Initial Licensure Internship Application Form

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FOR FALL 2024 - Must complete by February 2 at 5pm

Last Name *

First Name *

UMW Email *

Program *

Post-Bacc (M.Ed)

Undergraduate

Endorsement Area *

Computer Science

Elementary Education Pk - 6

English

Foreign Language - French

Foreign Language - German

Foreign Language - Latin

Foreign Language - Spanish

History and Social Sciences

Mathematics

Music Education Pk-12: Instrumental

Music Education Pk-12: Vocal/Choral

Science - Biology

Science - Chemistry

Science - Earth Science

Science - Physics

Special Education K - 12: General Curriculum

Special Education K - 12: Adapted Curriculum

Theatre Arts Pk-12

Visual Arts Pk - 12

CHECK HERE IS YOU ARE IN THE MIDDLE GRADES ENDORSEMENT PROGRAM

Required

In order to begin your internship, you should already have taken and passed all of the following: Praxis Core (or equivalent SAT/ ACT/ VCLA), VCLA, RVE (elementary and SpEd only), and Praxis II. Should you need to retake any of these, you must do so NO LATER than July 1. Have you taken and passed all of the requirement assessments?

Yes

Clear selection

Please list ALL of your practicum placements. Include School Division, School Name (add ES, MS, or HS), Grade(s), and Subjects (if not elementary); for example, Stafford, Ferry Farm ES, K, reading OR Prince William, Gainesville MS, Civics, OR Spotsylvania, Riverbend HS, Algebra II and Geometry.

Please list all relationships with faculty, staff, or students in Virginia public schools (other than professional relationships made during practicum experiences). Please list each school in which you know faculty, staff, or students and the type of relationship with said individuals.

We will be placing students in the following five school districts: Fredericksburg City, King George, Prince William, Spotsylvania, and Stafford. Do you have a preference for your placement? **Important: This request DOES NOT guarantee a placement in that school district. You also MAY NOT request a specific school.**

Grade Preference for the Internship. Elementary - Please state: K - 2, 3 - 5, 6, or no preference. Pk-12 - please state: Elementary or Secondary. Secondary - please state: High School or Middle School

I understand that the internship runs from the whole UMW academic semester (Monday, August 26, 2024 to Friday, December 6, 2024).

Yes

Clear selection

I understand that their is a mandatory Student Intern Orientation meeting that will be held on before the start of the semester (exact date - TBD).

Yes

Clear selection

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