APPLICATION FOR FIELD EXPERIENCE IN EARLY CHILDHOOD …



Semester:       Year:      

Name:       ID #:      

Local Address:      

     

Email:       Phone Number(s):      

Indicate below which field work you are applying for:

EDUINDP 443 section 2; 1 unit corresponds with EDUINDP 442 Planning for Individual Needs

EDUINDP 443 section 1; 1 unit corresponds with EARLYCHD 320 Curr./Progr.: Ages 3-8

EDUINDP 443 section 1; 1 unit corresponds with EDUINDP 452 Integrated Curriculum for Children 6-8

List any programs where you have been previously employed, completed volunteer hours, or fulfilled course requirements:

|Program Type |Level |Location |Teacher |Dates/Hrs. |

|(i.e. preschool, Head |(age of children, grade | | | |

|Start, birth to three, |level, special ed., | | | |

|child care, Kindergarten,|regular ed.) | | | |

|Early Elem.) | | | | |

|      |      |      |      |      |

|      |      |      |      |      |

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|      |      |      |      |      |

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|      |      |      |      |      |

List your preferences for your Special Education field placement:

| |City |School |Grade Level |

|Preference #1 |      |      |      |

|Preference #2 |      |      |      |

|Preference #3 |      |      |      |

Do you have a car? yes no If yes, are you willing to transport other students? yes no

How many passengers can ride with you ?      

If you have further questions or concerns about your placement or requirements, see your instructor

Procedures for Processing Applications for Field Work Placements

• Students complete applications for field experiences and submit to instructor.

• The instructor contacts area schools (via the principal) and provides names of educators who are willing to work with students.

• Within the first two weeks of classes, the instructor announces available placements and assigns students to area schools.

• Final placements will be announced in the methods class corresponding with the field experience.

Notes:

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