Name: Click here to enter text.
ELEMENTARY STUDENT TEACHING RESIDENCY APPLICATION
Congratulations and Welcome to the Student Teaching Residency!
The first-step in the application process begins with the completion of the Student Teaching Residency application.
When completing the application, it is essential that you represent yourself in the most professional way possible.
This means submitting an application ready to present to school districts without errors (spell checked, proofread,
and spell checked again).
The second-step in the application process is to complete and sign all the paperwork needed for submission with
the application.
The third-step in the application process is to have two (2) individuals proofread the application, cover letter,
resume, and philosophy. Have the proofreaders sign and date below to show that they completed this step.
The last-step in the application process is to meet with the placement coordinator to discuss the application, the
desired geographical area, and what you are hoping to gain from your Student Teaching Residency experience.
Please note that corrections to the application will NOT be discussed during your meeting with the placement
coordinator. If your application has multiple errors or is incomplete in any way, it will not be accepted
by the placement office. It will then be considered late, which may ultimately, cause a delay in your Student
Teaching Residency term.
Please note that LATE applications will not be presented to school districts until all applicants in
your subject area are placed.
Proofreader #1:_____________________________________ Date: ___________________
Proofreader #2:_____________________________________ Date: ___________________
Elementary Student Teaching Residency Application
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Page 1 of 6
Name: Click here to enter text.
Directions for Completing the Application
Notes:
Do not staple your application
Paperclip all pages together
Print resume and cover letter on copy paper - do NOT use resume paper
Submit single sided pages – do NOT print on both sides
1. Complete the Student Teaching Residency Application.
2. Read and Initial the Student Teaching Residency Guidelines and Department Policies.
3. Print your Merlin transcript.
4. Compose Cover Letter: Utilize the framework that Jeff Denard, Director of NCC Career Development,
shared during the Student Teaching Residency application workshop.
5. Resume: Utilize multiple examples in the Student Teaching Residency Application Workshop handout.
6. Describe your Educational Philosophy:
The philosophy statement should be one page (single-spaced); Choose one (1) starter statement below:
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
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What is the role of the teacher
What is the role of the student
How would you integrate technology in your classroom
What methodologies are most effective
Other topics related to teaching
7. Have two (2) proofreaders read the Student Teaching Residency Application, the cover letter, resume, and
the philosophy statement. Have them sign and date that they did.
8. Insert the cover letter, resume, and philosophy statement at the end of the application.
9. Complete the mandated DCFS reporter online training at: http://northcentralcollege.edu/academics/deptdiv-progs/education/mandatory-reporting-child-abuse. Print and Sign the training completion certificate.
10. Print the DCFS Acknowledgement of Mandated Reporter Status form:
http://northcentralcollege.edu/sites/default/files/Documents/academics/departments/education/dcfs.pdf.
11. The Student Teaching Residency Application is due the third Monday of FALL term by 8:00 am in Stadium
Room 240.
12. Sign-up to meet with the placement coordinator when turning in your application.
Elementary Student Teaching Residency Application
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STUDENT TEACHING RESIDENCY APPLICATION
NCC Student Identification Number: Click here to enter text.
Date: Click here to enter a date.
Last Name: Click here to enter text.
Middle Initial: Click here to enter
First Name: Click here to enter text.
text.
Address, City, State, Zip: Click here to enter text.
Cell Phone: Click here to enter text.
NCC Email: Click here to enter text.
Student Teaching Residency Term: FALL of 20Click here to enter text.
ELIS # / EIN #: Click here to enter text.
Date Passed TAP 400 or ACT (shown in ELIS): Choose an item.
Content Test Passed: Choose an item.
Date Passed: Click here to enter a date.
Date you will be taking the Content Test if you have not successfully passed: Click here to enter a date.
Schools Attended (List all schools you have attended)
Elementary: Click here to enter text.
City: Click here to enter text.
State: Click here to enter text.
Middle School: Click here to enter text.
City: Click here to enter text.
State: Click here to enter text.
High School: Click here to enter text.
City: Click here to enter text.
State: Click here to enter text.
Student Teaching Residency
City you will be living in during the Student Teaching Residency term: Click here to enter text.
Grade Level Preference:
☐
Primary (Grades 1-3)
☐
Intermediate (Grades 4-5)
List all family members or personal friends that attend or are employed by any school or district:
School: Click here to enter text.
District: Click here to enter text.
Relationship: Click here to enter text.
School: Click here to enter text.
District: Click here to enter text.
Relationship: Click here to enter text.
School: Click here to enter text.
District: Click here to enter text.
Relationship: Click here to enter text.
Department of Education Disclaimer
The Placement Office Reserves the Right to Make ALL Final Decisions on Student Teaching Residency Placements.
Placement decisions are made at the discretion of the Department and are made based on availability, district policy,
compatibility with cooperating teacher, and other factors related to the best interest of the student.
Signature:_________________________________________
Date: ___________________
Name: Click here to enter text.
Elementary Student Teaching Residency Application
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STUDENT TEACHING RESIDENCY GUIDELINES and DEPARTMENT POLICIES
The Student Teaching Residency Guidelines and Department Policies are strictly enforced to maximize the
Student Teaching Residency Experience. Place your initials on the line next to each item to indicate that you
have read and understood them.
________
No other classes will be taken during Fall term of the Student Teaching Residency experience.
________
You may not work nor participate in athletics during Fall term of the Student Teaching Residency
Experience.
________
You are not allowed to student teach in a school from which you graduated or in which your
children attend, or in a school in which you have a relative employed or who serves as a school
board member. Disclosure of this information must be provided on the Student Teaching
Residency Application.
________
You may not seek your own Student Teaching Residency placement. Likewise, no person may
seek a placement on your behalf. If a placement is sought by anyone other than the NCC
Placement Office, you will not be placed at the school / in the district in which you or someone
else, attempted to secure a placement.
________
You must have your own transportation to the Student Teaching Residency placement.
________
Your Student Teaching Residency placement must be located within a 30-mile radius of the
college campus.
________
You must receive results indicating that you passed the content test prior to the first day of
school at the Student Teaching Residency placement. The Department of Education
strongly encourages all teacher candidates to take the content test two reporting test
cycles prior to the first day of the Student Teaching Residency term.
________
Failure to pass the content test prior to the start of the Student Teaching Residency term will
result in your placement being canceled, and the Student Teaching Residency term being delayed
until such time as you receive a passing result. If the Student Teaching Residency placement is
canceled because you did not pass the content test prior to the Student Teaching Residency,
another placement will not be sought until passing scores are received.
________
If you receive a “Recommend with Reservation” from the Education Department, you will begin
the monitoring process, as described in the Department of Education Handbook. A Student
Teaching Residency placement is not guaranteed. In these instances, the Student Teaching
Residency term will be delayed if a placement cannot be secured three weeks prior to the first
day of the Student Teaching Residency.
________
Your name will be submitted to the Dean of Students to check for any known misconduct issues
that need to be considered prior to you being presented for Student Teaching Residency.
Information obtained from the Dean of Students could result in you being placed on monitoring.
________
The placement process may take up to 10 months to complete.
________
The placement office will not “retract” a placement request once it has been presented to a district.
________
A district may request an interview or additional information. It is your responsibility to provide
the information and schedule an interview in a timely and professional manner.
Your initials and signature indicate that you have read and understand the above Student
Teaching Residency Guidelines and Department Policies that are strictly enforced.
Signature:_________________________________________
Name: Click here to enter text. TACHING RESIDENCY
Elementary Student Teaching Residency Application
Date: ___________________
APPLICATION
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PERMISSION TO RELEASE INFORMATION
I authorize the Department of Education to release information contained in this application to school districts in
order to secure a Student Teaching Residency placement.
I further authorize the Department to release the results of my background check to school districts in order to
comply with district requirements for Student Teaching Residency placements.
I understand that a district may require an additional background check and/or TB test. Should an additional
background check and/or TB test be required, I understand that all costs are my responsibility.
I understand that North Central College will verify that I am not listed on either the State of Illinois Sex
Offender or the State of Illinois Violent Offender websites.
I understand that in order to be licensed in the State of Illinois, I must pass the edTPA.
Signature:_________________________________________
Date: ___________________
For Office Use Only:
I have initialed the above Student Teaching Residency Guidelines and Department Policies.
Signature:_________________________________________
Date:___________________
I have received a copy of the Student Teaching Residency Guidelines and Department Policies.
Signature:_________________________________________
Date:___________________
Name: Click here to enter text.
Elementary Student Teaching Residency Application
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Application Checklist
Be sure that all items below are in the packet that is to be submitted to the placement coordinator the third
week of the FALL term:
☐
Student Teaching Residency Application
☐
Initialed Guidelines / Department Policies
☐
Merlin Transcript
☐
Cover Letter
☐
Resume
☐
Philosophy Statement
☐
Signatures of two proofreaders
☐
DCFS Mandated Reporter Certificate
☐
DCFS Acknowledgement of Mandated Reporter Status form
☐
Sign up for a meeting with the Elementary Placement Coordinator
Elementary Student Teaching Residency Application
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