SB 2042-PHASE II FIELDWORK RECOMMENDATION
Teacher Education Division
California State University Dominguez Hills
Carson, California 90747
Spring Deadline: October 1st
Fall Deadline: March 1st
Student Information: Students who have completed or are currently completing Phase One must submit this letter of recommendation to the Teacher
Education Division for admission into Phase Two (fieldwork) for the following semester.
Date:
Anticipated Starting Term:
Check one: Multiple Subject
Single Subject
SID#
/Credential Subject Area:
Check one: EL
Bilingual
Ms.
Mr.
Last Name
Home Phone Number: (
First Name
)
Middle Name
Cell Phone Number: (
Former Name (if applicable):
)
Current e-mail address:
Home Address:
Street
City
Zip Code
School Name:
School Address:
Phone: (
Street
City
)
Zip Code
School District/Cluster:
Subjects/Grade Assignment:
Language(s) of instruction used by teacher:
CSUDH Phase I courses completed or intended date of completion. Attach Toro printout of transcript.
Multiple & Single Subject Phase I Courses
Course
Semester
Grade
TED 400 Seminar: Introduction to Education
TED 411 Classroom Management: Elementary
TED 402 Educational Psychology
TED 407 Language Learning
TED 420 Computer Literacy for Teachers
Courses(s) taken at another college/university that have been approved for the TED program. Attach copy of course substitution.
Non-CSUDH Course Number
TED Equivalent Course Number and Title
Semester/Year
Grade
I have attached the following (items previously submitted for TED file, need not be resubmitted):
 Letter of recommendation from school administrator (must be on attached form)
 Bilingual candidates ONLY- include verification of oral, written and culture knowledge
 Subject Matter Verification
 Certificate of Clearance, Substitute, Emergency or Pre-Intern Certificate
 Copy of current employment contract
 Copy of valid CPR (Adult, Child & Infant) card front & back. Certification must remain valid until completion of the TED
program. This training can be taken through a variety of agencies including the Red Cross and American Heart Association.
I understand that I am responsible for knowing and adhering to TED program, department and university regulations and policies.
I also, understand that my acceptance into the TED Credential Program is dependent upon my acceptance into the university.
Signature:
Date:
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SB 2042-PHASE II FIELDWORK LETTER OF RECOMMENDATION
Teacher Education Division
California State University Dominguez Hills
Carson, California 90747
Spring Deadline: October 1st
Anticipated Start Term:
Fall Deadline: March 1st
SID:
Credential Candidate:
Last Name
First Name
Middle Name
Principal Information: The aboved-name credential candidate is an applicant for admission to the fieldwork portion of the credential program at
CSUDH. Your realistic appraisal of the candidate's qualifications as a potential teacher will be very helpful. Please complete the following form and
return to fieldwork candidate or mail it directly to ATTN: Program Admissions Unit, School of Education 1000 East Victoria Street, Carson, CA 90747.
(This form will be retained in the candidate's file and will be available to student upon his/her request.)
Name of School Administrator:
Administrative Position:
Name of School:
District:
Signature:
Date:
Please check appropriate box:
Outstanding
Very Good
Good
Average
Poor
No Knowledge
Planning and Organization
Flexibility
Enthusiasm
Knowledge of Subject Matter
Ability to Change Teaching Behavior
Cultural Sensitivity
Your estimate of candidate's potential as a teacher:
Top 10 %
Top 30 %
Top 50%
Bottom 30%
Bottom 50%
Outstanding
Very Good
Good
Below Average
Poor
Please write an additional statement about the applicant, using both sides if necessary.
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