College of Education and Science | Teacher Education
Application for Placement in a Practicum or Clinical Practice
Licensure (check one): If completing online – click on drop down boxes for subject areas. If adding endorsement, please list it.
Parent and Family Education Grades K-12 content:
Birth through Grade 3 Grades 9-12 content: Kindergarten – Grade 6 Grades 5-12 content: Endorsement:
Please check all applicable: Fall Practicum (B-3; K-6 only) Student Teaching: Fall ______Spring ______
Name Maiden/Former
Current City/Zip Address
Address during student City/Zip teaching
Current Campus Mailbox E-Mail Telephone
Telephone during student teaching Student ID #
Lutheran Classroom Teacher Home Congregation/City
Extra curricular activities during student teaching Describe:
Admitted to program?* yes no Date? Semester anticipate completion:
Cumulative Check all MTLE tests taken and passed: Reading Writing Math GPA
Content GPA for K-12/ 5-12 Permission to send ePortfolio link? Yes No only ePortfolio link: (Please make sure this link is “public” for viewing.)
* Students must be admitted to the teacher education program before the placement process can begin. Unmet requirements may delay placement. If you have not yet been admitted, please explain your intention:
Revised 02/2016 Schools you have attended (preschool, elementary, middle/junior, high): School City/State Grades Attended
Local schools where any relatives are currently or have been employed: School City/State Relationship
PRACTICUM (for B-3, PK-6)
Birth-3rd candidates complete a 15-week Infant, Toddler, Pre-Primary Practicum prior to the student teaching clinical. PK-6th candidates complete an integrated Elementary Practicum in the fall semester prior to the student teaching clinical. Secondary (5-12) and K-12 candidates complete integrated Practicum hours in ED 347.
STUDENT TEACHING (TYPICALLY COMPLETED IN ONE 15-WEEK SEMESTER)
Clinical 1: Begins on the first day of the teachers’ school site semester calendar and typically lasts for 9 weeks. Clinical 2: Begins immediately after the completion of Clinical 1 and typically last for 6 weeks. Endorsement Clinical: Minimum of 5 weeks which may extend the clinical timeframe past 15 weeks. The teaching clinical follows the site calendar of the assigned school. The length of each clinical is coordinated with the assigned school. Some schools have specific length requirements.
Concordia University has a commitment to our local, urban schools and metro districts (including Lutheran schools and charter school partners) and will give priority to placement in these schools over other school districts.
Special Considerations Please explain any special considerations that may factor into your placement:
Please read the following carefully and verify by your signature on the line provided below:
Transportation: I am responsible for my own transportation to and from schools. If I have my own vehicle, I attest that it is properly insured. I understand that the university cannot require me to take additional passenger. (Please indicate transportation plans: ______)
Liability Insurance: I have obtained liability insurance and have provided proof of same to the Education Office. (The most reasonably priced insurance can be obtained through Education Minnesota: http://www.educationminnesota.org.)
Clinical Priority: I have been made aware of the College of Education and Science’s policy that Practicum and Student Teaching experiences are to be my priority – over and above such things as co-curricular activities, extracurricular activities, and employment. I also realize that regularly-scheduled seminars are held during the Student Teaching semester and that attendance at the seminars is mandatory.
Candidate’s Responsibility: I understand that it is my responsibility to meet ALL of the prerequisite requirements BEFORE any placement steps can take place. I understand that there may be a delay in placement if the requirements have not been met by the time of application. I
Rev. 02/2016 also understand that it is my responsibility to provide a link to my ePortfolio and potential placement site personnel will have access to it for the purpose of my placement.
Placement Considerations: I acknowledge that the Department of Undergraduate Teacher Education will work to place me in a timely manner; however, placement is dependent upon local school district capacity, any special considerations I might have, and my completion of all prerequisites. I understand that the designated placement semester may affected by these conditions.
Signature of Candidate ______Date ______
Signature of Advisor ______Date ______
Signature of Clinical Coordinator______Date ______
For office use only. Four Human Relations Reports Resume Philosophy of Education Current Planning Form
Rev. 02/2016