Willamette University

GSE Internal Resources

New Supervising Teacher

Application Form

Thank you for volunteering to supervise a Willamette University MAT student teacher. We value your contribution to the professional preparation of our students. This application will be used to make the best possible matches between student teachers and their supervisors. It does not guarantee that a student teacher will be available for placement with you this next year. The minimum commitment includes:

  • Providing significant instructional assistance
  • Conferencing with the student teacher weekly to assess TSPC competencies.
  • Three or four meetings at Willamette University.
  • At least three 3-way conferences with the student teacher and the university supervisor, scheduled at school site.
Name:
School:
Content Area(s):
Home Phone:
School Phone:
Summer Phone:
Email:
Years of Teaching Experience:
Principal's Name:
Principal's Email:
Strand:
If you are not sure of your Strand, check with your principal.
1. Please indicate your level of interest below:
Yes, I am interested in supervising an MAT student teacher and/or practicum student.
I am interested if:
I would like more information before deciding, such as:
2. Please rank three options for supervision:
A student teacher who will observe two or three days a week for six weeks in October and November. In November the student will be in your classroom full time for two weeks. During the November experience the student will complete a supported practicum teaching one class and a Work Sample. The student will not be in your classroom after November.
A practicum student who will observe two or three days a week during the fall and then do full time student teaching during the 2nd semester. During full time student teaching the student will teach the equivalent of one half of a full time teacher's load. The student will not be present at your site during his/her practicum experience in November.
Both a student teacher and a practicum student.
3. My anticipated subject area teaching assignment includes (if unsure put current assignment):
Semester I
Course Grade Level(s)
Semester II
Course Grade Level(s)
4. Please check any of the following that apply to how you teach or to your school organization:
Integrated curriculum (list integrated subjects):
Inquiry Learning
Performance tasks/work samples
Co-operative learning
Block Schedule (indicate AB or 4x4)
Scoring guides for assessment
Service learning/community service
Other:
5. Within the curriculum that I teach, there is the opportunity for a student teacher to explore the use of various teaching strategies:
Yes
No
6. Describe special training or your experience in relation to school reform:
7. What are your professional responsibilities outside the classroom, e.g., coaching, club advisor, 21st Century School Council, etc.?
8. Briefly describe your experience working with other student teachers:
9. Please indicate any other information that you would like us to consider in placing a student teacher with you.

Thank You!