Student Teacher Application

Thank you for choosing Irving ISD! This application is for clinical teaching and/or early field experience in coordination with your Educator Preparation Program.

For observation hours only, please complete the Volunteer Application (background check) and contact your preferred campus directly to accommodate the request.

Last Name

First Name

Middle Name

Maiden/Former Name

SSN (XXX-XX-XXXX)

Date of Birth

mm/dd/yyyy

Email Address

Phone Number

Phone

Current Address

City

State

Zip Code

Driver's License/ID Number

Driver's License/ID Issuing State

List all cities and states in which you have lived as an adult:

University or Alternative Certification Program (ACP) Information

Name of University/ACP

Anticipated Graduation Date

University/ACP Placement Coordinator

Coordinator's Email Address

Certification

Target Certification Area

Placement Information

Preferred Campus

Semester

Placement 1 Dates

Placement 1 Grade/Subject

If you need two separate placements for different grade levels or content areas, please complete the information for Placement 1 and Placement 2.

Placement 2 Dates

Placement 2 Grade/Subject

Please provide any other relevant information:

Attachments

Upload a syllabus or letter from your university or alternative certification program documenting your required student teaching hours, a copy of your picture ID, and your current resume.

Drop your files here

Criminal History Information Release

Acknowledgement

Per Senate Bill 9 and Texas Education Code 22.083, school districts are required to conduct national criminal history checks for all applicants for employment as well as student teachers, volunteers, and classroom observers prior to serving. I understand that the preceding information will be used by the Irving ISD to obtain criminal history information about me. This information is confidential and will be shared with no one without my permission.

Acknowledgement

Send me a copy of my responses

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