APPENDIX-7

Single Subject - Online Handbook

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APPENDIX-7: Internship Sample Forms

Page Content
•	Internship Forms
•	First Semester Program Forms
•	Second Semester Student Teacher / Internship Forms

Site Content
•	Welcome Page
•	Introduction
•	Program Overview
•	Chapter 1
•	Chapter 2
•	Chapter 3
•	Chapter 4
•	Chapter 5
•	Chapter 6
•	Chapter 7
•	Chapter 8
•	Appendix 1
•	Appendix 2
•	Appendix 3
•	Appendix 4
•	Appendix 5
•	Appendix 6
•	Download Forms Page

Go to . . .
•	Return to Secondary Education Web Site
•	Teaching Performance Assessment (TPA)

Internship Forms

‘I’s to be used by Internship Candidates only Department of Secondary Education, Single Subject Credential Program Internship Forms
Form	Form Name	Date Due
I-1	Individual Intern Development Plan	December 15 and May 15
I-2	Mentor “Buddy” Teacher Activity/Substitute Log	December 15 and May 15
Classroom Observations	Classroom Observations Forms are in your Mentor Folder obtained at the Intern/Mentor Teacher Orientation (October/March)	3rd Week and 8th Week
Go to Downloads Page for a copy of these forms.

Responsibilities – It is the responsibility of the Mentor Teacher to complete the forms, obtain the Intern’s signature, and for the candidate to deliver to the 440S Instructor (Ellen Kottler) first semester. Completed forms are required by the University to pay districts for subs and to pay Mentor Teacher stipends. The same forms are required second semester in the program and should be given to your 460 TPA Instructor.

First Semester Program Forms (See APPENDIX-3)

“EI” Forms used by Externs and Internship (Professional Track). Department of Secondary Education, Single Subject Credential Program First Semester Forms
Form	Form Name	Date Due
EI-1	Verification and Diversity of Student Population	3rd Week
EI-2	Master Teacher Qualifications	3rd Week
EI-3	TPE: Extern Level of Proficiency	15th Week
EI-4	First Semester Final Evaluation	15th Week
EI-5	TPE Reflections: EDSC 440S	15th Week
Go to Downloads Page for a copy of these forms.

Responsibilities – It is the responsibility of the Candidate and Mentor Teacher to complete the EI forms and for the candidate to deliver to the 440S Instructor (Ellen Kottler) first semester. Completed forms are required by the University for the candidate to advance into second semester of the internship program.

Second Semester Student Teacher/Internship Forms (See APPENDIX-5)

‘STI’s to be used by Student Teachers and Internship Candidates Department of Secondary Education, Single Subject Credential Program Student Teaching/Internship Forms
Form	Form Name	Date Due
STI-1	TPE Level of Proficiency: Student Teacher Midterm Evaluation	7th Week
STI 2	Student Teacher Final Evaluation	18th Week
STI-3	Teaching Performance Summary: EDSC 460	15th Week
Go to Downloads Page for a copy of these forms.

Responsibilities – Seminar Instructor: It is the responsibility of the Seminar Professor/Instructor to collect STI-1 and STI-2 from the Candidates and submit to the Coordinator of Secondary Education. It is the responsibility of the EDSC 460 Professor/Instructor to collect STI-3 and submit to the coordinator of Secondary Education.

Candidates should keep copies of all forms for their professional files.

Download a file copy of this page in MS Word®

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