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INFORMATION SHEET FOR EDUCATIONAL ADMINISTRATION PRACTICUM

 

(COMPLETE AND RETURN TO YOUR MSU SUPERVISING PROFESSOR)

 

Name:                                     ________________________________________________

 

Current position:                     ________________________________________________ 

 

School:                                    ________________________________________________

 

MSU’s Student Number:            ________________________________________________

 

Mailing Address:                      ________________________________________________

 

E-mail address:                       ________________________________________________

 

Names of Cooperating Administrators:

 

1.__________________     School: _________________      County_________     Ph._________

 

 

2.__________________     School: _________________     County_________     Ph._________

           

 

3.__________________     School: _________________     County_________     Ph._________

 

   

 

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Elementary School Cooperating Administrator Consent

 

 

____________________________________ has enrolled in a practicum at Morehead State University . The student will select from the activity areas outlined in the attached information to shadow you. The student is asked to spend a minimum of ___ hours working with you. These hours may be arranged at the convenience of the public school cooperating administrator and the student. No more than five (5) hours may be duty assignment (bus, cafeteria, ball games, etc.).

 

I, the undersigned cooperating administrator, do hereby accept the above-named student. I will assist in supervising his/her activities for the required amount of time this semester. I understand my responsibilities outlined in the program.

 

 

_____________________________                    ____________________________________        _____________

Name of Cooperating Administrator                Signature of Cooperating Administrator                Date

 

 

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Middle School Cooperating Administrator Consent

 

 

____________________________________ has enrolled in a practicum at Morehead State University . The student will select from the activity areas outlined in the attached information to shadow you. The student is asked to spend a minimum of ___ hours working with you. These hours may be arranged at the convenience of the public school cooperating administrator and the student. No more than five (5) hours may be duty assignment (bus, cafeteria, ball games, etc.).

 

I, the undersigned cooperating administrator, do hereby accept the above-named student. I will assist in supervising his/her activities for the required amount of time this semester. I understand my responsibilities outlined in the program.

 

 

_____________________________                    ____________________________________        _____________

Name of Cooperating Administrator                Signature of Cooperating Administrator                Date

 

 

***************************************

 

High School Cooperating Administrator Consent

 

 

____________________________________ has enrolled in a practicum at Morehead State University . The student will select from the activity areas outlined in the attached information to shadow you. The student is asked to spend a minimum of ___ hours working with you. These hours may be arranged at the convenience of the public school cooperating administrator and the student. No more than five (5) hours may be duty assignment (bus, cafeteria, ball games, etc.).

 

I, the undersigned cooperating administrator, do hereby accept the above-named student. I will assist in supervising his/her activities for the required amount of time this semester. I understand my responsibilities outlined in the program.

 

 

_____________________________                    ____________________________________        _____________

Name of Cooperating Administrator                Signature of Cooperating Administrator                Date