The information that you provide below will help complete our records for this student teaching assignment.
Name of cooperating teacher:
What is your email address?
THE FOLLOWING QUESTIONS HELP US TO DEVELOP A DEMOGRAPHIC PROFILE OF OUR FIELD-BASED FACULTY:
What is your assignment? (e.g., grade level, subject taught, etc.):
How many years have you taught in this assignment?
How many years have you taught in your career in other assignments?
What teaching certificate type(s) do you hold?
What is your highest level of studies? Select one Bachelors degree Have completed credits beyond bachelors Masters degree Have completed credits beyond Masters Currently in doctoral studies Doctoral degree Post-doctoral studies
From what institution did you receive your highest level degree?
Are you Latino/a - Hispanic?
Please select the category/categories below that describe you (select as many as apply):
THE FOLLOWING QUESTIONS ARE ABOUT THIS STUDENT TEACHING ASSIGNMENT & YOUR SCHOOL:
Name of Student Teacher:
Student Teaching Term:
Student Teaching Year:
Date student teaching term begins: [None]
Your school district number:
Your school district name:
In which county is your school district located?
What is the name of your school?
What is the mailing address of your school?Street: City: State: Zipcode:
School phone number (with area code):
School fax number (with area code):
What is your principal's name?
Other information or questions you might have (up to 1000 characters):
THANKS for providing this information!
When you are done, click below:
