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Forms & Documents

All the forms on one page:

F005-b Intern Information .DOC format  or F005-b .PDF format

F010-b Mentor Information .DOC format  or F010-b .PDF format

F015-a Mentor Teacher Schedule .DOC format  or F015-a .PDF format

F020-b Orientation/First Supervisor Visit .DOC format  or F020-b .PDF format

F023-a .PDF format  Michigan: Police Records Check  

F024-a .PDF format Ontario: Police Records Check  

F025-b .PDF format Criminal History Disclosure 

F030-b Intern Contract  .PDF format

F035-a Code of Ethics  .PDF format

F040-a Activities Checklist  .PDF format

F045-a Observation Request .PDF format

F050-a Focused Observation Guide .PDF format

F055-b Attendance Log .DOC format  or F055-b .PDF format

F060-a Class Description Profile .DOC format  or F060-a .PDF format

F075-a Activities Log .PDF format

F080-a Personal Goals/Objectives .DOC format  or F080-a .PDF format

F085-a Lesson Plan .DOC format  or F085-a .PDF format

F090-a Reflection on Lesson/Self-Evaluation .DOC format  or F090-a .PDF format

F095-a Unit Plan .DOC format  or F095-b .PDF format

F100-a Critique of Unit Plan  .PDF format

F104-a Technology Skills Survey .DOC format  

F105-b Incorporating Technology .DOC format  or F105-b .PDF format

F110-a University Supervisor Visit Record  .PDF format

F115-b 1st Progress Report .DOC format  or F115-b .PDF format

F120-b Classroom observation narrative .DOC format  or F120-b .PDF format

F125-b Classroom observation rubric  .PDF format

F130-c Periodic Formal Evaluation  .PDF format

F140-a Plan of Improvement Guidelines .DOC format  or F140-a .PDF format

F200-F Application for Initial Provisional Certification  .PDF format 

F205-C Application for Provisional Renewal  .PDF format

F210-C Application for Additional Endorsement .PDF format

F215-C Application for Professional Certificate .PDF format

F220-b Ontario Student Information Release  .PDF format OCT Guidelines

F225-a MDE-OCT Letter of Professional Standing (required for Ontario candidates) .DOC format 

F230-a  Verification of Teaching Experience (attach to F215) .DOC format  or F230-a .PDF format

F301-a Letter of Commitment to Professional Dispositions .DOC format  or F005-b .PDF format

F302-a Evaluation of Professional Dispositions  .PDF format

F303-a Student Contract for waiver of prerequisites .PDF format

F310-b Summary of Field Experiences .DOC format  or F310-b .PDF format 

F315-b Table for Field Work outside of class .DOC format  or F315-b .PDF format 

F320-b Field experiences associated with your TE250 course.   .DOC format  or F320-b .PDF format 

F325-b Field Experience Log for TE301 .DOC format  or F325-b .PDF format

F326-a Classroom Substitute Teaching Experience .PDF format

F330-a Evaluation of Professional and Ethical  .PDF format

F340 Technology Assessments and required artifacts 

F350-a Application for Intern Placement  .PDF format

F351-a Disclosure of Family/Personal Relationship in Placement Schoo.PDF format

F355-C Intern Requirements Checklist  .PDF format

F360-a Request for Letter of Professional Standing: MDE to OCT .DOC format  or F360-a .PDF format

F365-C Pre-Internship Interview  .PDF format

F500-b  Mentor Teacher Application for SBCEU credits - w/ evaluation.  .PDF format

G040-a Admission Checklist .PDF format

G050-a Graduate Program Checklist  .PDF format

G100-b Application to Graduate Program  .PDF format

G110-a Professional References  .PDF format

G120-a Graduate Plan of Study  .PDF format

G130-a Graduate Committee Appointments .PDF format

G150-a TEEPEE Assessment  .PDF format

G200-a Research Project Evaluation  .PDF format

G250-a Graduate Audit  .PDF format

G300-a Graduate Exit Survey  .PDF format

Questions: contact Dr. David Myton, Head for the Department of Education
Lake Superior State University
Department of Education
650 W. Easterday Avenue, Sault Ste Marie, MI
Office: (906) 635-2811 FAX: (906) 635-7565