HOPE COLLEGE
EDUCATION DEPARTMENT

STUDENT TEACHING APPLICATION

Last Name:

First Name:

Middle/Maiden:
Anticipated Date of Graduation:
Local Address:
Phone #:
Email Address: (Required)
Student #:
A. Student Teaching Assignment Requested:
1. Year Spring
Fall
2. Elementary:
RANK IN ORDER OF PREFERENCE:
Kindergarten
Lower
Upper
Middle School
Special Education:
Elementary
Middle School
High School
Secondary:
Middle School
Sr. High
K-12 (PE, Music, Visual Arts & Dance):
Middle School
Sr. High/Elementary
B. Major 1
Minor 1
Major 2
Minor 2
C. SECONDARY STUDENTS ONLY: Would you like a student teaching placement in your major only
( Yes / No) , or, if possible, in both your major and minor ( Yes / No)?
D. Give evidence of a field placement that represents a culturally diverse or multicultural
(20% or more schoolwide) experience.
School
Grade Level


Date of Placement
E. Professional Semester: Check when you will be taking the following courses:
Perspectives: Spring
Fall
Year
Senior Seminar: Spring
Fall
May/June/Summer
Year
NOTE: All special education majors take the 6-hour special education sequence
during the fall semester and complete Perspectives and Senior Seminar
in the spring semester.
F. Will you have transportation available?
Yes
No
G. High School attended:
H.

School preference:
RANK IN ORDER OF PREFERENCE:
Public
Private

Charter
No Preference

I. Will you be participating in a music or sports program or any other organization or activity at Hope during your student teaching semester?
Yes
No
If yes, which program/activity:
  Will your participation in the above program/activity require you to be absent from your student teaching placement?
Yes
No
If yes, how many days will you be absent from the classroom?
J. Have you ever been convicted of or pled no contest to a misdemeanor or felony?
Yes
No
Do you currently have any charges pending?
Yes
No
  (If you answered yes to either question above, please make an appointment to see the Director of Certification if you have not already done so.)
K.

Requests:
If you are interested in teaching in a particular geographical area, school, or with
a specific teacher, please identify below. Requests for off-campus placements must
be approved in advance by the department.

L. Comments:
REMINDER: You will need to have your resume reviewed by a staff member in the Office of Career Services prior to submitting it electroncially to the Education Department at studentteaching@hope.edu by the announced deadline next semester.