Morningside College--Education Department

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					Morningside College--Education Department
Application for Student Teaching—Special Education

           Fall Semester                        Spring Semester


College Address
College Phone

Home Address
       City, State, Zip
Home Phone:(         )
E-mail address

If student teaching is to be done during the fall semester, write the complete address and phone number
at which you can be reached during the summer:

Verification of completion of Teacher Education Requirements:
Teaching major(s)

Write the term in which you completed the following courses. If you have not yet completed a course,
indicate the term you will complete it.

Required coursework (in addition to requirements for regular elementary or secondary

Course Number                           Course Title                       Completed         Term
SPED 361            Intro to Mild/Moderate Disabilities
SPED 362            Principle of Special Ed. Teaching
SPED 364            K-6 Mild/Moderate Methods OR
SPED 366            7-12 Mild/Moderate Methods
SPED 402            School-Parent Collaboration
SPED 407            Diagnostic Teaching of Math
SPED 431            Applied Behavior Analysis
SPED 451            Education Assessment
SPED 455            Transition
SPED 470            Student Teaching: K-6 Inst’l Strategist OR
SPED 471            Student Teaching: 7-12 Instr’l Strategist
EDUC 324            Reading in the Content Areas (7-12)
EDUC 414            Diagnostic Teaching of Reading (K-6)
Current cumulative grade point average at Morningside College
Current cumulative grade point average in education (include special methods courses taken in another
Number of college credit hours completed at the end of the current semester

Request for Student Teaching Assignment (some teaching areas require specific subject and area
1. Grade preference (in order of choice)
    Elementary Major:         K       K      K
    Secondary Major:          Middle School 1        High School 1
2. Students are responsible for transportation to their teaching assignment. Will you have a vehicle for
    transportation to and from your assignment ?            Yes
3. Any information concerning special requirements of which the department needs to be aware when
    making your student teaching assignment. You may not request teachers or buildings.

Goal Statement:
Attach a typewritten essay that describes your progress toward becoming an Effective Educator
and that outlines the personal and professional goals you wish to achieve during student teaching.
This essay will be reviewed by the Director of Elementary Education and by the faculty in the
education department. An essay that does not meet high standards of writing will be returned for
revision. A copy of this essay will be given to your cooperating teacher.

Agreement regarding Student Teaching:
I understand the following rules that govern student teaching:
1. Student teaching is for full school days, and I will not enroll for other courses that meet between
    8:00 a.m. and 4:30 p.m.
2. I must enroll in EDUC 490 Effective Educator Seminar concurrently with student teaching.
3. I may enroll in no more than 16 credit hours, including student teaching, during the semester in
    which I student teach.
4. This application does not replace registration for student teaching.
5. An additional application must be completed for student teaching in special education.

I agree to follow these rules as well as the policies and procedures outlined in the Teacher Preparation
Program Handbook and Student Teaching Handbook.

       _____________________________________________________ ___________________
       Signature of Applicant                                               Date
Please print out this form and sign and date it and submit it to the Education Department for the final
Recommendation of Faculty Member:
Based on my knowledge of this student in the following areas—academic proficiency, teaching
potential, ability to communicate effectively, and personal qualities required of effective educators—
_____ I support this application to student teaching.
_____ I support this application with reservation and have attached a statement explaining my concerns.
_____ I do not support this application for student teaching and have attached a statement explaining
        my concerns.

          _____________________________________________________ ___________________
          Signature of the Professor of Special Education                   Date

Note: A $100.00 late fee will be assessed to applicants who return the application after the

Morningside College
Education Department

Statement of Fraud: Fraud in procurement of a license or falsifying records for licensure purposes will
constitute grounds for filing a complaint with the Iowa Board of Educational Examiners. It may not be
possible to obtain a teaching license in Iowa if any of the following items apply to you. Please read the
following questions and answer them truthfully. For any “yes” response, please provide a written
explanation that includes the date(s) of the violation(s). Then sign and date the form.

    Have you ever had an educational license revoked or suspended?

    Have you ever had a founded report of child abuse made against you?

    Have you ever been convicted of a crime other than parking or traffic violations?

    Have you ever been convicted of a felony?

Signature _________________________________________________ Date ______________________

Revised 1/06

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