UNIVERSITY OF DELAWARE

COLLEGE OF ARTS AND SCIENCE

SOCIAL STUDIES EDUCATION

STUDENT TEACHING APPLICATION FORM

For each of the questions, use typeover mode to add your information to the end of the line. If you need to add more information, use insert mode to add additional lines.

I. Name:

SID:

Home Address (Street, City, State, Zip):

Telephone:

Local Address (Street, City, State, Zip): Email Address:

Local Phone:

II. Teaching Major:

III. Preference for student teaching placement.

District (1st choice):

Middle School or High School:

District (2nd choice):

Middle School or High School:

IV. Where do you expect to live during your student teaching?

Will you have the use of a car (Yes/No)?

STUDENT TEACHERS ARE RESPONSIBLE FOR THEIR OWN TRANSPORTATION TO THE ASSIGNED SCHOOL(S).

V. Overall GPA:

GPA in Major:

VI. Are there any extenuating circumstances or information we should know about in regard to your student teaching semester? (These "extenuating circumstances" include courses taken while student teaching, transportation, jobs, home conditions, etc.) Yes/No

If "yes" write an explanation.

VII. Do you currently have any relatives working in a district in Delaware? If so, please indicate where they are working.

Name:

District:

Office/Building:

Job Title:

Relationship:

Name:

District:

Office/Building:

Job Title:

Relationship:

VIII. Do you currently have any children attending school in a district in Delaware? If so, please indicate where they will be attending school during your student teaching experience.

District:

School:

Grade:

District:

School:

Grade:

Student's Signature:________________________________________

Date:____________________________________________________

Advisor Use Only:

____ Approved

____ Provisionally Approved

____ Not Approved

Reason:

Advisor's Signature: ______________________________

Date:___________________________________________

UNIVERSITY OF DELAWARE

COLLEGE OF ARTS AND SCIENCE

SOCIAL STUDIES EDUCATION

STUDENT TEACHER INFORMATION FORM

For each question, use typeover mode to add information to the end of the line. If you need to add more information, switch to insert mode to add additional lines. For those questions which require you to enter information in columns, use insert mode to add additional lines and use the tab key to move from column to column.

This Information Form will be sent to the district office of the school to which you are assigned for student teaching. The information you provide will be used to secure a placement for you in the schools and to help your University supervisor and cooperating teacher become better acquainted with you. Please answer all questions as completely as possible.

I. Name:

Home Address (Street, City, State, Zip):

Telephone:

Local Address (Street, City, State, Zip):

Telephone: Email Address:

Place of Birth:

Birthday (Mo/Day):

Type of community in which you have lived most of your life:

(Put an X next to the appropriate one.)

Rural:

Suburbs:

City:

II. Major: Minor:

III. List schools and colleges/universities you attended:

Name of Institution Location Dates

IV. List the recreational activities in which you regularly participate:

V. List the extracurricular activities, volunteer experiences, and community service in which you have participated in the last three years:

VI. List the experiences you have had working with children - including University education courses:

Situation Length of Time Place

VII. List the travel experiences you have had (U.S. and foreign):

Description Length of Stay

VIII. Military Experiences:

IX. List the hobbies or skills which interest you (i.e., cooking, crafts, journalism, music, dance, computers, nature study, sports, art, storytelling, gymnastics, needlecrafts, other(s):

X. List the courses which you have or will have completed prior to student teaching, by title not course number:

Courses in the major:

Courses in related areas:

Education courses: