Fall 2017 Initial Licensure Internship Application This form MUST be completed by March 27th at noon.
Last Name, First Name
UMW Email Address
Elementary Education pK-6
Foreign Language- French
Foreign Language- German
Foreign Language- Latin
Foreign Language- Spanish
History & Social Sciences
Music Education pK-12: Instrumental
Music Education pK-12: Vocal/ Choral
Science- Earth Science
Special Education K-12: General Curriculum
Special Education K-12: Adapted Curriculum
Theatre Arts pK-12
Visual Art pK-12
CHECK HERE IF YOU ARE IN THE MIDDLE GRADE ENDORSEMENT PROGRAM
In order to begin your internship, you should already have taken and passed all of the following: Praxis Core (or equivalent SAT/ ACT/ VCLA), VCLA, RVE (elementary and SpEd only), and Praxis II. Should you need to retake any of these, you must do so NO LATER than May 15, 2017. Have you taken and passed all of the requirement assessments?
Please list ALL of your practicum placements. Include School Division, School Name (add ES, MS, or HS), Grade(s), and Subjects (if not elementary); for example, Stafford, Ferry Farm ES, K, reading OR Prince William, Gainesville MS, Civics, OR Spotsylvania, Riverbend HS, Algebra II and Geometry.
Please list all relationships with faculty, staff, or students in Virginia public schools (other than professional relationships made during practicum experiences). Please list each school in which you know faculty, staff, or students and the type of relationship with said individuals.
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