Dear Cooperating Teacher,

Thank you for hosting a student teacher from New York University. We appreciate your support and mentorship of our students and our teacher education programs. As compensation, we will assign you three (3) credits of tuition remission, valid for one year after the end of the current semester. You will receive your award letter and the related instructions by the end of the semester. To facilitate the compensation process, we need your updated contact information. Please complete the form below.

Cooperating Teacher Information

Supervisor’s Name: ______

Semester: Spring _____ Summer ______Fall _____ Year: ______

Student Teacher’s Name: ______

CT’s Last Name: ______

CT’s First Name: ______

Local Address: ______

City/State: ______Zip Code: ______

Phone: ______E-mail Address: ______

School: ______

Grade Level (lowest grade if multi-level): ______

Subject Area: ______

**This sheet must be returned to your STUDENT TEACHER (not the NYU Supervisor).

The student teacher will update the information on the NYU Apprentice system. **

Dear Partnership School Cooperating Teacher,

Thank you for hosting a student teacher from New York University. We appreciate your support and mentorship of our students and our teacher education programs. As compensation, three (3) credits of tuition remission will be awarded. Partnership Schools have been provided with greater flexibility in terms of how and when the credits may be used. Please check with your school administration as to the procedures specific to your school. Please complete the form below.

Cooperating Teacher Information

Supervisor’s Name: ______

Semester: Spring _____ Summer ______Fall _____ Year: ______

Student Teacher’s Name: ______

CT’s Last Name: ______

CT’s First Name: ______

Local Address: ______

City/State: ______Zip Code: ______

Phone: ______E-mail Address: ______

School: ______

Grade Level (lowest grade if multi-level): ______

Subject Area: ______

**This sheet must be returned to your STUDENT TEACHER (not the NYU Supervisor).

The student teacher will update the information on the NYU Apprentice system. **

239 Greene Street, 2nd Floor | New York, New York 10003-7599

212 998 5460 | 212 995 4049 fax | http://steinhardt.nyu.edu/teacher.education

C:\Documents and Settings\NYU\Desktop\share\Forms\Common Forms\Cooperating_Teacher_Information_Sheet.doc

Updated: 3-23-12