Morningside College--Education Department
Application for Student Teaching—Special Education
Fall Semester
Spring Semester
Name
College Address
College Phone
Home Address
City, State, Zip
Home Phone:(
)
E-mail address
If student teaching is to be done during the fall semester, write the complete address and phone number
at which you can be reached during the summer:
Verification of completion of Teacher Education Requirements:
Teaching major(s)
Write the term in which you completed the following courses. If you have not yet completed a course,
indicate the term you will complete it.
Required coursework (in addition to requirements for regular elementary or secondary
education):
Course Number
SPED 361
SPED 362
SPED 364
SPED 366
SPED 402
SPED 407
SPED 431
SPED 451
SPED 455
SPED 470
SPED 471
EDUC 324
EDUC 414
Course Title
Intro to Mild/Moderate Disabilities
Principle of Special Ed. Teaching
K-6 Mild/Moderate Methods OR
7-12 Mild/Moderate Methods
School-Parent Collaboration
Diagnostic Teaching of Math
Applied Behavior Analysis
Education Assessment
Transition
Student Teaching: K-6 Inst’l Strategist OR
Student Teaching: 7-12 Instr’l Strategist
Reading in the Content Areas (7-12)
Diagnostic Teaching of Reading (K-6)
Completed
Term
Current cumulative grade point average at Morningside College
Current cumulative grade point average in education (include special methods courses taken in another
department)
Number of college credit hours completed at the end of the current semester
Request for Student Teaching Assignment (some teaching areas require specific subject and area
assignments):
1. Grade preference (in order of choice)
Elementary Major:
K
K
K
Secondary Major:
Middle School 1
High School 1
2. Students are responsible for transportation to their teaching assignment. Will you have a vehicle for
transportation to and from your assignment ?
Yes
3. Any information concerning special requirements of which the department needs to be aware when
making your student teaching assignment. You may not request teachers or buildings.
Goal Statement:
Attach a typewritten essay that describes your progress toward becoming an Effective Educator
and that outlines the personal and professional goals you wish to achieve during student teaching.
This essay will be reviewed by the Director of Elementary Education and by the faculty in the
education department. An essay that does not meet high standards of writing will be returned for
revision. A copy of this essay will be given to your cooperating teacher.
Agreement regarding Student Teaching:
I understand the following rules that govern student teaching:
1. Student teaching is for full school days, and I will not enroll for other courses that meet between
8:00 a.m. and 4:30 p.m.
2. I must enroll in EDUC 490 Effective Educator Seminar concurrently with student teaching.
3. I may enroll in no more than 16 credit hours, including student teaching, during the semester in
which I student teach.
4. This application does not replace registration for student teaching.
5. An additional application must be completed for student teaching in special education.
I agree to follow these rules as well as the policies and procedures outlined in the Teacher Preparation
Program Handbook and Student Teaching Handbook.
_____________________________________________________ ___________________
Signature of Applicant
Date
Please print out this form and sign and date it and submit it to the Education Department for the final
signatures.
Recommendation of Faculty Member:
Based on my knowledge of this student in the following areas—academic proficiency, teaching
potential, ability to communicate effectively, and personal qualities required of effective educators—
_____ I support this application to student teaching.
_____ I support this application with reservation and have attached a statement explaining my concerns.
_____ I do not support this application for student teaching and have attached a statement explaining
my concerns.
_____________________________________________________ ___________________
Signature of the Professor of Special Education
Date
Note: A $100.00 late fee will be assessed to applicants who return the application after the
deadline.
Morningside College
Education Department
Statement of Fraud: Fraud in procurement of a license or falsifying records for licensure purposes will
constitute grounds for filing a complaint with the Iowa Board of Educational Examiners. It may not be
possible to obtain a teaching license in Iowa if any of the following items apply to you. Please read the
following questions and answer them truthfully. For any “yes” response, please provide a written
explanation that includes the date(s) of the violation(s). Then sign and date the form.

Have you ever had an educational license revoked or suspended?
Yes

Have you ever had a founded report of child abuse made against you?
Yes

Have you ever been convicted of a crime other than parking or traffic violations?
Yes

Have you ever been convicted of a felony?
Yes
Signature _________________________________________________ Date ______________________
Revised 1/06