Single Subject Internship Eligibility Form
Intern Applicant Name: ___________________________ Student ID: ____________ Subject Area: ____________
Admission Requirement Checklist
This section is to be completed by the Intern Applicant.
Undergraduate Degree: From an accredited college or university.
U.S. Constitution: Complete a course in the U.S. Constitution (with a ‘C’ or better) or pass an approved exam.
Admission to Fresno State and the Single Subject Credential Program
Subject Matter Competency: Subject Matter Competent either by CSET exam, coursework, or degree.
Course Prerequisites
Eligibility requires 120 hours or 9 units of coursework. Please list courses that meet this requirement.
This section is to be completed by SS Credential Coordinator.
| Completed | Term/Year | Course | Course Name | Units |
|---|---|---|---|---|
| CI 180T | Introduction to Pedagogy Curriculum Development | 3 |
Educational Plan
This section is to be completed by the Intern Applicant and verified by SS Credential Coordinator.
| Completed | Term/Year | Course | Course Name | Units |
|---|---|---|---|---|
| CI 151 | Social Contexts of Teaching and Learning | 3 | ||
| CI 152 | Adolescent Learning and Development | 3 | ||
| LEE 157 | Teaching English Learners in Secondary Classrooms | 3 | ||
| CI 161 | Methods and Materials in Secondary Teaching | 3 | ||
| EHD 155A | Initial Student Teaching: | 4 |
ロ Initial Student Teaching
ロ 1st Semester of Internship
| Completed | Term/Year | Course | Course Name | Units |
|---|---|---|---|---|
| EHD 154A | Initial Student Teaching Seminar | 1 | ||
| SPED 158 | Differentiated Instruction in Inclusive Secondary Settings | 3 | ||
| LEE 156 | Content Area Literacy and Communication in Secondary Classrooms | 3 | ||
| EHD 155B | Final Student Teaching: ロ 2nd Semester of Internship ロ 1st, 2nd Semester of Internship (5, 5) |
10 | ||
| EHD 154B | Final Student Teaching Seminar | 1 |
Applicants must initial beside each program policy and authorization to acknowledge they have read and understood each item:
| Initial | Policy |
|---|---|
| _______ | Single Subject Teacher Candidates must have successfully completed EHD 155A or CI 180T |
| _______ | All interns are encouraged to meet with their advisor when modifying their professional preparation program educational plans. |
| _______ | A 3.00 overall GPA must be maintained in credential coursework, with no grade lower than a ‘C’. |
| _______ | ALL interns must be enrolled in a field placement course during their duration of the internship. |
| _______ | All credential coursework must be completed no more than five (5) years prior to program completion. |
| _______ | Teacher credential candidates who are not continuing interns but who have completed all credential coursework are not allowed to apply to the Teacher Internship Program. |
| _______ | Clinical practice hours for credit may be earned only through student teaching or while teaching under a university internship credential in public schools, pre-approved charter schools or pre-approved non-public schools, within the university’s service area. (CCTC Intern Specific Preconditions, May 2011, page 3). |
| _______ | Fresno State does not accept field placements or internships in private, charter, or online schools not affiliated with an approved public school district outside the 45-mile radius from Fresno State. |
| _______ | Fieldwork placements, including placements as teacher of record, are at the discretion of the program, not the candidate nor the employer. (CCTC Intern Specific Preconditions, May 2011, page 6). |
| _______ | Teachers of record working under a temporary permit including STSPs, PIPs, substitute including long term permits, emergency permits or other permits must move to a university internship credential to receive credit for fieldwork experience while employed as the teacher of record. |
______ A salary deduction of $1,600 per semester will occur through district payroll.
I certify that all information I have provided in this internship application is accurate and I understand the requirements of the Teacher Internship Program. I also understand that failure to meet internship and program requirements each semester may result in the termination of the internship and possible dismissal from the credential program.
Intern Applicant’s Signature Date
Program Coordinator Verification
Transcripts Reviewed
If enrolling in 155A: Completed (or enrolling in) CI 180T
Subject Matter Competency is met by:
CSETs
Subject Matter Prep Program/Coursework
Program Coordinator’s Signature Date
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