TEH Appendix F: Request for Permission to Student Teach on the Job
Please note
The information below is provided for reference only and is not the form you will submit. You will complete the official application and return in-person to the Vacca Office of Student Services, Clinical Experiences in 304 White Hall.
Application for Student Teaching on the Job
Please return this application and the two letters of support from your district administration along with a copy of your transcript to the Vacca Office of Student Services, Clincal Experiences, 304 White Hall, Kent, OH 44242.
- Student Teaching Semester
- Year
- Name (Last, First, MI)
- Local Address (Street, Apartment #, City, State, Zip)
- Phone Number
- Previous Address (Street, Apartment #, City, State, Zip)
- Phone Number
- KSU Email Address
- KSU Status (Undergraduate or Graduate)
- Program Area
- Teaching Majors
- Rationale for requesting to student teach on the job
- Attach copies of transcripts
Information 51±¬ÁÏ Your Employment Site
- School District
- Superintendent
- School
- Principal
- School Address (Street, City, State, Zip)
- School Phone
- Grade Level
- Content Area
- Mentor Teacher's Name
- Grade Level
- Content Area
- Student Teacher's Signature
- Date
The Vacca Office of Student Services will complete information below:
- Student Teaching Eligibility Checked: Yes / No
- Superintendent Letter Attached: Yes / No
- Principal Letter Attached: Yes / No
- Copies of Transcripts Attached: Yes / No
- Student Teaching Request: Approved / Denied
- Assistant Director of Clinical Experiences
- Student Notified by: Letter / Phone / Email
Last updated July 25, 2025