Application Packet is due by the first Friday in June for Fall Student Teaching and the first Friday in
November for Spring Student Teaching.
Albany State University
APPLICATION FOR STUDENT TEACHING
2016-2017
Name:
RAM ID:
Local Street Address:
City, State, Zip:
Phone (include area code):
ASU Student Email:
Program:
Concentration(s):
Preferred Placement: Indicate your preferred city/town, grades, and subjects. Although ASU cannot guarantee
that your preferences will be met due to state and national guidelines, we will use these as a guide in making
placements.
Placement Preference
Preferred City/Town
Preferred
Grade
Preferred Subject
All applicants should have completed the state-required background check for field experiences. If you
have not, you must complete the process prior to submitting the student teaching application.
If you have to student teach away from your home campus, have you completed the Request to Student Teach
Away from Home Campus Form? If not, please email Dr. DaShonera Crawley at
dashonera.crawley@asurams.edu.
If you have a relative who is a teacher, administrator, or school board member in any of the two towns that you have
chosen, list their names, schools or districts, and positions. You MAY NOT student teach in a school where a
relative works or where a sibling or child attends school. This is a university policy. Failure to disclose
such information could result in you being removed from student teaching.
Name of Relative:
Name of School:
Position:
Application Packet is due by the first Friday in June for Fall Student Teaching and the first Friday in
November for Spring Student Teaching.
Name of Relative:
Name of School:
Position:
Name of Relative:
Name of School:
Position:
BEGINNING SCHOOL EXPERIENCE (BSE):
Have you completed your Beginning School Experience? Yes No
(If you are enrolled in Practicum III, during the Fall semester you should complete BSE in the Fall
during the Pre-Planning week through 1
st
full week of school). This is always completed in the Fall
regardless of the semester you plan to student Teach.
If so, where did you complete your BSE? _____________________________ Semester: _______________
Candidates that have paraprofessional experience are not required to complete BSE. However, you are
required to provide documentation on school letter from your administrator.
GACE:
Have you passed the GACE Content Exam? Yes No (Passing Scores are 220 or above)
You must provide digital proof of your GACE scores to with your application. Candidates will not be
permitted to student teach without passing GACE.
Pre-Service Certificate:
Do you currently have a Pre-Service Certificate? Yes No
If not, you should contact Ms. Teresa Fleming at Teresa.walker@asurams.edu to complete the application. You
must provide digital proof of your Pre-service certificate with your application. Candidates will not be
permitted to student teach without having a pre-service certificate.
Additional Items for Completed Packet:
Please provide the following items with your completed application:
Background check form
Copy of ID
Copy of Pre-service certificate
Copy of unofficial audit
Copy of transcripts
Copy of GACE scores (Content)
By signing below, I certify that the information I have provided in this application is correct to the best
of my knowledge, and I agree to comply with the established student teaching policies of Albany State
University.
__________________________ ________________
Signature Date
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signature
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