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ATU - Elementary Education Field Experience Placement Spring 2018
Please complete the following form in full in order to receive your placement(s) for the fall semester.
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First Name
*
Your answer
Last Name
*
Your answer
Student T#
*
Your answer
One Tech e-mail
*
Your answer
Where do you currently live during the school week?
*
Example: Tech Campus - Russellville, Ozark, Harrison, etc.
Your answer
Are you currently employed by a public school?
*
Choose
Yes
No
If yes, provide the position and the school district/city.
Example: Teacher's Aide - Two Rivers School District/Ola
Your answer
Do you have relatives employed by a public school in Arkansas?
*
Choose
Yes
No
If yes, provide their relationship to you, their position/grade level, and the school district.
Example: Father - Principal - Atkins School District
Your answer
Do you have children attending an Arkansas public school?
*
Choose
Yes
No
If yes, please list their relationship to you, the name of the school and district, and their grade level.
Example: Daughter - Rogers High School - 11th Grade
Your answer
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