Fall 2017 Practicum Information Form
This form MUST be completed by Friday, September 1 by 12 NOON.
Last Name, First Name
List CURRENTLY ENROLLED practicum-bearing course(s) (include course prefix and number (for example EDUC 203, EDUC 305, EDUC 351). Submit in the exact format as indicated
List the days and times you are available to attend practicum (for example: MW 8-11:30 OR T/TH 12-3). You must include a minimum of TWO 2.5 hour time blocks. Submit in the exact format as indicated
Elementary Education pK-6
Foreign Language- French
Foreign Language- German
Foreign Language- Latin
Foreign Language- Spanish
History & Social Sciences
Music preK-12: Instrumental
Music preK-12: Vocal/ Choral
Science: Earth Science
Special Education K-12: Adapted Curriculum
Special Education K-12: General Curriculum
Theater Arts preK-12
Visual Art preK-12
Please list ALL PREVIOUS UMW PRACTICA : 1) School Name (add to the name ES, MS, HS, for example, Stafford ES or Stafford MS), 2) Grade (for elementary only), and 3) Content Area (for example: Ferry Farm ES, K, reading OR Thornburg MS, Civics, OR Riverbend HS, Algebra II and Geometry. Submit in the exact format as indicated.
UNDERGRADUATE students only: Do you have a car?
Yes, but I can only transport myself.
Yes and I can transport my classmates as well.
No, I do not have a car and require a ride or a placement within walking/ public transportation distance.
Should be Empty: