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Teacher Education Withdrawal Form
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* Indicates required question
Email
*
Your email
I would like to
*
Withdraw from the teacher education program entirely.
Student First Name
*
Your answer
Middle Name
*
Your answer
Student Last Name
*
Your answer
Previous Last Name (if applicable)
Your answer
UT Student ID Number
*
9-digit number (000123456)
Your answer
UTK Email Address
*
Your answer
Student Current Phone Number (Enter phone number with area code.)
*
865-123-4567
Your answer
Choose your current clinical pathway (Student)
*
Internship (one year with a mentor teacher)
Student Teaching (one semester with a mentor teacher)
Job-Embedded Practitioner (working as a teacher while completing the teacher education program)
Choose your current program area (Student)
*
Agriculture Education
Art Education
Deaf and Hard of Hearing/American Sign Language Education
Early Childhood Education/Child and Family Studies
Elementary Education
English as a Second Language Education
Middle/Secondary STEM Education
Music Education
School Librarian, Library Information Specialist
Secondary English Education
Secondary English/English as a Second Language
Secondary Social Science Education
Special Education
World Languages Education
Other:
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