Student Teaching Prerequisite Form
FALL 2016 DUE: FEBRUARY 26, 2016
SPRING 2017 DUE: SEPTEMBER 9, 2016
This completed form and all attachments (as indicated) are to be submitted to the School
of Education – Office of Certification & Student Teaching, Butterfield Hall 140.
Forms will NOT be accepted without advisor’s signature and ALL attachments.
Please PRINT neatly. You are responsible for the accuracy of the information provided.
**Students who submit this form and attachments after due dates cannot be
guaranteed placements & will be subject to a $100 processing fee. **
Name (please print):
Major:
Student ID#:
e-mail address:
Current Phone #:
Alternate Phone #:
Yes No
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Have School of Education Teacher Candidacy
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Maintain a cumulative quality point average of at least 2.8 (UG) & 3.0
(GR): _____
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Undergraduate student has completed at least 96 semester hours of
undergraduate credit _____
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Graduate student has completed all required certification courses prior to
student teaching. Please include transcripts and plan of study issued.
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Passed ALL PAPA, CORE or Praxis I tests required for certification.
Copy of score report(s) MUST be attached.
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Attempted ALL Praxis II or PECT tests required for certification.
Copy of score report(s) or admission tickets MUST be attached.
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Health/Physical Education – Art – Music – Foreign Language majors
MUST also take the Praxis exam Fundamental Subjects: Content
Knowledge required for certification.
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Completed, with a C or better, educational measurement course
(assessment) required in curriculum. List Course:
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Completed, with a C or better, Level II field experience course required in
curriculum. List Course:
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Completed, with a C or better, the methods of teaching course required in
curriculum OR completed, with a C or better, the required methods
courses deemed necessary by student’s major department.
Please have your advisor sign and explain any “No” answer on the reverse side of
this document.
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Completed, with a C or better, the Educational Technology and Computer
Literacy course if required in curriculum. List Course:
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Secondary Education majors only: Completed, with a C or better, course
in the teaching of reading required in curriculum.
Advisor’s Review: I have reviewed this student’s course prerequisites for student
teaching and found all have been satisfactorily met.
Explanation:
Education Advisor’s Signature
Date
Student’s Signature
Date
Students must submit this completed form and all attachments
as indicated below:
ATTACHMENTS REQUIRED:
1. Degree Works Evaluation
2. Information Sheets (4 copies on resume quality paper)
3. Act 34 Criminal Clearance (valid through last day of student teaching)
4. Act 151 Child Abuse Clearance (valid through last day of student teaching)
5. Act 114 FBI Clearance (valid through last day of student teaching)
6. TB Test Results (valid through last day of student teaching)
7. Act 126 Mandated Child Abuse Training
8. Proof of Liability Insurance
9. Act 24/Act 82 Arrest/Conviction Report & Certification Form
10. PAPA and/or Praxis and/or PECT Tickets/Scores Required
**PLEASE NOTE: YOU ARE REQUIRED TO HAVE THE ORIGINAL
DOCUMENTS WITH YOU WHEN REPORTING TO THE SCHOOLS**
~~OFFICE WILL SCAN THE ORIGINAL DOCUMENTS~~