Colorado state university educator licensing program school of education student teaching placement request

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Content Exam

Speech or Oral English Exam

GPA – Cumulative

Advisor’s Sum. Form or Contract



Term (Fall or Spring)


1. Name

2. Social Security Number:

3. eID (for WebCT purposes only)

4. Local Phone:

5. E-mail Address:

6. Teaching Endorsement (art, English, etc.)

7. Specialties:

8. Former High School Name and Location

9. PLACE or Praxis II Exam Status

Have you passed the exam? If yes, indicate which exam (PLACE or Praxis) you passed and the date (m/d/y) of the exam administration.

REQUIRED ATTACH a copy of your score report.

If you have not taken the exam, when do you plan on taking and passing the exam?

10. CSU Teacher Education Program Field Experience sites:

School or Site



(Press the "tab" key at the end of the last row if you need more rows for your information.)
The following information is intended to provide the Teacher Licensure Office with sufficient information to begin the placement process. It does not guarantee a placement at any one level or specific location.
11. Level Preference (Secondary Candidates Only, Please Rank, 1st choice, 2nd choice)

Junior High

Senior High

No preference

12. Level Preference (K 12 Candidates Only, Indicate preferences for secondary level; elementary level required)­­


Junior High

Senior High

No preference for secondary level

13. Level Indication - ECE Candidates Only – Candidates will complete an 8-week experience at both the pre-kindergarten and

kindergarten-3rd grade sites.

14. Location Preference (Please Rank – 1 = first choice; 6 = last choice)

Larimer, Weld, St. Vrain, or Boulder areas (estimated 10-60 minute commute from Ft. Collins [does not include Denver area])

Denver Metropolitan Areas (DPS, Cherry Creek, etc). Specify District:

Douglas County. Specify District:

Colorado Springs Area. Specify District:

Out-of-State. Please explain:

Other. Please explain:

15. If there is any further information that would be of benefit in placement, please explain (e.g., name and contact information of a mentor teacher with whom you would like to complete student teaching. Providing this information does not guarantee this placement.) Use additional pages as needed.

Student Teacher Placement Policies and Eligibility Information

  • All placements are done through the Teacher Licensure Program. The Director of Teacher Licensure holds final approval for all student teaching placements. While every effort will be made to place candidates according to their preferences in location and level, candidates must be aware of the limitations of local schools, teachers, and programs. Candidates should be prepared to be placed outside the immediate Fort Collins area.

  • Candidates will not be permitted to student teach in a school where close relatives are employed or attending.

  • Taking additional course work during student teaching is strongly discouraged. Part time work outside of school hours is discouraged, but, if necessary, week end, part time work may be possible.

  • The student teaching application will be sent to one school at one time for consideration.

  • The application will not be pulled back from the school unless the school has determined that a placement is not possible.

  • The PLACE® or the Praxis II Content exam must be passed and scores submitted to the Licensure Office by December 20. There is no waiver of this policy.

  • Additional information may be found on the student teaching website or in the Student Teaching Handbook.

I understand and agree to the following with regard to student teaching through the Educator Licensing Program at Colorado State University. I hereby certify that to the best of my knowledge the information furnished on this application is true and complete without omission or misrepresentation of facts. I understand that if found to be otherwise, it is sufficient cause for rejection of this application or dismissal from the Educator Licensing Program.

  • The Teacher Licensure Office will make all student teaching placements. My preference will be taken into account as one of the considerations in the placement process.

  • Should I decline a placement, once it is confirmed, a future placement will be attempted but a subsequent placement is not guaranteed.

  • The University reserves the right to not place a candidate for student teaching on the basis of unacceptable academic and/or personal fitness/performance.

  • My cumulative GPA must be a 2.75 to start my student teaching experience.

  • All grades in content and education courses must be C or above to start my student teaching experience. (Incomplete grades are not acceptable and will be considered as a course not taken.)

  • I must pass the PLACE® or the Praxis II Content exam prior to starting my student teaching experience. The exam must be passed and scores submitted to the Licensure Office by December 20. There is no waiver of this policy.**

  • I understand that everything humanly possible will be done to find me a student teaching placement but, due to a variety of reasons including my endorsement area having an oversupply of candidates, school capacities, principal or teacher preferences, school district deadlines or expectations, or other factors, my placement is not guaranteed.

  • After submitting my student teaching application, if I choose not to student teach the following semester, I must notify the Teacher Licensure Office staff in writing as early as possible and no later than two weeks prior to the beginning of the student teaching experience. If I decide to student teach in a future semester, I am required to submit a new application for student teaching and meet any and all due dates and other deadlines. I may be required to meet with the Program’s Admission and Retention Committee prior to any action taken on my request to student teach.

  • I have read and agree to abide by the NEA Code of Ethics found on the final pages of this application.

Signature: ____________________________________________________ Date: ____________________________

** As of May 2004, candidates in English, Mathematics, Science, and Social Studies may select to take and pass either the PLACE® or the Praxis II exam. If taking the Praxis II exam, students must pass the following exam:

#0041 for English

#0061 for Mathematics

#0435 for Science

#0081 for Social Studies
Candidates in all other areas not mentioned above may only take and pass the PLACE® exam.
Do not submit with student teacher application. For review purposes only.
Code of Ethics of the Education Profession

The educator, believing in the worth and dignity of each human being, recognizes the supreme importance of the pursuit of truth, devotion to excellence, and the nurture of the democratic principles. Essential to these goals is the protection of freedom to learn and to teach and the guarantee of equal educational opportunity for all. The educator accepts the responsibility to adhere to the highest ethical standards.
The educator recognizes the magnitude of the responsibility inherent in the teaching process. The desire for the respect and confidence of one's colleagues, of students, of parents, and of the members of the community provides the incentive to attain and maintain the highest possible degree of ethical conduct. The Code of Ethics of the Education Profession indicates the aspiration of all educators and provides standards by which to judge conduct.
The remedies specified by the NEA and/or its affiliates for the violation of any provision of this Code shall be exclusive and no such provision shall be enforceable in any form other than the one specifically designated by the NEA or its affiliates.
Commitment to the Student
The educator strives to help each student realize his or her potential as a worthy and effective member of society. The educator therefore works to stimulate the spirit of inquiry, the acquisition of knowledge and understanding, and the thoughtful formulation of worthy goals.
In fulfillment of the obligation to the student, the educator--

  1. Shall not unreasonably restrain the student from independent action in the pursuit of learning.

  2. Shall not unreasonably deny the student's access to varying points of view.

  3. Shall not deliberately suppress or distort subject matter relevant to the student's progress.

  4. Shall make reasonable effort to protect the student from conditions harmful to learning or to health and safety.

  5. Shall not intentionally expose the student to embarrassment or disparagement.

  6. Shall not on the basis of race, color, creed, sex, national origin, marital status, political or religious beliefs, family, social or cultural background, or sexual orientation, unfairly--

    1. Exclude any student from participation in any program

    2. Deny benefits to any student

    3. Grant any advantage to any student

  7. Shall not use professional relationships with students for private advantage.

  8. Shall not disclose information about students obtained in the course of professional service unless disclosure serves a compelling professional purpose or is required by law.

Commitment to the Profession
The education profession is vested by the public with a trust and responsibility requiring the highest ideals of professional service.

In the belief that the quality of the services of the education profession directly influences the nation and its citizens, the educator shall exert every effort to raise professional standards, to promote a climate that encourages the exercise of professional judgment, to achieve conditions that attract persons worthy of the trust to careers in education, and to assist in preventing the practice of the profession by unqualified persons.

In fulfillment of the obligation to the profession, the educator--

  1. Shall not in an application for a professional position deliberately make a false statement or fail to disclose a material fact related to competency and qualifications.

  2. Shall not misrepresent his/her professional qualifications.

  3. Shall not assist any entry into the profession of a person known to be unqualified in respect to character, education, or other relevant attribute.

  4. Shall not knowingly make a false statement concerning the qualifications of a candidate for a professional position.

  5. Shall not assist a non-educator in the unauthorized practice of teaching.

  6. Shall not disclose information about colleagues obtained in the course of professional service unless disclosure serves a compelling professional purpose or is required by law.

  7. Shall not knowingly make false or malicious statements about a colleague.

  8. Shall not accept any gratuity, gift, or favor that might impair or appear to influence professional decisions or action.

Adopted by the NEA 1975 Representative Assembly

Code of Ethics from the National Education Association’s Website:
National Education Association

1201 16th Street, NW

Washington, DC 20036


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