Indiana University Bloomington
School of Public Healht-Bloomington

Physical Education Teacher Education Program

Application for Undergraduate PETE Program

Deadlines for application:

First Name: *
Middle Name:
Last Name: *
Date of Birth: (xx/xx/xx)
Gender: male
female
Email Address: *
Student ID Number: *

Current Address:
Street:
City:
State:
Zip Code:
Phone: (xxx-xxx-xxxx)

Permanent Address:
Street:
City:
State:
Zip Code:
Phone: (xxx-xxx-xxxx)

If you are a transfer student, please select your status below:
Transferring from IU University Division
Transferring from IU-B College or SchoolName:
Transferring from IU regional campusName:
Transferring from another university Name:

List the name, address and contact number of each of the three individuals you have asked to write a letter of recommendation. The letter can be submitted in two ways:

  1. The recommender may mail their letter directly to the HPER Records Office in a sealed envelope (preferred).
  2. The letter may be handed in by the applicant provided that the envelope is signed across the seal by the recommender. Letters of recommendation will not be accepted if sent by fax.
NameAddressPhoneWhat capacity have you known the recommender?
First: Last: (xxx-xxx-xxxx)
First: Last: (xxx-xxx-xxxx)
First: Last: (xxx-xxx-xxxx)

EDUCATION: Complete the following information on current semester classes.

Academic Data - Current Semester
Dept. HPER-PCourse# 140Course TitleCr/hrsExpected Grade

Credit hours completed at Indiana University
GPA

* Indicates required field