Supervision Course Application (Student Teaching and Clear)
DO NOT FILL OUT THE FORM IF YOU HAVEN'T PASSED ALL SECTIONS OF THE CSET.
Term Applying for *
Name(Last Name, First Name ) *
Student ID *
Email Address *
Cell Phone
Program Information (Track) *
Required
Course (select one) *
Required
Concentration *
Required
Clear Students: Name of the Current school
Student Teacher: State preferred school, Indicate the type of program
School Address (Street, city, state, zip), Phone
Principal (Name, Phone)
Special Education Principal or Administrator
Support provider Name (for Clear only)
Support provider email (for Clear only)
Preferred Age or Grade level (For student teacher only)
Name of Preferred Master Teacher
Is directed Teaching your Last Class? *
If no, please list the other courses that you intend to be enrolled in at the same time as Directed Teaching: *
Submit
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