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Application

Impact ETX

 

Please complete this application to be considered for acceptance into the Region 7 Alternative Certification Program, IMPACT ETX. 

Before starting the application, please note that you'll need to upload a resume. It's recommended to have it ready before completing the form, as the session may time out if inactive.

Fields marked with an * are required and must be completed before submitting the form.

Contact Information

State*
Answer required for "State"
Are you legally able to work in the U.S.?*
Answer required for "Are you legally able to work in the U.S.?"

Public Information Act - Personal Information Disclosure

I understand that the personal information I provide in this application will be collected, used, and maintained for the purpose of evaluating my eligibility for the program. I certify that all information provided is true and complete to the best of my knowledge and authorize verification of this information as necessary. I acknowledge that any false, incomplete, or misleading information may result in denial of admission, dismissal, or termination. 

Gender and Ethnicity Information

The U.S. Department of Education requires teacher certification programs to track gender and ethnicity primarily for equity, accountability, and civil rights compliance. This information is not used for admission decisions about individual candidates. United States Federal Register (71 FR 44866).

 

Please answer both of the following questions on gender and ethnicity. 

Teaching Experience

Have you ever taught in a Texas public school?*
Answer required for "Have you ever taught in a Texas public school?"
Do you have a potential job offer to be a classroom teacher from a school district in the East Texas area?*
Answer required for "Do you have a potential job offer to be a classroom teacher from a school district in the East Texas area?"
Are you, or have you ever been an Education Aide or served as a long-term sub in Texas?*
Answer required for "Are you, or have you ever been an Education Aide or served as a long-term sub in Texas?"
Have you ever been involuntarily terminated or asked to resign, or resigned in lieu of termination from the employment of another school district?*
Answer required for "Have you ever been involuntarily terminated or asked to resign, or resigned in lieu of termination from the employment of another school district?"

Certification Information

Choose your certification area of interest:*
Answer required for "Choose your certification area of interest:"
Have you ever had a professional certificate revoked or suspended?*
Answer required for "Have you ever had a professional certificate revoked or suspended?"
Have you previously been accepted to a teacher preparation program?*
Answer required for "Have you previously been accepted to a teacher preparation program?"
If you have taken a PACT or TExES test before, upload your scores here.
Answer required for "If you have taken a PACT or TExES test before, upload your scores here."
or drag it here.
Please upload your resume.
Answer required for "Please upload your resume."
or drag it here.

College/University Information

The application will only be processed with ALL college transcripts, GPA, and course hour requirements OR a passing PACT score and three references.  Meeting application requirements does not guarantee acceptance into the IMPACT ETX program.

Candidates with a degree from a foreign institution MUST have transcripts evaluated by a foreign credentials evaluation service recognized by TEA showing degree earned and grade equivalencies Foreign Credentials Services. AND take the TOEFL (Test of English as a Foreign Language), scoring a minimum of 22 in listening / 24 in speaking / 21 in writing. For more information and links to resources, see our Foreign Degree page.

Additional College/University Information

Additional College/University Information

Transcript Acknowledgement

We require transcripts from ALL colleges/universities you have attended. Typically, there are two ways to request an official transcript: PDF electronic transcripts or print/mailed transcripts. Because the printed/mailed option takes longer, we encourage using certified electronic (digital) transcripts if available. Certified electronic (digital) transcripts can be directed to [email protected].

I understand that a completed application must include transcripts from ALL colleges and universities attended. I have chosen to submit the transcripts via:*
Answer required for "I understand that a completed application must include transcripts from ALL colleges and universities attended. I have chosen to submit the transcripts via:"

Background Information

Have you ever been convicted or pled guilty before a court for any federal, state, or municipal criminal offense? (Include all felony or misdemeanor offenses. Exclude any minor traffic misdemeanors.)*
Answer required for "Have you ever been convicted or pled guilty before a court for any federal, state, or municipal criminal offense? (Include all felony or misdemeanor offenses. Exclude any minor traffic misdemeanors.)"
Have you ever received deferred adjudication or similar disposition for any federal, state, or municipal offense? (Include all felony or misdemeanor offenses. Exclude any minor traffic misdemeanors.)*
Answer required for "Have you ever received deferred adjudication or similar disposition for any federal, state, or municipal offense? (Include all felony or misdemeanor offenses. Exclude any minor traffic misdemeanors.)"
Have you been convicted of any offense for physical or sexual abuse of a child?*
Answer required for "Have you been convicted of any offense for physical or sexual abuse of a child?"
Have you ever had a charge of child abuse against you substantiated?*
Answer required for "Have you ever had a charge of child abuse against you substantiated?"
Have you ever received probation or community supervision for federal, state, or municipal offenses?*
Answer required for "Have you ever received probation or community supervision for federal, state, or municipal offenses?"
Have you ever been convicted of any criminal offense outside of the jurisdiction of the United States?*
Answer required for "Have you ever been convicted of any criminal offense outside of the jurisdiction of the United States?"
As of the date of this form, do you have any pending charges against you?*
Answer required for "As of the date of this form, do you have any pending charges against you?"

Consent to Perform Criminal History / Background Check

You MUST pass a criminal history background check to be admitted into the education preparation program. A conviction for a crime is not an automatic bar to admission. Be aware that conviction of an offense may affect your eligibility for teacher certification from the Texas Education Agency. Additionally, the school district's hiring policies may prohibit employment if any applicant has a criminal conviction. We recommend that candidates carefully review TEA's requirements and contact any district of interest to understand its specific hiring guidelines regarding criminal histories. This will allow you to make an informed decision about pursuing certification and employment in the education field in Texas.

Revised Texas Education Code §22.083 authorized the Region 7 Education Service Center to obtain terminal history information on every applicant. 

I am an applicant for the Region 7 ESC education preparation program and have been advised that, as part of the application process, the Region 7 ESC conducts a criminal history background check. I do hereby authorize Region 7 ESC to obtain, use, and evaluate my criminal history record for consideration of admissions as outlined in Texas Education Code §22.083. I understand that Region 7 ESC has the right to refuse admittance to the program based on information provided by the Texas Department of Public Safety on the criminal history check. In addition, I have been informed that I will have a reasonable opportunity to correct any mistaken information reported within a reasonable time frame established in the sole discretion of Region 7 ESC.

By typing your full name here, you consent to a background check.

CCH Verification

I have been notified that a computerized criminal history (CCH) verification check will be performed by the agency below, accessing the Texas Department of Public Safety Secure Website, and will be based on the name and DOB information I supply.

Because the name-based information is not an exact search and only fingerprint record searches represent true identification to criminal history, the organization (as listed below) conducting the criminal history check is not allowed to discuss any information obtained using this method, therefore the agency may offer the opportunity to have a fingerprint search performed to clear any misidentification based on the name search if the search provides a criminal report I know could not be mine.

For the fingerprint process, I will be required to submit a full and complete set of my fingerprints for analysis through the Texas Department of Public Safety AFIS (automated fingerprint identification system). I have been made aware that in order to complete this process, I must have the correct fingerprint (FAST) form from this agency, make an online appointment, submit a full and complete set of my fingerprints, and pay a fee of $49.00 to the fingerprinting services company. All this will be completed through my Texas Education Agency account. Once this process is completed and the agency receives the data from DPS, the information on my fingerprint criminal history record may be discussed with me.

I agree with this statement. By typing your full name, you consent to a criminal history verification check.

Professional Recommendation / Reference

State*
Answer required for "State"
Confirmation Email