CCM TEACHER EDUCATION PROGRAM. ‘SCHOOL PLACEMENT REQUEST b EDU 111 Teaching in America ~§ Hours of Classroom Observation are Required Requested Schools: Merhatn Township — adesubect "coed lek Grade GREER Grade/Sobect (2 chic) QLOAS BENE, @sscerestame: Courtney Wevenee eou secion_8G516 Adsress: O38 ffiruiewn five SOQOGEM— rw_Long, Valley ___ sore War: O18S3 Telephone wmber: 73 GY DGD3 Cemematladdes: Hoeuener, Couttness @ chadent. com. edu ‘High school Attended: WWOSt Mortis CRMC — Year Graduated: ION ev: student's signature: (guy, HA = pote: AIS fis With rezard to your observation hours, a stricto school may require you to havea criminal history background check and be ‘ingerprinted before you ae alowed to begin/complete your observation hous. Costs associated with this background check and fingerprinting willbe your responsibility. health examination (including the Mantoux test] may also be required. 'Hfor any reason, your schoo! placement i terminated or you are asked to leave your placement, ou must immediately notily your Professor and the Prof, Diana Aria, Special Projects Faculty, inthe Education Department in person andin writing. Her ofice is 12H 323. the school where you ae observing wll also notify Prof. Aria ofthe reason for yur termination, p ‘St agree to contact the school as stated below and complete my observation hours by November 2ist, 2018. Wreck href this student cn be accommodated yes please complete the foowt Asslened to i shlianne Kotha e IEW Haun. Sf: ‘Alani a buf le Cooperating Te | O check here if this student must be interviewed prior to assignment: ity, State, and Zip (Grade Level and Subject no interview i required, student should contact (person) emallor phone number ‘Student to be interviewed by. fp ‘Name, Title and Schoo! mo Phone /email ' agree to accept the above teacher candidate enrolled in CCM's Teacher Education Program. Signed: La a Sree re Date: fees, Z | BD eerie: couny oto ort 14 cet Gr Hang TED, AT On neon hone (13) S05651 tone saese White Copy ~ccm Yellow Copy ~ Student Pink Copy ~ Schoo! District‘CCM TEACHER EDUCATION PROGRAM ‘SCHOOL PLACEMENT REQUEST EDU 211 Behavior Observation -20 Hours of Classroom Observation are Required Mendlra mn “ousnsnip se Ord, Ats oF Sty Requested School Distt: SCHOO | list CE ‘Grade/Subject (1% Choice) Grady Subject (2 choice), Student's Name: COOL tT ey Vtuec £i EDU Section # 319 Address: D3% Caries Ayre cen Lon Nae state: 1ST am: 01853 Telephone under, 413 GU a3 ‘CCM Email address: _Vs\ eae, oui @ Sturt iit cr LAY High School Attended: Wt MACK Cis _ Colne? Year Graduated:_20 | 6 cep: Students signature: Ceti dig ate:_1(3/ 14) With regard te your observation hours, a district or school may requir you to havea criminal history background check and be fingerprinted before you ae allowed to begin/complete your observation hours. Costs associated with tis background check and fingerprinting wll be your responsibilty. A health examination (including the Mantoux test) may also be required, If fer any reason, your schoo! placement is terminated or you ate asked to leave your placement, you must immediately notify your Professor and the Pro. Diana Aria, Special Projects Faculty, in the Education Department in person and in writing. Her offices DH 323. The school where you are observing wil also notify Prof Aria ofthe reason for your termination. 35 agree to contact the school a stated below and complete my observation hours by April 28% 2019 noralieza % do [s+ Or aid. agin {Check her if this student canbe accommodated, If yes, please complete the following: ‘Assigned to: "J “ c 0 Sioa pa Kb) Mun Chet Mia Then Street Ades Seong Tear Boksile yal 0792 + ‘iy, Soe and Zp Sade tee and sated 0) 913-693-107 ie iTvointeview required, staden Should ontaa’[peson) ermal or phone number | 2 check here itis student must be interviewed prior to asignment: | student tobe interviewed by Tame, Tie and School Phone Fema {agree to accept the above teacher candidate enrolled in CM's Teacher Education Program. Signed: Dat 2 Check here if this student cannot be accommodated. Please return form to: County College of Morris, 214 Center Grove Ra., Randolph, NI, 07869. ATT: Cindy Johnson Phone: (973)328-5631 Fax (973) 328-5613 White Copy-CcM Yellow Copy Student Pink Copy Schoo! DistrictCCM TEACHER EDUCATION PROGRAM FIELD OBSERVATION ASSESSMENTIREPORT EDU 111 Teaching in America -§ Hours of classroom observation are required (2 visits) Student's Name: Courtney heuepyer Semester f@Il ioe vier Gacls) Childhved Eeluiccstisa Yer:_2O | School Visited: Teacersnene_Claro® cass Observed:_ NOH vd Wh vd. Assessment Guid ‘Attendance * reported o classroom on time Cooperation + remained in assigned area for duration of + wilingly assisted in any assigned the observation period ‘educational experience + followed the correct attendance procedure Profesional Demeanor Interest + dress was customary forthe particular * expressed interest and enthusiasm in the school classroom observation experience + adcesed students and faculty with + came prepared with all necessary noe- ‘rofssional courtesy and respect, ‘aking materials ““S” Satisfactory ~ Candidate's performance met or exceeded normal expectations. “U" Unsatisfactory ~ Candidate's performance substantially below minimal expectations, ‘Your evaluation will be shared with the student as part oftheir course grade. First Visit | Second Vist Date: njuli6| Date: ‘Attendance | Tnterest 5 Cooperation |S Demeanor ‘Comments or feedback othe student or nstructor:_ “Et WOS Q. pleosure to Please return this completed evaluation form in the enclosed envelope as soon as the students field ‘experience is completed. Thank you!