DocuSign Envelope ID: 9C3CFBD3-35D7-46BE-AF62-00211E748E18

NEW EDUCATOR PREPARATION PROGRAM PLANNING NOTIFICATION OF INTENT FORM 1 Program Information Program Name: Bachelor of Applied Science Education Institution or organization Name: Lake Washington Institute of Technology

Type of certificate to be offered Residency teacher certificate Residency principal

Residency program administrator

Initial superintendent

Residency school counselor

Residency school psychologist

Residency school social worker

Professional administrator (Principal and Program Administrator) Professional school psychologist

Professional school counselor

Professional school social worker

Initial teacher career and technical education business and industry route

Nature of program Certification with Master’s degree

Certification with B.A.

Certification only

If teacher certificate program, endorsement(s) to be offered: Early Childhood Early Childhood (P-3)

Early Childhood Special Education (Birth-3)

Elementary & Middle Level Elementary (K-8)

Middle Level Humanities

Middle Level Math

Middle Level Science

Secondary (5-12): Biology

Chemistry

Mathematics

Physics

Earth & Space Science Science

English Language Arts

History

Social Studies

All-level (P-12): Agriculture

Bilingual

English Language Learners Music (Choral)

Business & Marketing Education Family Consumer Sciences

Music (General)

Technology Education

Music (Instrumental)

Theatre Arts

Traffic Safety

Dance Health/Fitness Reading

Designated World Language Library Media Special Education (Birth-12)

Visual Arts

Proposed Start Date: September 2018 Projected Enrollment (FTE) in Year One: 20 (#FTE)

Projected Full Enrollment: 2020: 40 (year) (#FTE)

Main Office (360) 725-6275  FAX (360) 586-4548  http://www.pesb.wa.gov Old Capitol Building  600 Washington Street S., Room 400  P. O. Box 47236  Olympia, WA 98504-7236

DocuSign Envelope ID: 9C3CFBD3-35D7-46BE-AF62-00211E748E18

Location Central Site/Campus

LWTech Kirkland, WA 98034 (Enter locations)

Off-site (Enter locations) Mode of delivery Face-to-face Learning We can best accommodate a variety of learning preferences and increase flexibility for students by offering a variety of modalities across the spectrum of content. Some courses will be taught face to face. (Describe format) Distance Learning (Describe format) Blended/hybrid The majority of coursework will be delivered in this format where instruction is delivered at a distance and the face-to-face component, although reduced, will be mandatory and scheduled. (Describe format) Contact Information (Institutional/organizational Representative) Name: Title: Address: Telephone: Fax: Email:

Kim Infinger, EdD. Dean of Instruction nd 11605 132 Ave NE, Kirkland, WA 98034 425-739-8274 [email protected]

Endorsement by Chief Academic Officer or equivalent official

FORM 1

Date

NEW EDUCATOR PREPARATION PROGRAM PLANNING NOTIFICATION OF INTENT Page 2 of 2

(Rev. 6.7.12)

LWTech Signed Form 1.pdf

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