JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
New York City College of Technology - Career & Technology Teacher Education
Application for EDU 3681 Internship (You must provide your full SS# and complete home address on this form. Both are required to register you on the NYCDOE PETS system for internship or student teaching.)
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Semester
*
Choose
Spring 2021
Fall 2021
Spring 2022
Fall 2022
Date of Birth
*
MM
/
DD
/
YYYY
Name (last name, first name)
*
Your answer
You must provide your full SS# and complete home address on this form. Both are required to register you on the NYCDOE PETS system for internship or student teaching.
Social Security #
*
Your answer
CUNY EMPID
*
Your answer
Home Address (Street, Apt #, City/State, Zip Code)
*
Your answer
Phone Numbers (home, work, cell)
*
Your answer
Email Address
*
Your answer
When do you expect to graduate? (Semester, Year)
*
Your answer
What is your teaching subject?
*
Your answer
Do you have any special knowledge, skills, or experience expertise in your teaching subject that you would like the school of your placement to know about? List your special expertise below.
Your answer
Are you currently employed in a school? If yes, give name of school below.
Your answer
Please note: Internships are a minimum of 12 hours per week, at least 2 days per week, for 1 semester.
Is this your first internship?
*
Yes
No
If no, where did you do the first internship? Please indicate if this was during Middle School, Junior High School, or High School and the location.
Your answer
I understand that approval to register for EDU 3681 is granted by the Department after faculty review and subject to the successful completion of ALL PREREQUISITE COURSES. Applications will be reviewed by the CTTE faculty at the end of the semester and notifications will be sent to me prior to the start of the following semester. (Please Sign & Date below)
*
Your answer
Submit completed Student Teaching Application form by email to Ruben Rodriguez at
rurodriguez@citytech.cuny.edu
no later than TUESDAY, DECEMBER 8th 2020. Applications WILL NOT be accepted after this date.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
