University of South Florida
College of Education
Final Internship Application for Graduate and Undergraduate Interns

4202 East Fowler Avenue, Mail Stop 105, Tampa, FL  33620
Tel: 813 974-3440  *  Location: DAC 101


You must complete, type, and print each page of the final internship application.


STUDENT CONTACT INFORMATION

NAME:  First:    Last:

USF ID (Must begin with the letter "U"):  (e.g. U12345678)

DATE OF BIRTH:  (e.g. 03/19/90)      

GENDER:  Male  Female      

USF E-MAIL: 

Present Street Address: 
City, State:  Zip Code: 
Present Phone:  (e.g. 813-999-9999)

If your Present Address is the same as your Intern Address select the checkbox:

Address While Interning: 
City, State:  Zip Code: 
Telephone While Interning:  (e.g. 813-999-9999)


Are you a member of the SunCoast Area Teacher Training & Education Research (SCATTER)? Yes  No

Select the following link to learn more about SCATTER: http://www.coedu.usf.edu/main/SCATTER/scatter.html


Florida Teacher Certification Exam (FTCE)

In order to successfully complete your final internship and graduate, you must submit official passing test scores for all relevant portions of the Florida Teacher Certification Exam (FTCE).

NOTE: Official scores must be submitted to your academic advisor in Student Academic Services, EDU 106, by the Friday following the commencement ceremony.

In the space provided, indicate the date(s) you will be taking or took the FTCE:
(e.g. MM/YY)
FTCE Other:   


DEGREE & MAJOR INFORMATION

Undergraduate Degree:  B.S.   B.A.  B.M. 
Graduate Degree:  M.A.   M.A.T.  M.Ed.  Ed.D.  Ed.S.  Ph.D.

SELECT MAJOR: 
If (and only if) "Other Major" was selected, please indicate the major: 

For interns in Secondary Education or Music Education, please select your preference for grade level: 


Final Semester Interning: 

Semester Graduating, if degree seeking:  (e.g. Semester Year: Fall 2015, Spring 2016, Summer 2016)

Have you ever begun a final internship which you were unable to complete?  Yes   No

If you indicated "Yes", you are required to submit a College of Education Petition along with your application.
The College of Education petition can be found at: http://www.coedu.usf.edu/main/sas/forms.htm

In yes, please indicate the semester and year you were unable to complete your internship:
(e.g. Fall Year or Spring Year)


English For Speakers of Other Languages (ESOL) Endorsement Requirements - Tampa Campus

To graduate from an ESOL endorsed program, you must complete an ESOL Late Field Experience. To learn more, select the following link: http://www.coedu.usf.edu/main/ESOL/ESOL.html

If you need an ESOL Late Field Experience and will NOT be able to satisfy the requirement in a term PRIOR to your final internship, please check "Yes." Yes   No


JUDICIAL HISTORY

Have you ever been arrested, had adjudications withheld, appeared in court, pleaded nolo contendere, or been convicted of any crime?  Yes  No

NOTE: If yes, your arrest may impact your internship placement, graduation, and teacher certification.
Select the following link for instructions: http://www.coedu.usf.edu/main/sas/DisclosureofConviction.htm


PLACEMENT INFORMATION

You are able to request your preference for final internship placement. Your preference is only a request and IS NOT guaranteed! Each academic program can specify where their interns may perform final internship. You may not choose a county outside of the counties designated within your program.
To learn more about the counties and schools your program partners with, please check below:

Program

County Options for Final Internship

Elementary Education (M.A.T.)

Hillsborough

Elementary Education - Cohort (Undergraduate)

Hillsborough, Pasco

Elementary Education - Teacher Residency (Undergraduate)

Hillsborough Partnership Schools ONLY

Early Childhood Education (Undergraduate)

Hillsborough

Counselor Education (M.A.)

Hillsborough, Pasco, Pinellas, Hernando, Polk, Sarasota, and Manatee

Physical Education (Undergraduate)

Hillsborough, Pasco - Weightman MS ONLY

Exceptional Student Education (M.A.T., Undergraduate)

Hillsborough, Pasco

Secondary Education - English, Foreign Language, Mathematics, Science, and Social Science (M.A.T., Undergraduate)

Hillsborough, Pasco, Pinellas, Hernando, Polk, Sarasota, and Manatee

Middle Grades - Mathematics and Science (Undergraduate)

Hillsborough Partnership Schools ONLY

Music Education (Undergraduate)

Hillsborough, Pasco, Pinellas, and Polk

At this time, the College of Education is not placing any interns in the Florida Virtual School for a final internship experience.

COUNTY CHOICE 1:
COUNTY CHOICE 2:

NOTE: Please verify county choice above for accuracy. If you have chosen Polk or Hernando County, please print the respective agreement form found on the following website:


REASONABLE/APPROPRIATE ACCOMODATIONS

Student Academic Services complies with Americans with Disabilities ACT (ADA) guidelines by informing the school district of students who may be eligible for reasonable and appropriate accommodations.

Please indicate any special accommodation(s) needed or placement information that should be considered when arranging the internship assignment, if item does not apply to you, please enter "n/a." If you have indicated a need for reasonable/ appropriate accommodations, please attach verifying documentation.

Disability Accommodations:
If you have a disability, you must attach documentation from University of South Florida's Student Disability Services detailing reasonable and appropriate accommodations and submit with your application. In addition, indicate "Letter attached" in the text box below, otherwise leave "n/a"

Transportation concerns:
If you have transportation needs, attach a letter explaining your circumstance(s) and indicate "Letter attached" in the text box below:

List any schools where you have relatives employed or attending:  

List any schools where you are employed as a coach:


NOTE: Please ensure that the information above is true, complete, and correct before you select the "Submit" button below.

 

 

DATE: