EPI Application

EPI Application
Thank you for your interest in the Educator Preparation Institute (EPI) at Palm Beach State College. Please review our EPI webpage and watch the EPI Information Video before completing the application below. 
- PBSC Student ID
- PBSC Student Email
  example@my.pbsc.edu
- Name
  
  PrefixFirst NameMiddle NameLast Name
- Primary Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Alternate Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Alternate Email Address
  example@example.com
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState
  
  Zip Code
- County
- If your degree was obtained from outside the U.S., transcripts must be accompanied by a course-by-course evaluation from an academic credential-evaluating agency prior to applying to the Educator Preparation Institute (EPI).
- BA/BS Degree
- BA/BS CUM GPA
- Major
- Date Awarded
  
  MonthDayYear
- Institution
- Subject Area
- Date Issued
  
  MonthDayYear
- Expiration Date
  
  MonthDayYear
- Subject Area
- Date Issued
  
  MonthDayYear
- Expiration Date
  
  MonthDayYear
- Teaching Experience (if applicable): Which of the following best describes you?
- Name of School
- Hire Date
  
  MonthDayYear
- End Date
  
  MonthDayYear
- Grade Level
- Subject Area
- Referral source: How did you find out about the program?
  
  Other
- Acknowledgement
- By submitting this application, I understand that...
- ...I am responsible for adhering to all Palm Beach State College policies (i.e. admission, registration, drop/withdrawal, and standards of academic progress)
- ...as part of the EPI program, I am responsible for program, course, and field practicum requirements.
- ...as part of the EPI program, I must observe a Clinical Educator (CE) in my subject area for a minimum of sixty (60) hours.
Should be Empty:

EPI Application

BA/BS Degree

Acknowledgement