Student Teacher Placement Application – Strand 1

2009 – 2010 School Year

This information will be used to make the best possible match between you, your school and your school supervising teacher. We welcome your candor for there are no right or wrong answers.

Name:
Address in July:
MAT Address (or the community where you plan to live during 2009-10):
Phone number in July:
MAT phone number:
Email:
Languages Spoken Frequently:
Type of school preferred:
Elementary school you/your children/your siblings attended (if in local area):

I have read the accompanying information and understand that I may select a preference for my first and second level of authorization. I also recognize that the best possible placement will be made for me.

I would like my first level of authorization to be:	Early Childhood (K-3) Elementary (grades 4-8)
My preferred grade level is:
I would like my second level of authorization to be:	Early Childhood (K-3) Elementary (grades 4-8)
My preferred grade level is:
	By checking the box below, I certify that I have answered the questions and agree to the terms and conditions. I Agree

Background

	1. Describe your educational background and work experience.
	2. How could your experiences be integrated in the classroom?

3. Assess your experience with the following:

Classroom Management:
Assessment:
Planning:
Instruction:
Experiences with K-5 Students:

Teaching and Learning

	4. How do you think children learn best?
	5. How do YOU learn best?
	6. What is the difference between a good teacher and a great teacher?

Student Teaching

	7. What are your expectations and your commitment to student teaching?
	8. Describe the type of classroom setting where you feel you will be the most successful. Explain.
	9. What do you expect from your supervising teachers?

Personal Interests

10. What hobbies, interests, free-time activities do you enjoy?

For Supervising Teacher

11. Please write a paragraph to your supervising teacher telling what you hope to achieve during student teaching

Résumé

12. Please email your résumé to Heather Daniels (hdaniels@willamette.edu).

Check box if you agree to have this information shared with area school districts for placement purposes.
Agree

If you have any questions, please contact the School of Education Admissions Director, Heather Daniels: hdaniels@willamette.edu or 503-375-5453.

After you 'Submit Online' below, please mail your criminal background statement(PDF) to:

Heather Daniels
School of Education
Willamette University
900 State Street
Salem, Oregon
97301