Field Experience Placement Request Form
Completed by the person requesting the placement after principal/central office approval has been obtained
Processing Directions
Confirm the "Request to Place a Teacher Candidate" email went out
Airtable -> Placement Assignments -> Add Term
If no reply within 1 business day, resend said email and copy your personal @sau email account
If no reply within 1 more business day, resend email from your personal @sau email account
Continue sending daily emails until a response is received
Name of person completing this form:
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First Name
Last Name
In which program is this candidate enrolled?
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Undergraduate Education
MAT
What is the course number and name of the undergraduate course that requires this placement?
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EDUC 233 Children's Literature
EDUC 238 K-8 Bible Methods
EDUC 243 Fundamentals of Elementary Literacy
EDUC 253 Responsive Teaching
EDUC 298 Teaching Writing in 6th-12th Education
EDUC 302 ESL Strategies and Methods
EDUC 305 Primary Literacy
EDUC 324/327/339/454/457 Elementary Immersion
EDUC 342 Secondary Curriculum and Content Methods Secondary
EDUC 346 Secondary Immersion
EDUC 448 Response to Intervention
EDUC 476 ESL Practicum Placement 1
EDUC 476 ESL Practicum Placement 2
EDUC 480 Student Teaching Placement 1
EDUC 480 Student Teaching Placement 2
Music Education Course
PE/Health Education Course
Other
What is the course number and name of the graduate-level course that requires this placement?
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EMAT 505 Foundations of Education
EMAT 524/554 Elementary Math Methods
EMAT 525/555 Elementary Language Arts Methods
EMAT 526/556 Elementary Reading Methods
EMAT 527/557 Elementary Science & Health Methods
EMAT 528/558 Elementary Social Studies Methods
EMAT 546 Content Methods for Secondary
EMAT 612 MAT Student Teaching and Seminar Placement 1
EMAT 612 MAT Student Teaching and Seminar Placement 2
EMAT 624 Job-Embedded Clinical Experience and Seminar I
EMAT 625 Job-Embedded Clinical Experience and Seminar II
Other
K-12 Mentor's First Name
*
K-12 Mentor's Last Name
*
K-12 Mentor's Email
*
example@example.com
Candidate's First Name
*
Candidate's Last Name
*
Subject(s)
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Grade Level(s)
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Placement Start Date
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Placement End Date
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Name of School
*
Principal's Name
*
Principal's Email
*
example@example.com
SAU Field Instructor (If known)
Optional Comments:
To receive a copy of your responses, enter your email here:
example@example.com
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