CPALMS PreService Program Initiative Application

1

I was designated as the representative for my college/university to be the administrator for this partnership* This field is required.

Yes

No

2

Please check with your college administrator to make sure that you should be the one submitting this request. There can only be one integration per college/university.

3

Your Name* This field is required.

First Name

Last Name

4

Your Email Address* This field is required.

5

Phone Number* This field is required.

Area Code

Phone Number

6

Your role* This field is required.

7

Name of University/College* This field is required.

8

Name of the Program* This field is required.

9

Program Website* This field is required.

10

Is your organization public or private?

Public

Private

11

How many students are enrolled in your teacher education program?* This field is required.A close estimate is ok. Please only include students in the teacher preparation program and not others.

12

How many teaching faculty are in your teacher education program?* This field is required.

13

What is the email domain for your students?* This field is required.The domain is whatever shows after the @ in the email address. For example, @fsu.edu.

14

How do you plan to use CPALMS?* This field is required.

15

Is there anything else we can do to help? Do you have any questions for comments you like for us to address as part of this process? (Optional)

16

User Agreement* This field is required.Please read the terms below

By submitting the application, I understand and agree with the following: 1) I am authorized by the college administration to be the administrator of this partnership; 2) Only active students and faculty in the teacher education program can be given and have access to CPALMS; 3) I will remove access to students or faculty that no longer need access to CPALMS or after they graduate; 4) I will serve as the contact person for everything related to CPALMS; 5) I allow CPALMS team to share my contact information with students/faculty from my program interested in using CPALMS; 6) I understand that access to CPALMS can be removed at any time and for any reason; and 7) I understand that all the CPALMS privacy (https://cpalms.org/terms/privacy.aspx) and terms of use (https://www.cpalms.org/terms/terms.aspx) policies apply to this agreement.