College of Education
Office of Student Field Experiences
PERSONAL AND PROFESSIONAL INFORMATION
[Your written information and description of activities are of primary importance in the placement process. They offer you an opportunity to describe your background,
accomplishments, academic ability, and plans for the future. We ask that you give as complete and candid a picture of yourself as possible. Your personal and
professional information materials must be your own honest, accurate and grammatically correct autobiographical sketch.]
I. PERSONAL INFORMATION
Name:
Birth Date:
I.D. Number:
Current Address:
Current Local Telephone Number:
Permanent Address:
Permanent Telephone Number:
E-Mail Address:
Emergency Contact Information
Name:
Relationship to you:
Address:
Telephone Number:
II. PROFESSIONAL PREPARATION
Major(s):
Minor(s) and
Endorsements:
III. EDUCATIONAL BACKGROUND
Name of High School(s) Attended:
Location(s) (City/State):
Date Graduated:
Other Colleges/Universities:
IV. TEACHING/NON-TEACHING WORK EXPERIENCES
List teaching experiences in school/non-school settings: (Do not list experiences associated with UNI Teacher Education Program.)
Teaching Experience
Agency/Company/Organization
Location
Year(s)
Employer
Location
Year(s)
List Non-Teaching Work Experiences:
Non-Teaching Work Experience
V. MISCELLANEOUS INFORMATION
Activities/Honors (from high school or other colleges):
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UNI activities, community service, or volunteer work:

Hobbies, Special Interests, and Travel Experiences (foreign & domestic):
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VI. PERSONAL REFLECTIONS
Please respond to the following three prompts to document your preparation in the areas of performance, essential knowledge, and
critical dispositions. You will need to think carefully about your prior learning, experiences, and personal motivations that have led
you to student teaching. Address each of the following areas with general statements and supporting details (approximately 700-900
words in the combined total).
Essential Knowledge: How has your education prepared you for student teaching? (You may refer to specific content classes and/or even assignments. Feel free to
discuss authors or “big ideas” you are taking away from your course work. The use of academic language is encouraged.)
Performance: What have you done that has prepared you for student teaching? You may refer to field experiences and/or volunteer experiences. Reflect on lessons
you have planned/taught. Please discuss those opportunities that helped you to develop and understand multiple perspectives: varying abilities and talents, language,
culture, community, etc.
Dispositions: Why do you want to be a teacher? You may include your core beliefs along with information about “your story”. Other things to think about include
who or what has influenced you or how you see yourself as a leader.