Phase I (fillable) Phase II (fillable) Phase III (fillable) Vistitations/Observations Form (fillable) Observation Record Form (fillable)
	Preliminary (Level I) Specialist Credential Application Available from the Credential Analyst Office, Eureka Hall Room 209, (916) 278-4567. Please check with your advisor and the Credential Analyst Office for details near the end of your Level I program.

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Level II [Professional Clear] - Educational Specialist Credential -
Bay Area Program, College of Continuing Education (CCE) ONLY

Please note that Professional Clear-Level courses will not be offered on the Sac State campus as of Fall 2011. If you need to complete this CCTC requirement, contact your district BTSA office or the Sacramento County Office of Education, for an alternate means of meeting this credential level. The Clear-Level Program is available through the College of Continuing Education for Bay Area Program. Contact Lori May at mayl@csus.edu for more information.

	Document Title	Type
	Level II Application
	Level II - Induction Plan Sample
	LV II Program Description and Portfolio Guide (Includes Portfolio development information. Reviewed in EDS 252A/B)
	Mentor Letter - Sample (Reviewed in EDS 252A/B)
	Level II Mild/Moderate Standards Checklist
	Level II Moderate/Severe Standards Checklist
	Level II Early Childhood Special Education [ECSE] Standards Checklist
	Level II Advisement/Completion Form

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Master of Arts in Education (Special Education) - New Applicants

	Document Title	Type
	MA Department Application Fall 2012 Semester Classification: Due March 1, 2012 If the deadline has passed, contact eds@csus.edu.
	MA Application Instructions [for Fall 2012]
	Classification Application (already admitted to credential program)
	Graduate Writing Assessment Requirement (GWAR) Information available at www.csus.edu/gradstudies/gwar.html (Please note: there are limited testing dates for the Writing Placement for Graduates (WPG); August 8, 2011 & January 9, 2012. Click here for more information.)
	MA Program Coursework

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Master of Arts in Education - Current Students

	Program Advisement Available from your assigned faculty advisor. A M.A. Program Advisement Form should be started your first semester of acceptance and updated as needed with your advisor. Disenrollment from program if this advisement does not occur. Please Note: A copy of your most recent M.A. Program Advisement Form should be brought with you to every meeting with your advisor. It is strongly suggested that you maintain an updated version of this form as it is needed for many department and university processes.
	Advancement to Candidacy Advanced to Candidacy forms also available in the Department office, EUR 316. Should be completed as soon as the student has: Cleared all conditions, including WPE, through the department (ie., full classification); and Completed at least 12 units of 200-level coursework towards the MA with a 3.0 GPA or better in all courses. Must be advanced to candidacy in order to register for EDS 297, 298, 500, and 501 Available online through the Graduate Center at: www.csus.edu/gradstudies/forms.htm
	Reservation Forms for EDS 297, 298, 500/501 PDF Version A separate reservation form must be submitted for each semester you intend to register. No exceptions. Deadlines:  Fall/Summer: April 1st                    Spring: November 1st
	Human Subjects Guidelines
	Human Subjects Request Form
	EDS Thesis and Project Advisement Guide
	Miscellaneous MA forms - available on our website or online through the Graduate Center at: www.csus.edu/gradstudies/forms.htm WPE waiver Petition for Exception Petition for Currency Graduation Application Thesis/Project Receipt form Microfilming and Binding Receipt Thesis/Project Submission Checklist Data Change form Thesis/Project Resources
	Graduation Application for Masters Fall Semester: October 1 Spring/Summer Graduation: February 1
	Commencement Click on this Commencement link to learn what you need to do to participate in commencement, where and when it is held, and what will be expected of you during the ceremony.

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Supervisors

	Mild/Moderate	Type
	The PDFs bellow are fillable. When you open the document, save it to your computer then enter the student's information in the form fields. When finished, Save As with their name as part of the title. The information you entered will be saved with the PDF.
	Mild/Moderate Student Teaching Handbook
	Mild/Moderate Phase I Evaluation: EDS 471 and 420A
	Mild/Moderate Phase II Evaluation: EDS 420B
	Mild/Moderate Phase III Evaluation: EDS 472/473
	Observation Record, Special Education Credential Programs

	Moderate/Severe	Type
	Student Teaching Handbook
	Student Teaching Evaluation
	Moderate/Severe Advisement

	Early Childhood	Type
	ECSE Field Handbook
	ECSE Advisement

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