Student Teaching / Observation Hours / Internship Requests

Thank you for your interest in completing your student teaching, observation hours, or internship with Cicero School District 99.

Please complete the form below as thoroughly as possible. After submission, a member of our team will contact you to review next steps.

All applicants are required to complete a background check at the Cicero School District 99 Administration Building. The cost for the background check is $28.25, payable by cash or money order. Additionally, applicants must provide documentation of a recent physical examination and a negative TB test.

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First and Last Name *
What is the type of assignment you are interested in: *
Are you currently an employee of Cicero School District 99? *
Personal email address: *
Personal Phone Number: *
Home address: *
The name of the College or University you are currently attending: *
What is your program of study?  *
Degree being pursued: *
Name of your University Advisor (the person who arranges your field experience) and their contact number: *
Anticipated completion date of degree (month and year): *
Total number of hours required for your placement: *
Requested start date for your placement: *
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End date for your placement: *
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Preferred days/times for your placement: *
Grade level(s) preferred: *
Required
Do you have a preference of school buildings?
Can your placement be in a Bilingual-Spanish setting? *
Emergency Contact Name: *
Emergency Contact Phone Number: *
Emergency Contact Relationship: *
Additional comments or information:
Acknowledgement: I understand that submission of this form does not guarantee placement and that all district requirements must be completed prior to placement. *
Required
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