Coweta County - Request for College Student Placement
College/University Request for College Student Placement
This request is to be submitted by a college representative with a college email address to be accepted.
The requested should be submitted at least 6 weeks before the day of the placement to begin, if not earlier.
College/University Name *
Your answer
College Students Name *
Your answer
Is the student an employee of Coweta County School System? *
If so, what is their location of employment and job title/responsibility?
Your answer
Does the student have children/relatives that work or attend CCSS? *
If so, what location(s) and relationship to student.
Your answer
Does the student have a Pre-Service or PSC clearance certificate for Georgia? *
Complete the information below for the placement being requested with Coweta County School System.
Please note that we will work to meet your request; however, due to the number of request that Coweta County School System receives, the final placement decision many not match your initial request. Please request placement at least 6 weeks prior to start date.
What semester is being requested? *
Time frame for dates/hours/days requested to complete request. *
Your answer
What kind of placement is being requested? *
What level of placement is being requested? *
Grade preference for placement (1st Choice) *
Your answer
Grade preference for placement (2nd Choice)
Your answer
Subject area needed for placement
Is there a special subject/target area of accommodation being requested for this placement? If so, describe a brief description? (Counseling, Early Childhood, History, Sp. Ed. etc.)
Your answer
The student is responsible for submitting the following information to be considered for the request for placement process.
1. A hard copy of the CCSS health information form.
2. An original/notarized self obtaining criminal background check from a local sheriff or police station. The CBC should be within 30 to 45 days of the starting date of their placement.
The address is CCSS Central Office, 167 Werz Industrial Drive, Newnan, GA 30263.
Electronically sign this request for placement with your email address to authenticate all information provided is true and correct. *
Your answer
An electronic signature is just as valid as a written signature as long as both parties agree to conduct the transaction electronically.
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