UMD Department of Education
Application for Student Teaching
Unified Early Childhood Licensure Programs
Unified Early Childhood Candidates, this application consists of five requirements as follows :
1.) You must complete and submit the information form on this page and the placement request form on the
following page(s). Please read carefully, and review with your advisor to make certain that you are requesting
a placement that will provide for you the best place to grow as a teacher. If you are choosing to be placed out
of the Duluth area, please complete requested information and sign as appropriate. Note that you are not
guaranteed a placement out of the Duluth area. Out-of-area placements are dependent upon recommendation
of the Associate Department Head in consultation with UECH program faculty.
2.) Submit a copy of your current APAS, or Post-bac agreement
3.) Submit 2 copies of your resume. One hard copy should be handed in with this application, and one electronic
copy should be sent to eruark@d.umn.edu Label the file: (Your last name. First initial. resume) before
sending. Your resume will be sent to your potential cooperating teachers to help them decide if you are a
good fit with their courses.
4.) Submit 2 copies of an essay that will be shared with your potential cooperating teachers to help them
determine whether you are a good fit with their classroom philosophy. Your essay should be your introduction
of yourself as a teacher to your potential cooperating teacher. The essay should identify and share your
current understanding of what meaningful learning is for students in early childhood, and explain how you
would likely structure classroom opportunities and environments to contribute to meaningful learning for your
students. The essay should include examples of methods and environments you hope to see in place in your
classroom. Give examples of topics and concepts in early childhood that excite or inspire you. As you write,
think about what you have learned about early childhood teaching and about yourself as a future teacher in the
course of our program.
5.) International Student Teaching only: One hard copy should be handed in with this application, and one
electronic copy should be sent to eruark@d.umn.edu (Label the file: Your last name. First initial. IST) Submit
Write an essay reflecting on the following questions:
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Why do you want to complete a portion of your student teaching internationally instead of solely
here in the United States?
How will this experience develop you as an educator? How will you use this experience to
improve your teaching and your students learning?
What personal and professional goals do you have for yourself that you hope to accomplish
during this opportunity?
What experience(s) do you have traveling overseas? What experience(s) do you have in
learning from cultures other than your own?
In what ways do you plan to represent your home institution and cultures well?
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Your essay(s) should be submitted in hard copy as part of this application, and electronically to
eruark@d.umn.edu (Label the file: Your last name. First initial. essay) Make sure your essay contains
no grammatical or spelling errors. Keep descriptions about yourself and your experiences positive.
Maximum length: two pages, word processed and double spaced. Include your name in the upper
right-hand corner.
Please note that this essay is an essential and vital portion of the application, as you will be working very
closely with your cooperating teacher for an extended period of time. Your essay should establish to the
reader who it is you hope to become as a teacher
6.) Submit your program clearance summary form. These forms are available through CEHSP and directions and
clearance requirements can be found at http://www.d.umn.edu/educ/programs/field_experience/application/
UMD Department of Education
APPLICATION FOR STUDENT TEACHING (1/29/14)
Name (Last, First and Middle Initial)
Student ID number
Local address
Local phone number
City
State
Zip
Permanent address
City
UMD email address
Cell phone (if applicable)
State
Zip
Phone number of someone who can
contact you at any time.
I have read all the information in this packet and am aware of my responsibilities. I understand I will not be eligible for
student teaching if I do not meet all of the stated requirements by the end of the semester preceding student teaching.
Once a placement has been confirmed, I understand that I may not request a change in the placement.
I am aware that student teaching is a full-time commitment and that UMD discourages student teachers from taking
other classes, with the exception of the Professional Issues Seminar (Professional Development Seminar for K-12, 512 majors), or being employed while student teaching.
I understand that this information will be shared with student teaching sites and UMD personnel as part of the
placement process and that I am not guaranteed a placement location of my preference.
Student Signature
Date
For advisor use only – this application will not be accepted without the advisor's signature.
I have reviewed this student’s progress.
Advisor Signature
All requirements met.
Deficiencies (see Program Clearance Summary).
If you are requesting a placement in Zone 4, Special, Abroad, or Other, you must get the signature of the Program
Coordinator. If your student teaching placement is beyond a 40 mile radius around Duluth, a fee will be
assessed to cover the additional costs of supervision.(PLEASE INITIAL -ACKNOWLEDGING YOUR
ACCEPTANCE OF THIS OF OUT OF AREA FEE!) _____(Approx. $618)
This student meets the criteria for student teaching outside the Duluth area:
 Does not have a special contract (Professional Development Plan) related to practicum work, dispositions, UMD
coursework or performance.
 Has maintained satisfactory progress in Block I and Block II field experiences.
Associate Department Head Signature
STUDENT TEACHING PLACEMENT REQUEST
This is an application to student teach during __________ semester, __________ (year)
License for which the field experience is requested, and grade level preferences:
General Education. Preference:
infants and toddlers
Early Childhood Special Education: Preference:
Location Selection:
preschool
Birth to 2
K-3 elementary
3-5 years
Indicate your top three preferences for geographic area, not specific school site or
community: (1 = first choice; 2 = second choice; 3 = third choice within the ZONES)
_____ Zone 1 (Within 40 miles, e.g., Duluth, Superior, Proctor, Hermantown, Albrook, Cloquet, Carlton,
Esko, Two Harbors, Wrenshall, Barnum, Moose Lake)
_____ Zone 2 (Iron Range, North Shore, and northern Wisconsin) Where? _______________________
_____ Zone 3 (Interstate 35 Corridor - Willow River, Sandstone, Hinckley) Where?__________________
_____ Zone 4 (Minneapolis, St. Paul, 694 Corridor.) Where?___________________________________
_____ Special - International Student Teaching (IST). (12 weeks abroad)
____ Ireland______Slovenia
Special Considerations: List transportation concerns, wheel chair accessibility, interpreters, guides, etc.
Transportation available during student teaching:
_____ own car; _____ public transportation (bus); _____ other (bike, walk, etc.)
For office use only – check that each item is included in the application. NO STAPLES PLEASE!
_____
_____
_____
_____
Information Sheet with advisor signature
Placement Request Form
Current APAS or updated Post-baccalaureate contract from Student Affairs.
Resume - two copies 1 hard copy and one electronic copy sent to eruark@d.umn.edu (Not
required for already licensed teachers)
_____ Essay (Not required for already licensed teachers) (submit two copies one hard copy and one
electronic copy to eruark@d.umn.edu )
_____ Program Clearance Summary Form