Student Teaching Agreement Form

This form serves as an initial step for those who are planning on student teaching, to connect with a cooperating teacher and faculty supervisor. This form helps collect necessary data and start initial conversations between student, cooperating teacher, and principal. This form is to be filled out at the beginning of the semester prior to your student teaching semester. 

You are encouraged to review all questions first and prepare all materials before completing the form. Your responses will not be saved until the form is submitted.

All fields marked with asterisk (*) are required.

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Student Teacher Contact Info (student teaching semester)

required text field
Legal Name
required text field
required text field
required textarea field
Address during student teaching semester
required text field
required e-mail address field
Personal email for contact post graduation
horizontal_line field
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Student Teaching School

required text field
required text field
required textarea field
required text field
date field
date field
horizontal_line field
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Principal Contact

required text field
required e-mail address field
checkbox field
I acknowledge that
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Cooperating Teacher

required text field
required text field
please list the best number to reach you
required textarea field
street name, city, state, zip
required e-mail address field
file attachment field
Please attach a copy of teaching license or statement from your district verifying that you have at least 3 years full time teaching experience in your content area
(50 MB max)
required checkbox field
I acknowledge that*
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Faculty Supervisor

required text field
text field
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street name, city, state, zip code
e-mail address field
file attachment field
Attach a copy of your resume to keep on file at Beloit College, if you have not worked with Beloit College in the past.
(50 MB max)
checkbox field
I acknowledge that
horizontal_line field
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Affirmation of student teaching responsibilites

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By signing below, I acknowledge the following:*

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