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Please TYPE all pages of this form. The Autobiographical and Goals and Philosophy sketchs should be a maximum of 1 1/2 pages typewritten, double-spaced. Submit original and seven duplicates of this completed 3-page form. Staple as sets.
NAME ____________________________________________ DATE OF BIRTH ________________
ADDRESS _________________________________________ MAJOR: _______________________
CITY _____________________________________________ MINOR: _______________________
STATE _______________________________ ZIP ________________
PHONE ( ) __________________
FROM WHICH HIGH SCHOOL DID YOU GRADUATE?
School _______________________________City ___________________________ State __________
IN WHICH SPECIFIC TEACHING AREA OF YOUR MAJOR ARE YOU BEST PREPARED?
___________________________________________________________________________________________
Student teaching assignment will be made by the director of the Multiple Subject BCLAD Credential Program. Placements cannot be made without these forms (make an additional copy for your own files).
Keep the PLC Department office informed of any changes in address, last name or any circumstances which would interfere with your fulfilling a student teaching assignment. Phone: 594-5155.
COURSES IN YOUR MAJOR: List below all the courses already completed,
and those to be completed concurrently with student teaching. DO NOT include
courses in Education.
| YEAR COURSE TITLE WHERE TAKEN
UNITS GRADE
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Please write a brief autobiography around the following three major topics. This information will help the school administrators, master teachers, and the University supervisor to become better acquainted with you.
1. Personal information relative to your birthplace, elementary and secondary schooling, interests, hobbies, etc.
2. Experiences you have had with high school age youth that have helped you gain insight into adolescent growth and development and into school procedures and operations.
3. A brief statement indicating the reasons why you are interested in
teaching and why you have the potential for becoming an excellent teacher.
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