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 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. Richard Ruppel 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 490A CCC 110E TNR 101 CPS 490A CCC D332 Science 477 CCC B246 Science 254B NFAC D332 Science B109 Science 484 CCC D240 Science 477 CCC 488B CCC 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 Worksheet 6/2015