SPRINGFIELD COLLEGE
Educator Preparation & Licensure Office
ECED/ELEM/SPED Education
Undergraduate Practicum Application
1.
2.
3.
TYPE ALL ENTRIES. Be sure to complete all three pages of the application.
Get approval from the Education Department.
Return approved application to the Office of Educator Preparation & Licensure
(Room 209 in the Administration Building, 748-3155).
Name
Box #
SS#
DOB
Cell/local Phone #
Permanent Address:
Email
Street
City
State
Zip
Elementary School Attended
High School Attended
school
city
state
Schools are assigned by the Educator Prep Office in collaboration with the program departments. To assist us in
determining an appropriate match, please provide the following information.
MAJOR
PROGRAM
Semester Preferred?
Where will you live?
Springfield Area
Other
If other, where?
Will you have a car?
Yes
No Time/Distance willing to drive?
Minutes/Miles
Placement site:
No Preference
Urban (within 20 mins./3-15 miles)
Suburban (20-45 mins./10-30 miles)
Early Childhood Education Students:
You will be placed in two grades, please choose:
Gr. PK or
Gr. K and
Gr. 1 or
Gr. 2.
No Preference
Elementary and/or Special Education Students:
You will be placed in one grade all semester, please type in the grade(s) you prefer
Give any information/preferences you consider to be important in the determination of the site and semester
of your practicum assignment:
533580852
Rev 2/13
SPRINGFIELD COLLEGE
Educator Preparation & Licensure Office
ECED/ELEM/SPED Education
Undergraduate Practicum Application
Prerequisites To Practicum – ECED/ELEM/SPED Education
Courses (Give semester and year)
Grade
Received
Enrolled
Now
Will
Enroll
Early Childhood/Elementary/Special Education
EDUC 100: Intro to Education
EDUC 162: Exceptional Children
EDUC 210: Children’s Literature
EDUC 237: Found of Multicultural Education
EDUC 238: Pre-Practicum (“B” or better)
EDUC 305: Teaching Social Studies
EDUC 327: Teaching Reading & Language Arts
EDUC 442: Educational Assessment & IEP
ENGL 113: College Writing I
ENGL 114: College Writing II
ENGL 209: World Literature
ENGL 220: Grammar &Usage
HIST 103: World History
HIST 105: Colonial-Civil War
HIST 106: Civil War-Modern
MATH 101: Foundations of Math
MATH 105: Survey of Algebra & Geometry or higher
or MATH 205: Geometry (MACT only)
PHSC 105/110: Physical Science/Earth Science
PSYC 250: Childhood & Adolescent Dev
SCIE 144: Learning &Teaching Science
Elementary/Special Education
EDUC 232: Teaching Elementary Math
EDUC 262: Special Education in the Reg Class
ENGL 241/242: American Lit I/II
MATH 201: Applications of Math
Early Childhood
EDUC 225: Math Concepts
4. Students are reminded that they must have a minimum cumulative academic index of 2.50 in all
subjects and a minimum cumulative professional index of 2.75 prior to the beginning of the
practicum semester. All prerequisite courses (listed above) must also have been successfully
completed.
533580852
Rev 2/13
SPRINGFIELD COLLEGE
Educator Preparation & Licensure Office
ECED/ELEM/SPED Education
Undergraduate Practicum Application
Pre-Practica Information:
Example:
10/16 – 12/22/00 Dorman Elementary School
Springfield, MA
mm/dd/yr
city
1st
80 Hrs.
EDUC 327:
school
grade
clock hours
Date admitted to Educator Preparation Program
MTEL Passed:
Reading
Writing
Application approval:
Education Advisor’s signature
Date
Education Department Chair’s Signature
Date
MTEL Foundations of Reading Test Passed:
MTEL ECED Subject Test Passed:
MTEL ELEM Multi-Subject Test Passed:
MTEL ELEM Math Test Passed:
533580852
Rev 2/13
SPRINGFIELD COLLEGE
Educator Preparation & Licensure Office
ECED/ELEM/SPED Education
Undergraduate Practicum Application
533580852
Rev 2/13