OFFICE OF CLINICAL
EXPERIENCES AND CERTIFICATION PROCESSES
STUDENT TEACHER INFORMATION SHEET
Name__________________________________________________________________________ Date___________________
Last
First
Middle
Phone
(_____) ____________________________________
Your
address while student teaching
__________________________________________________________________City___________________________________________
Subject(s)
and Grade Level(s)__________________________________________________________________________________________________________
Supervising
Teacher(s) ______________________________________________________ Phone (____)
___________________________
University
Supervisor _______________________________________________________ Phone
(____)____________________________
SCHOOL VACATION CALENDAR
Please
list below the dates of school vacations, institute days, school
assemblies, field trips, or any other times when your school will NOT be
in session during our term of student
teaching.
DATE
ACTIVITY
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Mail this student information sheet to your University Supervisor
only at the end of your first week of student teaching.