Student Information – Winter/Spring 2004

 

Please complete the following information.

Course Number______________ Course Name ______________________________________________

Name: __________________________________ Augsburg Campus Box # ___________

Adress:__________________________________________________________________

Telephone: _________________________ Cell: _________________________________

E Mail: __________________________________Best time to reach you: _____________

Advisor: ___________________________

 

 

Previous practicum placements: (As best as you can)

School	Grade Level(s) and Discipline	Total Hours

 

Other education courses you are currently enrolled in:

Course Code	Course Title	Instructor	Class Days and Hours

 

You will need to complete the practicum hours stated by your instructor in the course syllabus. In most cases this will be 20 hours during the current term. You are expected to be active participants in the classroom rather than passive observers. You must complete activities that are given by your instructor and then negotiated with the supervising teacher in the school. These learning activities should be beneficial to both you and the students you work with.

1. Depending on your school and work schedule please indicate some block time (2 –4 hours a week, not including travel time) you will be available to complete your practicum hours.

 

 

2. Describe any other issues or special needs we should know as it relates to completing the required hours for the practicum experience.

 

 

3. After reading through the list of partnership schools, please indicate two schools you may be interested in working with. The school or district does not have to be on the list although it is encouraged. (would you like a copy of all the partnership schools descriptions e-mailed to you? ______yes ______no)

1^st________________________________ 2^nd ____________________________________

______ I would like help in my placement _______ I do not need help in my placement