Student Teaching/Observation/Internship Request
It is required to obtain a background check at the Cicero District 99 Office.  In addition you will need to provide the district with a negative TB test and a recent physical exam.  There is a fee of $28.25 for the background check that can be paid in cash or money order.
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Full Name *
What assignment would you like? *
What placement are you seeking? Teaching? Social Work? etc. *
Date of Birth *
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Home Address *
Personal Phone Number *
Personal Email Address *
College or University currently attending? *
Name of University Advisor (The person who arranges your field experience) and a contact number. *
Anticipated completion date of degree *
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How much time do you need to complete your observation hours or student teaching? *
What days/hours are you available? *
Do you have a preference in schools? *
Do you have a preference in grade level(s)? *
What date would you like to start by? *
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Emergency Contact Name *
Emergency Contact Phone Number *
Emergency Contact Relationship *
By selecting this option I verify that all information submitted is answered accurately. *
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