Practicum/Student Teaching Clearance Form

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All teacher candidates are required to complete and return clearance forms to Human Resources prior to commencing field experience work or student teaching. You will be notified via email when your application has been cleared. Please direct any questions pertaining to this form and/or its stipulations to Janet Rico Uhrig at Janet.RicoUhrig@tusd1.org

Notice of Nondiscrimination
Tucson Unified School District does not discriminate on the basis of race, color, national origin, gender, sexual orientation, age, religion, or disability in admission or access to, or treatment or employment in its educational programs or activities.

First Name *

Last Name *

Please Select one: *

Practicum

Student Teaching

Email Address *

Mailiing Address

Phone Number *

Cooperating/Mentor Teacher Request *

Please fill in a name of the cooperating or Mentor teacher you are requesting

School *

Please fill out the name of the school you are requesting placment

University/ College Affiliation *

Major/Minor Field

Expected Graduation Date

State of Arizona Fingerprint Clearance Card number *

Please enter Card number

State of Arizona Fingerprint Clearance Card expiration date *

Please enter card expiration date

Arizona Educator Proficiency Assesment (AEPA)/National Evaluations Series(NES)

This field is not required.

I have taken the following

I will be taking the following Subject Knowledge Exams

I plan to take my assessments closer to graduation

Please fill out the Subject Knowledge Exams and Date taken or scheduled (or NA)

Out of State Scheduled Assessments(if applicable)

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