TEFB 406 Placement Application

First Name

Last Name

UIN

TAMU Email

Phone

Select section and field day/time:

Select your certification area:

Other Certification Area

Select your certification program:

Select your TAMU campus:

College Station

Galveston

Have you completed a field experience in any other course (e.g. TEFB 324)?

Yes

No

Select any/all campuses to which you have been previously assigned.

A&M Consolidated High

Aggieland High (ILT)

Bryan High

College Station High

Rudder High

College View High School CSISDCollege View High School CSISD

List all teachers observed:

Last names only

List all subjects observed:

If you have a relative or child at an area school, list the campus.

Emergency Contact Name

Emergency Contact Phone

Please explain any extenuating circumstances that might affect your placement.