Benchmark II Student Teaching Application Form

Benchmark II Student Teaching Application

Name:
Student ID:
Student Teaching Term/Year:
Major:
Minor/Certification:
High School Attended:
Mailing Address:
City:
State/APO/FPO:
Zip:
E-mail Address:
Telephone

Geographical Preferences

You may request a geographic area of your preference; however, there can be no assurance that your application will be sent to districts in that geographial area or that you will, or can, be assigned to the area of your preference. Faculty and staff recommendations are considered first. Site and supervisor availability also affect placement decisions.

1st Choice:

2nd Choice:

3rd Choice:

You will not be placed in a school that you have graduated from or in which close family members work. If there are schools in the geographic area which you identify that meet either of these criteria, indicate which school(s) you are not eligible for:

Other geographic site placements, including international student teaching, may be made available through the School of Education. All candidates eligible for student teaching will be notified and invited to apply for those opportunities.

Student Teaching Placement and Registration Policies and Procedures

All conditions outlined in Benchmark I and Benchmark II must be met to be considered for student teaching placement. Please note: To be assured of a placement, DEADLINES MUST BE ADHERED TO.
The Coordinator of Clinical Placement, with input from faculty/staff in each program, will determine where and with whom students are to be assigned.
Student teaching packets with placement information will only be distributed on a designated day of the semester.
Once the Student Teaching Assignment form is approved, it is final. The Coordinator of Clinical Placements and Coordinating Chair must participate in any chages made in the placement, cooperating teacher, dates, etc...
Candidates who decline a placement will be reconsidered for a placement the following semester.
The School of Education will register candidates for student/intern teaching once all Benchmark II prerequisite requirements are met.

By typing my name below, I understand and agree to the following:

I will follow UW-Stout's School of Education student teaching placement and registration policies and procedures
Under no circumstances will I contact a school or teacher in an attempt to arrange my own placement
Failure to follow these conditions may result in a denial of admission to student teaching/internship
The information submitted with this application, as well as academic records and the results of the background check, may be shared with student teaching sites as part of the placement process
Schools may use additional internal procedures such as interviews, internet searches, or character questionnaires to determine acceptance of a placement request
Placement is dependent on acceptance by a school, and that I am not guaranteed a placement
Attempts to secure a placement will be discontinued after multiple schools who have student teaching/intern placements available deny a placement request for me

Type name here: Date: