School: ______________________________ City: __________________ State: _____ Sch. Phone: ______________
Grade/Subject(s): ___________________________ Cooperating Teacher(s): ________________________________
Teacher Candidacy Dates: __________________________________Semester/Year: _________________________
Directions: Please read the agreement sections of both the cooperating teachers and student teachers. If you agree,
please sign the acknowledgement section below.
Cooperating Teacher Agrees to:
Be specific in directions for all work assignments and due
Acquaint/integrate the teacher candidate with/into the
classroom, school, and district environment and policies.
Actively model effective planning for instruction
throughout the experience.
Provide specific and meaningful feedback of teacher
Function as a mentor/resource person in matters
pertaining to classroom and professional practice.
Teacher Candidate Agrees to:
Put forth his/her best effort, arrive on time, be well
prepared, and meet all deadlines.
Maintain a professional attitude toward all members of the
Know, follow, and enforce rules, regulations, and policies
of the cooperating teacher and school.
Prepare written unit and lesson plans for any teaching
assignments in advance of teaching as prescribed.
Be proactive to improve teaching skills by being reflective,
observant of other teaching methods, and taking
Checklist: All items listed below must be completed and checked off prior to the start of the teacher candidacy
experience and before returning this form.
______ Cooperating teacher has been provided a copy of the Teacher Candidacy Policies of WLC.
______ Cooperating teacher and teacher candidate have discussed expectations/roles/assignments.
______ Teacher Candidate and cooperating teacher have set next meeting date and time for ___________________.
______ Teacher Candidate has been or will be provided a school/district handbook and/or other materials to help
prepare for the teacher candidacy experience.
Acknowledgment and Acceptance: I have reviewed this document and discussed its contents. My signature means
that I understand what is expected of me as a cooperating teacher or teacher candidate and that I will do my best to
follow the aforementioned guidelines/ agreement.
Cooperating Teacher Teacher Candidate
____ I accept the student teaching placement. ____ I accept the teacher candidacy assignment.
____ I do not accept the placement. ____ I do not accept the assignment.
Cooperating Teacher Signature Teacher Candidate Signature
This completed and signed form must be returned to the
Director of Teacher Education’s office prior to
the start of teacher candidacy.
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