Background Check Form
You may not begin your field placement until a criminal background check has been completed. You will receive an email with instructions and a link to the Criminal Background Check Authorizatoin Form.
Conviction Disclosure Form Printable
Conviction Disclosure Form Online
Students, interns and teacher certification candidates are obligated to report convictions to the certification officer in the Student Affairs Office. You must submit a Conviction Disclosure Form prior to (1) admission to the Teacher Preparation Program and (2) internship placement. Please click on the link above for more information
Exit Performance Description (EPD) Coversheet
The final evaluation of the intern's performance is formally written as an Exit Performance Description (EPD). Both the field instructor and the mentor teacher are responsible for producing individual EPDs representing the intern’s performance for the year based on the Program Standards. An EPD is not a letter of recommendation. It is an evaluative document designed to assess an intern's strengths and weaknesses as a prospective teacher. The EPD is the documentation that supports the final grade in TE 502. The intern may choose to include this document in his/her portfolio or credential materials. Please contact the appropriate program secretary if you need access to this form.
Field Placement Logs
Field placement hours are submitted and Mentors approve submissions in ViaLiveText.com.
Request to Change Internship Year
Please contact the Student Affairs Office in 134 Erickson Hall.
Request for Reinstatement
Please contact the Student Affairs Office in 134 Erickson Hall. This form is for students who request reinstatement into the Teacher Preparation Program following a delay. Students must address the extent to which they have fulfilled all criteria to return to the program. Completion of this form does NOT guarantee an internship placement nor approval to return to the Teacher Preparation Program.
Teaching Major/Minor/Additional Endorsement Change Request
Intern Substitute Teaching Request Form
Before an intern may substitute teach in her or his assigned field placement mentor teacher's classroom, this form must be filled out and signed by appropriate personnel. See Internship Policies for more information about substitute teaching requirements. Please contact the appropriate program secretary if you need access to this form.
Intern Substitute Teaching Report Log
Please print off this form and return it to the Student Affairs Office in 134 Erickson Hall.
Mentor Teacher Application Form
This form is used to collect confirmation of approval from your district/school administrator for your participation as a mentor teacher with the MSU Teacher Preparation Program. Please contact the appropriate program secretary if you need access to this form.
Field Placement Confirmation Form
This form assists our program in collecting confirmation of field placement assignments. Mentor teachers must complete this form in order to gain access to MSU field placement funds.
Assessment of Intern Progress Form
This form should be used as a tool for discussion. Intern, mentor teacher and field instructor complete this form as they prepare for the mid-semester assessment conference and end of the semester evaluation. Please contact the appropriate program secretary if you need access to this form.
Feedback Form on Field Instruction
Field instructors want to be helpful to mentor teachers as they work with interns and your feedback can help them improve their practice. Use this form to evaluate and provide feedback to your field instructor about her or his role in the internship. Please contact the appropriate program secretary if you need access to this form.
Blank Travel Mileage Log
This form must be submitted no later then the 7th of each month, for reimbursement of field mileage for field instructors only. Please see Mileage Reimbursement Policy.
Intern Observation Form
Field instructors will use this to keep and maintain a record of visits and observations you make at your interns' school(s). This form can also be used to keep track of your hours and time in the field