Beruflich Dokumente
Kultur Dokumente
COLLEGE OF EDUCATION
Teacher Education Department
The information you provide will be used to help your Cooperating Teacher become better
acquainted with you and guide you during your student teaching activities. Please answer each
question completely and accurately.
Name:
Civil Status: Gender:
Major Field of Study: Birthday:
Home Address: _______________________________________________________________
Barrio/ Sitio/ Town Province/City
Type of community in which you have lived the major part of your life:
__________ Barrio/Sitio ____________ Town/ Poblacion ____________City
Father’s Name: __________________________________
(Last) (First) (M.I)
_____________ Living ____________ Deceased
Grade Finished: _________________________________________________
Elementary High School College
Please check the following which you really like to participate in:
__________a. Reading ___________j. fishing
__________b. meeting ___________k. riding
__________c. conversing with people ___________l. hiking
__________d. art ___________m. swimming
__________e. music ___________n. hunting
__________f. dancing ___________o. camping
__________g. movies ___________p. card playing
__________h. golf/athletics ___________q. chess
__________i. tennis ___________r. photography
What special experiences would you like to get during your student teaching?
______________________________________________________________________________
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Student Teacher Signature Over Printed Name