ON-THE-JOB INTERNSHIP APPLICATIONS MUST MEET THE FOLLOWING CONDITIONS

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1 ON-THE-JOB INTERNSHIP APPLICATION PAGE 1 ON-THE-JOB INTERNSHIP APPLICATION Towson University Department of Special Education, Hawkins Hall York Road, Towson, MD (Phone) (Fax) To be completed by a Teacher Candidates using current employment as a teacher in an inclusive setting for an internship placement. Teacher Candidates requesting Towson University identify the internship placement. DO NOT complete this application. The application for a Towson University identified internship placement can be found in the Teacher Candidate Handbook appendices Our greatest concern is all interns receive adequate support and supervision during the internship experience. Periodic visits from a university supervisor cannot fill the gap created by the absence of daily modeling and feedback from a qualified mentor. The purpose of this application is to ensure the on the job intern is getting the support needed from a qualified mentor teacher, university supervisor, and school officials. ON-THE-JOB INTERNSHIP APPLICATIONS MUST MEET THE FOLLOWING CONDITIONS to be considered for approval: 1. An appropriate mentor teacher must be identified to provide support and feedback to the intern during the internship period on a regular and consistent basis. The teacher candidate may identify a mentor teacher themselves or have a principal at their school select a teacher who is currently (a) certified in Special Education, successfully taught for a minimum of two years as a special educator. 2. The teacher candidate s position/teaching assignment for the on the job internship must include students requiring modifications, adaptations, or accommodations to the Maryland Voluntary State Curriculum (VSC). This can include students currently on IFSP, IEP s or those currently in the special education assessment process 3. The on-the-job internship must provide the intern with experiences at the grade levels in which they seek licensure. 4. The intern must be consistently supported by a mentor teacher who is licensed and experienced in special education. 5. The intern must complete the full period of internship prescribed for the state-approved program. Presently the prescribed internship period is a minimum of 180 hours of supervised field experience. 6. If the intern currently holds a position other than as a full-time teacher (in an inclusive classroom), the intern s employer must approve the change in the intern s employment status to fulfill the requirements stated above.

2 ON-THE-JOB INTERNSHIP APPLICATION PAGE 2 STEPS FOR APPLYING CHECK APPROPRIATE DEADLINE FOR YOUR APPLICATION. Applications must be signed by your advisor before being submitted to the Center for Professional Practice. Submit one complete packet to your advisor for review at least 2 weeks prior to the deadline. Spring On-The-Job Applications Due October 1 st Fall On-The-Job Applications Due May 1 st **Note: Only complete internship application packets submitted by the deadline will be processed. STEP 1. Complete the TIMs on-line registration. Directions for completing this can be found elsewhere in this packet. STEP 2: COMPLETE ON-THE-JOB INTERNSHIP APPLICATION PACKET. A complete on the job internship application packet includes ONE (1) copy of the following: On-the-Job Internship application form Administrative Approval Page with REQUIRED signatures Application for Graduation Copy of Unofficial Transcript(s) STEP 3: OBTAIN ADVISOR S SIGNATURE. Your application must have your advisor s signature before it will be forwarded to the Center for Professional Practice Office. Submit one complete packet including all supporting documentation to the Graduate Program Director at least two weeks prior to deadline stated at the top of this page. Teacher Candidates are encouraged to meet with their advisor at this time to review their program status and plan for internship. STEP 4: SUBMIT COPIES OF THE COMPLETED APPLICATION PACKET, WITH REQUIRED SIGNATURES TO THE GRADUATE PROGRAM DIRECTOR (HH 404A). Alternatively, a complete application packet can be mailed to the address at the top of this application. Teacher Candidates are strongly encouraged to retain a copy of the internship application packet for their records. STEP 5: REGISTER FOR SPED 741: INTERNSHIP. All Teacher Candidates must have advisor consent to register for SPED 741. Advisor consent will be gained when the internship application packet has been approved. PRAXIS II: TEACHER CANDIDATES ARE ENCOURAGED TO REGISTER AND TAKE THE PRAXIS II (# 0352 & # 0353) THE SEMESTER PRIOR TO ANTICIPATED INTERNSHIP YEAR. Results of the PRAXIS II examination will be posted on the ETS website. Teacher Candidates are requested to submit a copy of their test results to Towson University, College of Education, Hawkins Hall 304, 8000 York Rd, Towson, MD

3 ON-THE-JOB INTERNSHIP APPLICATION PAGE 3 ON-THE-JOB INTERNSHIP APPLICATION APPLICANT INFORMATION: Internship semester: Fall Spring Year: Name: Last First Middle Initial Student ID # TU Current Address Street City State Zip Current Phone: Day Evening Cell: I am in Towson University campus Program I am in a cohort program in County ON-THE-JOB INTERNSHIP SETTING/INFORMATION (TO BE COMPLETED BY THE TEACHER CANDIDATE): District/County: School: SPED 741 Internship: 6 credit hours. During my internship, I will work as a teacher in a to students in grade/s Type of classroom setting Grade Levels with. I will teach Disabilities Subject(s) Note: During the internship/s, Teacher Candidates must work with students identified with disabilities. If you do not have students in your classroom with disabilities, please consult with your principal on ways to work with students with disabilities during your internship. I certify the information provided in this application is accurate and as part of this position I will develop student IEP s, lesson plans, and participate in meetings regarding student progress. My teaching responsibilities will include direct instruction, co-teach support and/or small group direct instruction. I understand I will be responsible for reporting student progress toward IEP goals and objectives and classroom standards. If my position changes, I will notify my advisor and the Center for Professional Practice. I understand if the parameters of my position change, I may no longer be eligible for an on-the-job internship. I certify I have completed all endorsement requirements and pre-requisites and will conduct myself in a professional manner at all times during my internship. Should I withdraw or defer my application, I will be responsible for all fees incurred and for alerting my University Supervisor, Program Advisor, and the Center for Professional Practice via a written request. Signature of Internship Applicant: Date:

4 ON-THE-JOB INTERNSHIP APPLICATION PAGE 4 ON-THE-JOB ADMINISTRATIVE APPROVAL MENTOR TEACHER INFORMATION: Note: The mentor teacher should be someone with a minimum of 2 successful years of teaching experience and who is licensed in the area Special Education. The mentor teacher will provide written and verbal feedback regarding lesson planning and classroom instruction. S/he will meet with the intern no less than every 2 weeks to complete university paperwork. Name: Phone: Area/s of licensure/endorsement (exclude provisional/conditional): Years of teaching experience: Briefly describe the agreed upon schedule for meetings/feedback between the intern and mentor teacher: I certify the information above is accurate, and I agree to fulfill the responsibilities of the mentor teacher, as outlined in the Teacher Candidate Handbook during the period of the applicant s internship. Signature of Mentor Teacher: Date: PRINCIPAL APPROVAL: I certify the descriptions of the on-the-job internship setting and mentor teacher are accurate and that the school administrative officials are aware and have agreed to make any necessary changes in employment status to fulfill the onthe-job internship. Name of Principal: Date: Signature of Principal: ADVISOR REVIEW (TO BE COMPLETED BY ADVISOR): I certify the teacher candidate has completed all required course work to participate in this internship and meets the standards for a professional disposition, and have reviewed the setting and supervision of the applicant s current employment and agree that the placement is conducive to fulfilling the requirements of the internship. Advisor: Date: ASSISTANT DIRECTOR OF CENTER FOR PROFESSIONAL PRACTICE: I certify the teacher candidate has on file a completed application and has registered for TIMS. The requested internship placement and mentor teacher have been approved by this office. Signature: Date:

5 ON-THE-JOB INTERNSHIP APPLICATION PAGE 5 Criminal background paper Page 8 is TIMs registration.

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