2009 WINTER TERM Recruitment Form: Secondary Mentor Teacher Information

2009 WINTER TERM Recruitment Form: Secondary Mentor Teacher Information

/ 2015 FALL TERM Secondary Recruitment Form

EDFX 350: Introductory Field Experience (5 weeks)Observation Days: Oct. 16, 23 and 30, 2015

5 Week Field Experiences: Nov 9 – Dec 11, 2015

EDFX 450: Advanced Field Experience (9 weeks) Oct 13 – Dec 11, 2015

Please complete and submit to your School Coordinator.

School: ______

Mentor Name: ______Email: ______

School Coordinator:School Coordinator’s Email:______

Honorarium Payment Information:

Check how you would prefer to be paid:Pay to SELF

Pay to SCHOOL

If you selected ‘Pay to SELF’, please provide SIN #: ______

Teaching Assignment:

*Please indicate if it’s a specialized program classroom, i.e. language immersion, LOGOS.

*PHYSICAL EDUCATION teachers should indicate if class is Male, Female or Co-Ed.

Courses Taught This Term / Grade(s) / Approximate Minutes per Week per Subject
Example: English 10-1 / 10-1 / 480
(Example: 2 classes of ELA 10-1 x 3 periods/week x 80 minute periods)

Please note that we only require Mentor Teacher placements in the following subjects for the Fall Term:

EDFX 350: Art, Biology, Chemistry, Physics, General Sciences, CTS, Drama, English, Math, Music (junior high preferred),

PhysEd, Second Languages, Social Studies.

EDFX 450: Biology, Chemistry,Physics, General Sciences, English, Social Studies, PhysEd.Please note that there will be NO

MATH MAJORS completing their 9-week practicum in the Fall term.

Student Teacher Preference:

Course / Order of Preference (1st, 2nd) / Additional Information

EDFX 350

/ For EDFX 350
Yes, I will take 2 students (i.e. 1 mentor with 2 student teachers.)

EDFX 450

/ n/a

Any personal information collected through this form is collected under authority of section 33 © of the Alberta Freedom of Information and Protection of Privacy Act to assign Student Teacher placements for the BEd degree program and to facilitate the payment of Mentor Teacher Honoraria. For information about the collection and use of this information contact: FOIPP Liaison Officer, Undergraduate Student Services, 1-107 Education North, University of Alberta, Edmonton T6G 2G5. Phone: (780) 492-7532 Fax: (780) 492-9496 06/01/2015