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UAS Student Teaching Request Form (Gate 2)
*If you do not have your basic competency exam (i.e. Praxis Core, or other DEED approved exam) passed and a processed Student Teaching Authorization (STA) by the start of your placement we will pull you from your internship and have you postpone to a different semester.
Note: you are not guaranteed a placement in the school or grade level you have listed.
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Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Student ID number
*
Your answer
Current Physical Address
*
Your answer
Current Phone Number
*
Your answer
Your UAS Degree Program
*
BA Elementary Education
BA Special Education
MAT Elementary Education
MAT Special Education
MAT Secondary Education
If you are in the MAT Secondary Education, what is your content area?
Your answer
Check which Practicums you have completed or are currently registered for
MAT Elementary - ED 615
MAT Elementary - ED 616
MAT Elementary - ED 617
MAT Elementary - ED 618
MAT Elementary - ED 619
MAT Elementary - ECE 661
BA Special Education - EDSE 494
MAT Special Education - EDSE 694
None of the above
Please write which school(s), location(s), and grade(s) you completed your practicum(s) and which course it was for. (i.e. ED 618 - Gastineau Elementary, Juneau, 4th grade)
Your answer
Have you passed the Praxis Core or other DEED approved Basic Competency Exam? (If other please write which exam you completed)
*
Yes
No
Other:
Do you plan to student teach in a paid teaching role/in your own classroom?
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Yes
No
Semester you are requesting placement
*
Fall 2024
Spring 2025
Year-long 24-25
Required
School District
*
Your answer
If you are student teaching in one of the following districts, have you applied to them directly? Anchorage, Matsu, Fairbanks, or Kenai
Yes
No
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City
*
Your answer
Name of Requested School - First Choice
*
Your answer
Name of Requested School - Second Choice (if there is only one school in your location write N/A)
*
Your answer
Name of Requested School - Third Choice (if there is only one school in your location write N/A)
*
Your answer
Teacher Request (optional - please specify the school(s) they teach at)
Your answer
Grade Level First Choice
*
Your answer
Grade Level Second Choice
*
Your answer
By checking the box below you are verifying that the information you have entered is true and you acknowledge that placements are not guaranteed.
I acknowledge the statement above.
A copy of your responses will be emailed to the address you provided.
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