School of Ed Info Night Mission Valley RSVP

To RSVP for the San Diego/Mission Valley School of Education Information Night on Wednesday, May 23, 2012 at 6:00pm, please complete this form. We look forward to seeing you at our information session at the Mission Valley Regional Center, located at 4007 Camino Del Rio South, San Diego, CA 92108.

First Name: *

Last Name: *

Street Address: *

City: *

State: *

Zip Code: *

Telephone Number: *

Email: *

How did you hear about our Info Night?: *

Radio*

Billboard

Television

Direct Mail

Word of mouth

PLNU Website

Web Ad

College Newspaper

Email Flyer

Other (Please specify):

*If you chose radio, please list specific station:

If you are currently a student, please indicate your year:

Undergrad-Junior

Undergrad-Senior

Post graduate

Other (Please specify):

Intended Start Date:

Summer 2012

Fall 2012

Spring 2013

Other (Please specify):

Please mark program(s) of interest:

M.A. in Teaching with Preliminary Credential:

Single Subject

Multiple Subject

Education Specialist Mild/Moderate or Moderate/Severe Disabilities

M.A. with Concentrations in:

Teaching and Learning/Clear

Counseling and Guidance

Educational Leadership

M.A. in Special Education:

Special Education/Clear

Added Authorizations in Special Education:

Autism Spectrum Disorder

Traumatic Brain Injury

Other Health Impaired

Emotional/ Behavioral Disorders

Early childhood Special Education Curriculum, Services and Supports

Service Credentials:

Administrative Services

Pupil Personnel Services (School Counseling)

Certificates:

Reading

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