<p> Child Development and Education Program (Early Field Experiences) Student Observer PLACEMENT APPLICATION FALL, 2017</p><p>NAME:______last 4 digits of SS#:______</p><p>ADDRESS:______CITY:______ZIP:______</p><p>HOME PHONE:______CELL PHONE:______</p><p>EMAIL ADDRESS:______DEPARTMENT LEAD: _ Dr. Elaine Zweig______PHONE: (972) 881-5967 ______</p><p>AREA OF CERTIFICATION (SUBJECT):______</p><p>CERTIFICATION LEVEL: ______</p><p>TOTAL NUMBER OF OBSERVATION HOURS REQUIRED:______16 hours______</p><p>SCHOOLS REQUESTED: 1)______2)______3)______GRADE LEVEL REQUESTED: 1)______2)______3)______TEACHER REQUESTED: 1)______2) ______3)______Please note: Placement in the schools of your choice may be requested, but is NOT guaranteed. Please list ALL McKinney ISD schools in your volunteer application. PROGRAM COORDINATOR’S SIGNATURE:______Date:______</p><p>Placement Confirmation to be completed by ______</p><p>Date Criminal Background Approved:______Date of Placement:______</p><p>School Name:______Observation Start Date: ______</p><p>Address:______Zip:______</p><p>Principal:______School Phone:______</p><p>Cooperating Teacher:______Email:______</p><p>Grade Level/Subject:______Teacher’s Phone:______</p><p>______(For McKinney ISD Only)______Special Instructions to the Student Observer: Once placement is confirmed, student is responsible for communicating with the assigned teacher to schedule specific observation dates and times. *If your child/children attend school in this district, please provide name(s) of these schools. *If a relative works in a school in this district, please provide name(s) of these schools. You will NOT be permitted to observe your own child(ren)’s campus or relative’s campus.</p><p>My Child/Children attend: ______My Relative works:______Please return to: Glenda Strange, Lab School Instructor – Child Development and Education Program [email protected]. Collin College – 2800 East Spring Creek Parkway, Plano, TX 75074</p>