Educational Studies Program
Request for Clinical Field Experience (EDUC 360) Form
Name Rhodes ID
Email Mobile phone
Major Track Graduation Year
Semester of clinical field experience request EDUC 360 credits
Do you have a car or another means of transportation? Yes
Select one grade level and one concentration within the grade level:
Elementary (K - 5)
Reading and Language Arts
Math and Science
Special Education
Music, Art, and
Health and Physical Education
Secondary (6 – 12)
Middle (6 - 8) Content area
High School (9 - 12) Content area
Special Education/Instructional Resource (6 8)
Special Education/Instructional Resource (9 12)
List your questions or concerns in this space:
Educational Studies Program 03/19/2018