Admission to Student Teaching Worksheet
Office of Field Experiences
Name:
Student ID:
Date:
Teaching Major(s)
Teaching Minor(s)
Non-Teaching Major(s)
Non-Teaching Minor(s)
Please list any courses being taken over this coming Summer/Winterim or next semester or at another
University/School that do not show up on your Degree Progress Report.
Course Prefix and #
Credits
University/School
Term/Year
Required Department Signatures
Signatures are required for any major/minor you plan on student teaching in. Advance signatures are not required for the
following majors/minors: early childhood major, early childhood special education minor, elementary education major, special
education major, cognitive disabilities minor, emotional behavioral disabilities minor, learning disabilities minor, physical
education major and/or health education minor. Coursework in these programs will be verified after paperwork is submitted.
Department representatives: I have reviewed the student’s Degree Progress Report. I verify that, upon completion of any
coursework currently in progress, coursework being taken elsewhere (see above), and courses being taken this upcoming
Winterim/summer term (see above), this student will have completed their major/minor requirements.
Department of major signature
Date
Department of minor signature
Date
Department of 2nd major signature
Date
Department of 2nd minor signature
Date
Please list any substitutions, waivers, or any other special considerations
Student Responsibilities
If I am accepted in the student teaching program, I understand that it is my responsibility to:
1. Keep a continuous and accurate check of my overall program as to the required courses in my major and minor areas,
the general education requirements, and all other requirements for graduation.
2. Provide the cooperating school district with all required forms and information requested (may require additional
background check, etc.).
3. Make the necessary arrangements for transportation, food, and housing to accommodate my placement.
4. Fulfill all required responsibilities of student teachers described in the UWSP Handbook for Student Teaching
(http://www.uwsp.edu/education/Documents/fieldExp/STHandbook.pdf)
5. Complete a full semester of student teaching as defined by my host district’s calendar.
6. Communicate with the cooperating teacher, building principal and my university supervisor in the event of any absence.
(Notify the Office of Field Experiences for extended absences.)
7. Participate in school and district-based professional activities.
8. Register for the appropriate departmental 400 course and participate in all on-campus seminar meetings.
9. Conduct myself, both in the school and community, in a manner that will reflect favorably upon the teaching profession,
the School of Education, and the UWSP.
10. Keep track of any additional course fees, as they are non-refundable after the first week of class per campus policy.
I hereby commit myself to try to meet all the responsibilities that are required in the student teaching program. I
understand that failure to meet performance expectations or fulfill responsibilities may result in removal from
my assignment.
Student Signature
Date
Teaching Major/Minor
Signature Required
Location
Biology
Chemistry
Earth Science (Earth/Space)
Economics
English and Broadfield Language Arts
English as a Second Language
Environmental Studies minor
Family & Consumer Education
Foreign Language (French, German, Spanish)
Geography
History
Mathematics
Music Education (General, Choral, Instrumental)
Natural Science (Broadfield Science)
Physics
Political Science
Psychology
Social Science (Broadfield Social Science)
Sociology
Dr. Chris Yahnke
Dr. Paul Hladky
Dr. David Ozsvath
Dr. Gary Mullins
Dr. Michael Williams
Dr. Tobias Barske
Dr. Becca Franzen
Dr. Annie Wetter
Dr. Tobias Barske
Dr. David Ozsvath
Dr. Lee Willis
Dr. Andrew Felt
Dr. Patricia Holland
Dr. David Ozsvath
Dr. Mick Veum
Dr. John Blakeman
Dr. Craig Wendorf
Dr. Lee Willis
Dr. Robert Enright
167A TNR
D129A Science
D332 Science
420 CPS
486 CCC
490 CCC
110E TNR
101 CPS
490 CCC
D332 Science
477 CCC
B246 Science
254B NFAC
D332 Science
B109 Science
484 CCC
D240 Science
477 CCC
488B CCC
Worksheet 12/2015