On a 1/4~5/2i/|4 Student Teaching Dates:, ois 14 = FIELD EXPERIENCE.RECORD fi The following form is on the S-drive under Education Dept. Complete this form on the hard drive and DO NOT SAVE to the hard drive. Make two copies, one that you will give to your EDU 411 Seminar instructor and one for yourself. Your grades for Student Teaching and the Student Teaching Seminar will not be submitted to the Registrar until this form is delivered to your 411 instructor. Part A STUDENT TEACHING Name of Student teacher: Amand purhan Name of College supervisor: [)/, Snepardson . First placement (school and grade level: PEP] Yu Elementary ~ 4" grace Name of Sponsor Teacher: MS. LINE illete Dates: 2/04]!4- 3/14/14 If Special Ed.- students (number and disability): Requian I general ed. Number of hours: | (98 Seeond placement (school and grade level): NEE Elemnentar - 3rd qn unde Name of Sponsor Teacher: MY. ‘Angie (aK bates: 3/17/14 - 5/21/14 | edu- inclusive If Special Ed, — students (number and diSability): * i U et S Number of hours; = OR 332Part B FIELD PERIODS — Fill in 1 for each of your required Field Periods Regular! High Needs ~ Course #_31| Name of sco Kiem South Elementary Location of Schoo! NE aE Name of Supeiing Teachers MISS Katie HaMSon crosarae 2™ Qfade inclusive Subject Areas, Identify Disabilities in the Classroom( if applicable) ieclletually d Sabitd, Deseription of 4... | Experiencas ASIST in + Class, Corrected a Special Education/High Needs - Course #_4) 2: Name of School {NA E nt Location of sco Penfitld, NY hae tit Teachers) MOS. Cie Tdrritn eradeiage 34 grade Special tduintion areas. Special ae Self contminedIdentity disabilities present in classroom_If all [SAbI mM. OH D. OH) Eesha i the /tarni rovidra LL aide # 1 seat ae Part C Other Field Periods and Experiences (e.g.-Dundee Tutoring) Location of schoo_Pentitld, SNM s 5 tage Eat ag Name of Supervising Teaches): Miss AMANMA Durr a cracarage 5" rade Subject aveas_2CQUIAL Idéhtify Types of Students (if Ne Desoription of Experiences, ASG wi if Corrected papers. Small gfoup Work fp vin ica u)Name orseroo Kechter Koriry Sunshine Cunp Location oferdet LUSH aMNG' nition Ai Wns ign MA Name of Supervising Feaskeds: OUFMN NfviN Graco AOC ads Zc nsnsori irene nih. Mais Subject hiss Manta «physical disabilities _ Identify Types elle, applicable) Autism, ADHD, Down Syndron Gi OHL, Cerebral Palsay, imbelieetudly disabled Reseiponof i 7-2\) wih adtvinizs during rt. Him Ofer +) niglat