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First Name
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Last Name
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District Email
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School District
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Bryan ISD
College Station ISD
IL Texas
BISD Campus Name
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Bonham Elem
Bowen Elem
Branch Elem
Bryan High
Crockett Elem
Davila Middle
Fannin Elem
Henderson Elem
Houston Elem
Johnson Elem
Jones Elem
Long Inter
Kemp-Carver Elem
Mitchell Elem
Navarro Elem
Neal Elem
Rayburn Inter
Ross Elem
Rudder High
Sadberry Inter
SFA Middle
CSISD Campus Name
(Required)
AMC Middle
AMC High
College Hills Elem
College Station Middle
College Station High
Creek View Elem
Cypress Grove Inter
Forest Ridge Elem
Greens Prairie Elem
Oakwood Inter
Pebble Creek Elem
Pecan Trail Inter
River Bend Elem
Rock Prairie Elem
South Knoll Elem
Southwood Valley Elem
Spring Creek Elem
Wellborn Middle
Grade
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Pre-K
Kinder
1
2
3
4
5
6
7
8
9-12
Content Area
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All Subjects
ELA
Math
Science
Social Studies
Other
Other content
List specific content taught (e.g. Algebra, Biology, etc.)
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Do you teach in a dual language or bilingual program?
(Required)
No
Yes
Select which best describes your classroom
Instruction in English with little/no Spanish support (student will be monolingual if assigned)
Instruction in English and Spanish (student will be bilingual if assigned)
Instruction in Spanish (student will be bilingual if assigned)
Total years experience
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Have you hosted a TAMU student before?
(Required)
Yes
No
Number of days/week you are willing to host Aggies
(Required)
1
2
3
4
Best time to host students
(Required)
ALL DAY
Mornings ONLY
Afternoons ONLY
Unsure at this time
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Qualifications for hosting a clinical teacher
(Required)
To be considered to host a clinical teacher you must meet the following required cooperating teacher guidelines:
3+ years teaching experience;
current Texas teaching certification (in primary certification category of clinical teacher);
accomplished educator (as shown by student learning);
willingness to complete cooperating teacher training and report clinical teacher’s progress to supervisor;
commitment to guide, assist and support clinical teacher in planning/classroom management/instruction/assessment/working with parents/obtaining materials/district policies.
I confirm that I meet the outlined qualifications.
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List your current teaching certification(s)
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For verification, visit https://secure.sbec.state.tx.us/SBECONLINE/virtcert.asp
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ESL certification
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Yes, I have a current ESL certification
No, I do not have a current ESL certification
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Name on TEA certificate
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TEA ID
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Are you willing to host an early field student if not assigned a clinical teacher?
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Yes
No
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Provide 3 words to describe your teaching style and elaborate/explain
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Share any additional information as necessary
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