This program is designed to prepare teachers and other special education service providers to deliver effective services for students with severe disabilities in inclusive school, work, home, and community settings.  The program consists of a sequence of seven courses covering curriculum, assessment, instructional practices, and service delivery practices.  A fixed number of dollars is available to support tuition for these classes during the summer of 2006.  Support is provided on a reimbursement basis (i.e., you must successfully complete a class in order for your tuition to be paid.)  The tuition support review process is weighted around the following priorities:

• Applicants who agree to complete the entire sequence of seven courses.
• Applicants who are currently responsible for providing services to students with severe disabilities.
• Applicants who are likely to be responsible for providing services to students with severe disabilities in the future.
• Applicants who take this course sequence as part of a graduate degree program.
• Applicants who are committed to an inclusive approach to education for students with severe disabilities.
• Applicants who have necessary technology access.

Applicant  Information: - Please complete this entire section

Educational Background and Goals:
Complete information to describe your bachelor’s level preparation, as well as any additional graduate coursework and/or degrees you have completed.
 

	Bachelor’s Degree	Graduate Coursework/Degree
Where
When
Major Area of Study

Are you currently certified to teach in Montana?

___ Yes
___ No

If so, what certification do you have?

Do you have special education endorsement?

___  Yes
___  No

What are your future educational plans?  Do you have a goal for obtaining a graduate degree?
 

Does your current caseload include one or more students with severe disabilities?
Yes ______ No _______
 

Employment History:

Current employer:
Position:

My previous experience in the field of education is summarized below.
 

I worked at....... (ex: Elm Street School)	My role was..... (ex: resource room teacher)	I did this (when)... (ex: 1994-1996)

Please provide additional detail about any positions that you have had that involved providing services for students with severe disabilities.  (Feel free to attach additional sheets).
 
 
 
 

During the fall and spring semesters, course activities will require access to a computer and the internet.  Please check the specifications of the system(s) you will have access to during the school year, and check the boxes to indicate those requirements that you meet.

Minimum Equipment Requirements (Higher end equipment would be desirable):

• Windows 2000 or higher
• Broadband Internet Access (256K DSL, Cable, Wireless, or better)
• Microsoft Internet Explorer 6.0 or higher
• Sound card
• Speakers
• Computer microphone
• CD-ROM Reader
• Email address
• 1 GB available hard drive space
• 128 MB RAM minimum
• 15 inch monitor or larger, capable of displaying 800 x 600 or greater in 16 bit color

• Basic knowledge of computer operation
• Ability to send and receive email
• Working knowledge of the internet
• Ability to send documents as email attachments

Please describe your current access to technology.  Check all that apply.

• I have access to email at school.
• I have access to email at home.
• I have internet access at school.
• I have internet access at home.

• Promising practices in the area of severe disabilities promote the inclusion and active participation of students in integrated age-appropriate home, school, community, and work settings.  Describe your perspective on this philosophy.
• Describe your experience to date in delivering services to students with severe disabilities in an inclusive manner.
• What would you hope to be able to gain from the courses in this program?

The Partnerships for Diversity website is at:  http://www.ruralinstitute.umt.edu/class
 

The names and contact information are provided below for program faculty and support personnel at the University of Montana-Missoula and MSU-Billings.

University of Montana	Contact for Information About...
Dr. Gail McGregor (406) 243-2348 mcgregor@ruralinstitute.umt.edu	Course content; Graduate programs Tutition Support Application
Dr. R. Timm Vogelsberg (406) 243-5467 rtvogels@ruralinstitute.umt.edu	Course content; Graduate programs, Tuition Support Application
Marnie Bastian   (406) 243-5813 mbastian@ruralinstitute.umt.edu	Admission procedures; Dorm info, Course registration; Reimbursement
MSU-Billings	Contact for Information About...
Dr. Linda Christensen   (406) 657-2081 lchristensen@msubillings.edu	Course content; Graduate programs
Jolene Burdge (406) 657-2097 jburdge@msubillings.edu	Registration; Reimbursement
Please direct any inquiries about technology requirements to...... John Tesdal (406) 243-5467 tezz@ruralinstitute.umt.edu