Field Experience Placement Request Form: 2017-2018

Year 1 Students

EDUC 4003 & EDUC 40A3

Name: (Please print) ______

Contact address while at Acadia: ______

Contact address while on practicum: ______

Telephone: ______

Acadia email: ______

Elementary ____ (Secondary ____ 1st teachable______2nd ______)

(If Science or Social Studies list area: eg. Biology or History)

Transportation:

Acadia University is a located in a small town in a rural setting. Therefore many schools will require vehicle transportation to get to and from the school. Supporting a colleague via carpooling is very helpful in this process of placements. The request is that there are shared expenses for the carpool.

We do make an effort to assist with this process by asking the following:

1.  Are you likely to have access to a car for the practicum placements? Yes__ No__

2.  If YES are you willing to transport a colleague? Yes__ No__

3.  Including the driver, the car’s capacity is ______persons.

* Please note* ultimately it is your responsibility to make your own practicum travel arrangements. The university is not responsible for your travel to and from your practice teaching site. The Annapolis Valley Regional School Board encompasses a large geographical area, and schools might be as far as 100 km away from Wolfville.

Practice Teaching Request:

EDUC 4003 Term I: November 23-December 21, 2017

EDUC 40A3 Term II: March 26-April 27, 2018

To assist with the placement please indicate the school and the School Board you are requesting to practice teach. While efforts will be made to accommodate your request, they cannot be guaranteed.

Please note that in AVRSB the schools closest to the university cannot possibly take all students who request them.

Ex. 1) School…Central Kings…
School Board …..AVRSB….

Please do not list schools you attended/worked/volunteered in or where a parent, child, partner or close connection works.

1.  School: ______

School Board: ______

2.  School: ______

School Board: ______

3.  School: ______

School Board: ______

**Students wanting to practice teach in the Halifax Regional School Board must also complete a separate HRSB form.

Please list any special factors that require consideration when making the school placement (e.g., health issues, special placements, any unique contributions you may bring to the school setting or any other factors of which we should be aware).

______

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