UNG GenCyber A.G.E.N.T.s Application Form 2024

This application is your first step to enroll in the AGENT Program. Not everyone who applies will be admitted. You are competing against many other applicants, so please make sure you follow all instructions and check that your video link is accessible externally. If a portion is missing (working link, principal rec, etc.) your application will be considered incomplete and may be placed on the waitlist.

Please note that the University of North Georgia will not share your information with any outside entities. However, we may e-mail you information pertaining to UNG cyber education or other educational opportunities.

Important Dates:
Application Due Date: February 16, 2024
AGENTs Kickoff Event: March 2024 via Zoom
In-Person Dates: June 3 - June 7, 2024

*Required information is tagged with a red asterisk.

Your name: Your name: * First Last
Best phone number to reach you: Best phone number to reach you: * - ### - ### ####
Your email address: *
Your mailing address: Your mailing address: *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
School and Background Information

Georgia Teaching Certificate Number:

The Name of Your School: *

Principal's Name: *

Public School District: *

Position/Title: *

The grade level(s) you teach in fall 2023: *

The grade level(s) you teach in fall 2023: Sixth Seventh Eighth Ninth Tenth Eleventh Twelfth

Subject(s) Taught: *

Is your school a UNG Professional Development Community (accepts UNG teaching candidates for pre-service internships)? *

Is your school a UNG Professional Development Community (accepts UNG teaching candidates for pre-service internships)? Yes No Unsure

Is your school Title 1? *

Is your school Title 1? Yes No Unsure

Do you currently hold any of the following? 1.) a Computer Science Teaching Endorsement, 2.) a passing score on GACE exam in Computer Science, or 3.) a special exemption to the endorsement/GACE due to extensive computer science industry experience?

Do you currently hold any of the following? 1.) a Computer Science Teaching Endorsement, 2.) a passing score on GACE exam in Computer Science, or 3.) a special exemption to the endorsement/GACE due to extensive computer science industry experience? Yes No

If you do not currently hold any of these, please tell us why you would like to teach Computer Science (required for CS Endorsement Pathway AGENTs).
Maximum of 250 characters allowed. Currently Entered: 0 characters.

Please provide the link to your 2-5 minute YouTube video containing:
a. A brief introduction to you
b. Why you are interested in becoming a GenCyber AGENT
c. How you see this being used in the classroom *

All GenCyber AGENTs are expected to participate in the full program experience with dates/time commitments including: 40+ hours in person from June 3-7, 2024 in Dahlonega followed by online activities that vary by AGENT Team:

Gold Team – Review the AGENT Plan of Study (PDF)
Blue Team - Review the requirements on the AGENT website.

Please choose ONE of the following AGENTs Pathways: *

Please choose ONE of the following AGENTs Pathways: GOLD TEAM: Computer Science Endorsement (Tuition and fees for 4 PSC-approved courses paid by the two grants). Note: this option is only available to those who are unendorsed, without a passing GACE, and who do not hold a CS GACE exemption due to industry experience. BLUE TEAM: Cyber-only Professional Development pathway (Stipend, no course credit)

***Important Note*** Once applicants are accepted as an endorsed or unendorsed AGENTs, they cannot switch to the other. AGENTs participants must commit to either the full CS Endorsement pathway or the cyber-only pathway.

I understand that I cannot switch from the selected pathway (CS Endorsement OR cyber PD) once the program begins. *

I understand that I cannot switch from the selected pathway (CS Endorsement OR cyber PD) once the program begins. Yes No

If accepted to the program, would you need to stay on campus? AGENTs stay by themselves in Liberty Residence Hall (single occupancy). Off-campus housing is not available in 2024.

If accepted to the program, would you need to stay on campus? AGENTs stay by themselves in Liberty Residence Hall (single occupancy). Off-campus housing is not available in 2024. Yes No

What is your shirt size?

*If you selected "other," list your preferred shirt size.

Please rate your computer science/cyber comfort level from 1-10. It's okay to have no cyber knowledge at this point!

Recommendation

Each application requires a letter of recommendation and support from a supervisor (principal preferred) using your supervisor's official school email address. An email requesting the letter of recommendation will be automatically generated and sent to the email on record. Please instruct your administrators to look for this form and remind them about the deadline.

Your are responsible for ensuring that all required documentations are submitted to the AGENTs Initiative team by the deadline.

Name of Supervisor Who Will Provide Letter of Recommendation and Support: Name of Supervisor Who Will Provide Letter of Recommendation and Support: * First Last

Official School Email Address of Supervisor: *

Draw your signature into the box below.

Draw or Type

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Full Name

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UNG GenCyber A.G.E.N.T.s Application Form 2024

UNG GenCyber A.G.E.N.T.s Application Form 2024

School and Background Information

Recommendation