TBC Teaching Intern Information Form

TBC Teaching Intern Information Form
Student Information:
Name*

First NameLast Name
Choose One:*
Are you an international student attending TBC on F-1/I-20?*
You MUST email sdowning@tbc.edu to request CPT approval prior to starting the internship/practicum. Failure to receive CPT approval prior to starting an insternship/practicum will result in the termination of your I-20 status.
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email:*
Phone Number:*
Anticipated Month and Year of Graduation*
Month and Year
Semester for Internship*
Would you like your name to be distributed to schools with teacher vacancies?*

YesNo
Will all course work be completed prior to internship?*

YesNo
Preferred Grade Level:*
Preferred Teacher #1*
Preferred Teacher #2*
Should be Empty:

Student Information: