UNDERGRADUATE
Student Teacher Application
College of Education, Office of Field Services
Select Semester/Year:
Select Placement Area:
___ Fall 20_____
___ Spr 20_____
___ Mobile ___ Saraland City ___ Out of Area
(See OFS for Policy)
___ Baldwin ___ Satsuma City
JAG #: J00________________ Social Security #: ____________________ Date of Birth: ____________
Applicant Name: _____________________________, __________________________ ________________
Last
First
Middle PHOTO
REQUIRED
lready taken If not ain OFS Local Address – This address is used to determine school placements only and does not affect your address with the University
________________________________________________________ _____________________________ ______ ____________
Street Address
City
State
Zip Code
Cell Phone (____)____________ Home Phone (____)____________ Email Address: _________@jagmail.southalabama.edu
SELECT MAJOR:
___ K-6 Teacher Education (Elementary/SPE)
___ 6-12 English/LA
___ 6-12 General Science/Biology/Chemistry/Physics
___ 6-12 Health
___ 6-12 Mathematics
___ 6-12 Social Studies
___ 6-12 Special Ed Collaborative:
___ English/LA
___ General Science
___ Mathematics ___ Social Studies
___ P-12 Music-Choral
___ P-12 Music-Instrumental
___ P-12 Physical Education
LIST ALL PREVIOUS FIELD EXPERIENCE:
Placement Type
(i.e., methods, tier 2, tier 3)
Semester/
Year
School
Grade/
Subject
Cooperating
Teacher
University
Supervisor
If you have any children/parents/siblings in a local school district, please complete the following:
School District: ___ Baldwin ___ Mobile ___ Saraland ___ Satsuma
School Name(s) & Grade(s): ________________________________________________________________________
COMMENTS:____________________________________________________________________________________________
A degree evaluation must be attached for your advisor’s review. Advisor’s signature is required on application.
11/9/15 STUDENT NAME: _____________________________________________
JAG#: J00_________________________________
Internship Applications must be filed with the Office of Field Services at least one semester in advance of the
planned internship. LATE APPLICATIONS MAY RESULT IN DELAYED INTERNSHIP.
Fall Semester student teaching deadline to turn in application is February 28th
Spring Semester student teaching deadline to turn in application is September 30th
•
•
**STUDENT AND ADVISOR SHOULD REVIEW AND COMPLETE
CHECKLIST BELOW BEFORE SIGNING**
REQUIREMENTS THAT MUST BE COMPLETED BEFORE INTERNSHIP:

Admission to Teacher Candidacy and senior standing. Attach a degree evaluation.

Minimum USA (overall) GPA of 2.50.

Minimum Program GPA of 2.75.

Minimum Professional Studies GPA of 2.75.

Completion of a minimum of ¾ of Teaching Specialization(s) with a minimum GPA of 2.75.

Completion of required methods, tier or block courses for this field.

Continued satisfactory progress in meeting requirements for admission to the program of teacher education.

Completion of any departmental prerequisites. Department/program may have additional admission requirements. See
departmental section of the USA Bulletin.

Internship course registration. Completing this application does not register you for your internship course.

Achieved passing score on APTT/AECTP and required Praxis II tests. Official scores must be reported to USA prior to student
teacher orientation. Required Praxis II tests by Program (see below):
Program
K-6 Teacher Education (Elementary/SPE)
6-12 English/LA, Math, Science, Social Studies
6-12 Health Education
6-12 Special Education Collaborative Teacher
P-12 Music Education Choral/Instrumental
P-12 Physical Education
Content
Knowledge
Yes
Yes
Yes
--Yes
Yes
Date Taken/
Score
Teaching
Reading
Yes
-----------
Date Taken/
Score
PLT
Date Taken/
Score
Yes
--Yes
----Yes
If Praxis has not been taken yet, date you plan to take it: _________________________________________________

Verification of clear background status. Print and attach a copy of your background status (if not on file in OFS) from the ALSDE
portal at https://tcert.alsde.edu/Portal/Public/Pages/SearchCerts.aspx.

Proof of current Professional Liability Insurance. Print and attach a copy of your receipt (if not on file in OFS) showing
expiration date (www.nea.org).

Recommended for student teaching by faculty advisor. Advisor’s signature is required on application.
___________________________________ ____________
Advisor’s Signature for Recommendation
Date
11/9/15 ___________________________________ ___________
Student’s Signature
Date
STUDENT NAME: _____________________________________________
JAG#: J00_________________________________
POLICY REGARDING OFF-CAMPUS STUDENT TEACHING ASSIGNMENTS:
Student teaching is one of the most important experiences and is generally regarded as the culminating activity
in one’s training to become a teacher. The College of Education recognizes its responsibility to identify,
coordinate, and provide student teachers access to support services within the College and the University; offer
continuing professional development experiences in conjunction with student teaching, such as student teaching
seminars and conferences with College faculty and staff; and assist student teachers in dealing with specific
difficulties or deficiencies. Further, because of good rapport with local schools and school systems, supportive
administrative and teaching staffs, compatibility of philosophy of training programs, and access to local district
resources and support services, the positive framework for quality training experiences is enhanced.
The College of Education has neither the personnel nor financial resources to adequately qualify, coordinate,
evaluate, and supervise student teaching assignment in locations outside the Mobile area. Therefore, the
following policy will govern student teaching placements.
All student teaching placements and non-traditional fifth year teaching field internships will be coordinated by
the Office of Field Services. Placement sites and cooperating teachers will be selected by academic departments
in such a manner as to assure the quality of the student teaching experience and supervision provided by the
cooperating teacher. All student teaching placements will be made in the greater Mobile area in order to
facilitate the supervision of the student by University of South Alabama faculty or other personnel so designated
by the Departmental Chairperson in which that student is enrolled. In the rare circumstance of student teaching
outside the greater Mobile area, approval must be granted by the Director of Field Services, Program Faculty,
and/or the Departmental Chairperson. In those cases, the candidate is responsible for following the out of area
or out of state placement policy. The out of area or out of state policy is available in the Office of Field Services.
Student teaching is considered a full-time experience and no student is expected to have employment, campus
duties, or other hindrances that tend to interfere with the responsibilities which regular teachers are expected
to assume. I, the undersigned student, hereby attest that I understand the above policies and requirements as set
forth and that the information supplied in this application is accurate and current to date.
___________________________________ ____________
Student’s Signature
Date
RETURN COMPLETED FORM TO:
University of South Alabama
College of Education
Office of Field Services, UCOM 3604
75 N University Blvd, Mobile, AL 36688
Phone: 251-380-2739 Fax: 251-380-2728 11/9/15