PRACTICUM CHECKLIST OF FORMS AND PROCEDURES - CI 351/EE 375

In an effort to assist you in the management of the forms and procedures associated with the Secondary/Elementary Education Practicum (CI 351/EE 375) the following checklist has been prepared. This abbreviated list should be used to guide your experience, knowing that complete details are provided in your course syllabus or in the materials provided in your teacher education program developmental portfolio.

Form Title / Procedure / Final Recipient / Date Completed
Contract for Performance of Practicum Student-
CI 351/EE 375
(Pink) / ·  Filled out by student
·  Reviewed at first meeting with teacher
·  Signed by student and teacher
·  Returned to College Supervisor immediately upon signing / College Supervisor
Practicum Student Profile for Cooperating Teacher -CI 351/EE 375
(Pink) / ·  Filled out by student
·  Reviewed and left with cooperating teacher at first meeting / Cooperating Teacher
Practicum Student Time Sheet - CI 351/EE 375
(Pink) / ·  Filled out by student each visit
·  Reviewed by teacher at end of experience
·  Signed by student and teacher
·  Returned to College Supervisor at practicum exit conference / College Supervisor
Lesson Plan Template –
CI 351/EE 375
(2; Pink) / ·  Filled out by student
·  Reviewed by teacher prior to implementation
·  Completed form submitted to College Supervisor after implementation with self-assessment / Student-placed in teacher education developmental portfolio
Self-Assessment of Lesson Plan –
CI 351/EE 375
(2; Pink) / ·  Filled out by student
·  Submitted to College Supervisor with lesson plan after implementation of lesson / Student-placed in teacher education developmental portfolio
Practicum Student Observation Record -
CI 351/EE 375
(2; Yellow) / ·  Filled out by teacher during lesson implementation
·  Submitted to College Supervisor with lesson plan after implementation of lesson / Student-placed in teacher education developmental portfolio
Reflective Journal Assessment –
CI 351/EE 375
(Pink) / ·  Filled out by student
·  Entries made to journal during each visit in accordance with the observation guide for reflective thinking and journal entries
·  Returned to College Supervisor at practicum exit conference with journal entries attached / Student-placed in teacher education developmental portfolio

(OVER)

Assessment of Practicum Student Performance –
CI 351/EE 375
(Yellow) / ·  Filled out by Cooperating Teacher
·  Reviewed with student at final meeting
·  Returned to College Supervisor at practicum exit conference / Student-placed in teacher education developmental portfolio
Assessment of Cooperating Teacher - CI 351/EE 375
(Pink) / ·  Filled out by student
·  Returned to College Supervisor at practicum exit conference / College Supervisor

C:\Documents and Settings\education01\My Documents\C&I Practica\CI 351 & EE 375\CI 351 Practicum Checklist of Forms and Procedures.doc

Revised on 1/24/2007