{"id":280,"date":"2017-07-20T21:42:10","date_gmt":"2017-07-20T21:42:10","guid":{"rendered":"https:\/\/nau.edu\/coe\/?page_id=280"},"modified":"2024-05-14T16:42:04","modified_gmt":"2024-05-14T16:42:04","slug":"practicum","status":"publish","type":"page","link":"https:\/\/in.nau.edu\/college-education\/practicum\/","title":{"rendered":"Practicum resources"},"content":{"rendered":"<div class=\"nau-block nau-block-left-nav-top-bound\">\n    \t<button id=\"left-nav-toggle-btn\" onclick=\"toggleNav();\">\n\t\tON THIS PAGE \n\t\t<i id=\"chevron-icon\" class=\"fas fa-solid fa-chevron-down\"><\/i>\n\t<\/button>\n\t<div id=\"left-nav-menu-track\">\n\t\t<div id=\"left-nav-wrapper\">\n\t\t\t<div class=\"rfi-above-anchor-tags\">\n\t\t\t\t<div class=\"ri-container\">\n\t\t\t\t\t<a href=\"https:\/\/nau.edu\/admissions\/request-information\/\" id=\"request-info\" class=\"btn bg-true-blue left-nav-menu-bottom-button display-mobile\">Request info&nbsp;&nbsp;<\/a>\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div id=\"left-nav-menu\">\n\t\t\t\t<div class=\"menu-section menu-section-links\"><h6 class=\"hidden-mobile left-nav-list-header\">ON THIS PAGE<\/h6><ul class=\"left-nav-menu-list on-this-page\">\t\t\t\t\t\t\t\t<li><a href=\"https:\/\/in.nau.edu\/college-education\/practicum\/#teacher\" title=\"Teacher preparation for students\">Teacher preparation for students<\/a><\/li>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<li><a href=\"https:\/\/in.nau.edu\/college-education\/practicum\/#experiences\" title=\"Practicum field experiences\">Practicum field experiences<\/a><\/li>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<li><a href=\"https:\/\/in.nau.edu\/college-education\/practicum\/#resources\" title=\"Teacher candidate resources\">Teacher candidate resources<\/a><\/li>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<li><a href=\"https:\/\/in.nau.edu\/college-education\/practicum\/#request\" title=\"Request for Affiliation Agreement\">Request for Affiliation Agreement<\/a><\/li>\n\t\t\t\t\t\t\t<\/ul><div class=\"ri-container\"><a href=\"https:\/\/nau.edu\/admissions\/request-information\/\" id=\"request-info\" class=\"btn bg-true-blue left-nav-menu-bottom-button display-mobile\">Request info&nbsp;&nbsp;<\/a><\/div><\/div>\t\t\t\t\t\t\t\t<div class=\"menu-section backcolor\">\n\t\t\t\t\t<div class=\"header\">\n\t\t\t\t\t\tHOW CAN WE HELP?\t\t\t\t\t<\/div>\n\t\t\t\t\t<ul class=\"responsive-icons\">\n\t\t\t\t\t\t\t\t\t\t\t\t<li>\n\t\t\t\t\t\t\t<button class=\"link-button\" onclick=\"embedLouieChatbot();\">\n\t\t\t\t\t\t\t\t<img decoding=\"async\" style=\"width: 20px;\" src=\"https:\/\/in.nau.edu\/wp-content\/themes\/nau-marketing-2021\/img\/icon-chat.svg\" alt=\"Live chat:\">\n\t\t\t\t\t\t\t\tChat\t\t\t\t\t\t\t<\/button>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<li><a href=\"tel:928-523-3678\"><img decoding=\"async\" src=\"https:\/\/in.nau.edu\/wp-content\/themes\/nau-marketing-2021\/img\/icon-phone.svg\" alt=\"Telephone:\"> 928-523-3678<\/a>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t\t<li><a href=\"mailto:COEPracticum@nau.edu\"><img decoding=\"async\" src=\"https:\/\/in.nau.edu\/wp-content\/themes\/nau-marketing-2021\/img\/icon-email.svg\" alt=\"Email:\"><span class=\"left-nav-email\"> COEPracticum&#8203;@nau.edu <\/span><\/a><\/li>\n\t\t\t\t\t<\/ul>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n<section class=\"nau-block left-nav-section\"><header class=\"entry-header\"><div class=\"breadcrumb\"><ol class=\"breadcrumbs\"><li><a href=\"https:\/\/in.nau.edu\">IN<\/a><span class=\"breadcrumb-chevron\" aria-hidden=\"true\">&gt;<\/span><\/li><li><a href=\"https:\/\/in.nau.edu\/college-education\">COE<\/a><span class=\"breadcrumb-chevron\" aria-hidden=\"true\">&gt;<\/span><\/li><li class=\"current\">Pages<\/li><\/ol><\/div><h1 class=\"entry-title text-left \">Practicum resources<\/h1><hr class=\"h1-hr  text-left \" role=\"none\"><\/header><!-- .entry-header --><\/section><!-- <section class=\"nau-block left-nav-section grid-md-12\">\n    <header class=\"entry-header\">\n        <h1 class=\"entry-title text-left \" tabindex=\"0\" id=\"h1-first\">Dummy H1<\/h1>\n        <hr class=\"h1-hr  text-left \" role=\"none\">\n    <\/header>\n<\/section> -->\n\n<section class=\"nau-block left-nav-section grid-md-12\">\n    <div class=\"page-content\">\n        \n\n<h2 class=\"wp-block-heading\" id=\"teacher\">Teacher preparation for students<\/h2>\n\n\n\n<p>NAU College of Education teacher candidates are required to participate in practicum field experiences in each of the three-to-five terms that precede their student teaching semester. Over the course of these early field experiences, teacher candidates will progressively develop new teaching skills and assume more responsibilities within the classroom.<\/p>\n\n\n\n\n<section id=\"experiences\"        class=\"nau-block full-width-image-with-text-box secondary grid grid-md-12 -grid-fullwidth no-padding span-md-12  mobile-image-yes tablet-image- desktop-imageheight-  textbox-registration-bottomright  textbox-xl-width-2-3 textbox-background-true-blue  bg-true-blue-95 content-type-wysiwyg_linkbank  \">\n\n    <div class=\"full-width-image-with-text-box-picturediv\">\n\n            <picture class=\"left-nav-top-bound main\">\n            <source media=\"(min-width: 1650px)\" srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/05\/3079_coe_20191204-2000x1125.jpg\">\n            <source media=\"(min-width: 1100px)\" srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/05\/3079_coe_20191204-2000x800.jpg\">\n            <source media=\"(min-width: 768px)\" srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/05\/3079_coe_20191204-1200x675.jpg\">\n            <img decoding=\"async\" src=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/05\/3079_coe_20191204-800x450.jpg\" alt=\"N A U student teacher gives a child a high five.\">\n        <\/picture>\n    \n    <\/div>\n    <div class=\"fwi-text-box  bg-true-blue-95 \">\n\n    <h2>\n    \n    Practicum field experiences\n    <\/h2>\n\n\n    <p>Practicum field experiences provide opportunities to observe, plan, and teach in authentic classrooms and apply information and strategies learned from method and theory coursework. It is also an introduction to diverse classroom settings and the dynamics of the teaching profession. A mentor teacher and practicum supervisor provide support to teacher candidates as they develop the knowledge, skills, and dispositions expected of professional educators.<\/p>\n\n\n\n\n\n\n\n    <\/div>\n\n\n    <\/section>\n\n\n<h2 class=\"wp-block-heading\" id=\"resources\">Teacher candidate resources<\/h2>\n\n\n<!--\nPANELS LITE CONFIGURATION:\n\nLINK \/ FULL WIDTH \/ EVEN \/ NO BODY-->\n\n<section\n                class=\"nau-block nau-block-panels-lite linkPanels  fullWidth bodyContentHide\"\n        data-layout_mobile=\"size4-1 layoutStack vertical headlineCenter\"\n        data-layout_tablet=\"size16-9 layoutGrid vertical headlineCenter\"\n        data-layout_desktop=\"size16-9 layoutGrid vertical headlineCenter\"\n        data-layout_xl=\"size5-2 layoutGrid vertical headlineCenter\">\n\n        <div class=\"panel-wrapper\">\n                        <a class=\"panel bg-twilight\" href=\"https:\/\/in.nau.edu\/college-education\/practicum-supervisor-resources\/\" target=\"\" alt=\"\">\n                    <picture>\n                        <source srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/06\/7824_tariat_20220325-2000x800.jpg\" media=\"(min-width: 1650px)\" \/><!-- xl : 5:2 large -->\n                        <source srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/06\/7824_tariat_20220325-2000x1125.jpg\" media=\"(min-width: 1100px)\" \/><!-- desktop : 16:9 large  -->\n                        <source srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/06\/7824_tariat_20220325-1200x675.jpg\" media=\"(min-width: 768px)\" \/><!-- tablet : 16:9 tablet  -->\n                        <source srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/06\/7824_tariat_20220325-800x200.jpg\" media=\"(min-width: 0px)\" \/><!-- mobile : 4:1 mobile  -->                        <img decoding=\"async\" src=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/06\/7824_tariat_20220325.jpg\" alt=\"Two people looking at each other and shaking hands.\"  \/>                    <\/picture>\n                    <div class=\"content\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"h5\">Practicum overview for supervisors<\/h3>\n\t\t\t\t\t\t                        <div class=\"body\">\n                                                    <\/div>\n                    <\/div>\n                                                        <\/a>\n                                <a class=\"panel bg-gold\" href=\"https:\/\/in.nau.edu\/college-education\/mentoring-for-arizona-teachers-academy\/\" target=\"\" alt=\"\">\n                    <picture>\n                        <source srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/06\/1326_jazmyn_gardner_20230303-2000x800.jpg\" media=\"(min-width: 1650px)\" \/><!-- xl : 5:2 large -->\n                        <source srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/06\/1326_jazmyn_gardner_20230303-2000x1125.jpg\" media=\"(min-width: 1100px)\" \/><!-- desktop : 16:9 large  -->\n                        <source srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/06\/1326_jazmyn_gardner_20230303-1200x675.jpg\" media=\"(min-width: 768px)\" \/><!-- tablet : 16:9 tablet  -->\n                        <source srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/06\/1326_jazmyn_gardner_20230303-800x200.jpg\" media=\"(min-width: 0px)\" \/><!-- mobile : 4:1 mobile  -->                        <img decoding=\"async\" src=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/06\/1326_jazmyn_gardner_20230303.jpg\" alt=\"N A U professor and student sitting at a table talking to each other.\"  \/>                    <\/picture>\n                    <div class=\"content\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"h5\">Practicum overview for mentor teachers<\/h3>\n\t\t\t\t\t\t                        <div class=\"body\">\n                                                    <\/div>\n                    <\/div>\n                                                        <\/a>\n                                <a class=\"panel bg-monsoon\" href=\"https:\/\/in.nau.edu\/college-education\/student-resources\/classroom-management-aspiring-teachers\/\" target=\"\" alt=\"\">\n                    <picture>\n                        <source srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/05\/3168_educate2act_20150410-2000x800.jpg\" media=\"(min-width: 1650px)\" \/><!-- xl : 5:2 large -->\n                        <source srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/05\/3168_educate2act_20150410-2000x1125.jpg\" media=\"(min-width: 1100px)\" \/><!-- desktop : 16:9 large  -->\n                        <source srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/05\/3168_educate2act_20150410-1200x675.jpg\" media=\"(min-width: 768px)\" \/><!-- tablet : 16:9 tablet  -->\n                        <source srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/05\/3168_educate2act_20150410-800x200.jpg\" media=\"(min-width: 0px)\" \/><!-- mobile : 4:1 mobile  -->                        <img decoding=\"async\" src=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/05\/3168_educate2act_20150410.jpg\" alt=\"N A U students working together in a classroom.\"  \/>                    <\/picture>\n                    <div class=\"content\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"h5\">Classroom management for aspiring teachers<\/h3>\n\t\t\t\t\t\t                        <div class=\"body\">\n                                                    <\/div>\n                    <\/div>\n                                                        <\/a>\n                                <a class=\"panel bg-true-blue\" href=\"https:\/\/in.nau.edu\/college-education\/student-resources\/resume-writing-aspiring-teachers\/\" target=\"\" alt=\"\">\n                    <picture>\n                        <source srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/04\/3106_coe_20191204-e1685572136462-2000x800.jpg\" media=\"(min-width: 1650px)\" \/><!-- xl : 5:2 large -->\n                        <source srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/04\/3106_coe_20191204-e1685572136462-2000x1125.jpg\" media=\"(min-width: 1100px)\" \/><!-- desktop : 16:9 large  -->\n                        <source srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/04\/3106_coe_20191204-e1685572136462-1200x675.jpg\" media=\"(min-width: 768px)\" \/><!-- tablet : 16:9 tablet  -->\n                        <source srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/04\/3106_coe_20191204-e1685572136462-800x200.jpg\" media=\"(min-width: 0px)\" \/><!-- mobile : 4:1 mobile  -->                        <img decoding=\"async\" src=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/04\/3106_coe_20191204-e1685572136462.jpg\" alt=\"Student teacher stands next to young student and teaches them.\"  \/>                    <\/picture>\n                    <div class=\"content\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"h5\">R\u00e9sum\u00e9 writing for aspiring teachers<\/h3>\n\t\t\t\t\t\t                        <div class=\"body\">\n                                                    <\/div>\n                    <\/div>\n                                                        <\/a>\n                    <\/div>\n    <\/section>\n\n\n\n<section  \n    class=\"nau-block nau-block-panels   \" \n    data-layout_mobile=\"groupLayout-Stack gutter_Default panelLayoutPhotoTextVertical  photoAspect-1-1\"\n        data-layout_tablet=\"groupLayout-Stack gutter_Default panelLayoutPhotoTextVertical  photoAspect-1-1\"\n        data-layout_desktop=\"groupLayout-Stack gutter_Default panelLayoutPhotoTextVertical  photoAspect-1-1\"\n        data-layout_xl=\"groupLayout-Stack gutter_Default panelLayoutPhotoTextVertical  photoAspect-1-1\">\n\n    <div class=\"background-wrapper\">\n        <div class=\"block-main-content\">\n            \n            \n            \n            \n            \n            <div class=\"panel-wrapper\">\n                \n                                \n                        <div class=\"panel bg-green  panelTypeText  noHover  hasLink panelLinkTypeArrow\"\n                            data-role=\"tabpanel\"\n                            data-panel=\"panel--0\"\n                            id=\"panel--0\">\n\n                                                            <a href=\"https:\/\/legacy.nau.edu\/pep\/cooperating-teachers\/\"\n                                    target=\"\"\n                                    alt=\"\">\n                            \n                                                                    <div class=\"content\">\n                                            <div class=\"text-wrapper\">\n                                                                                                <h3 class=\"\">Supervising practitioner training modules<\/h3>\n                                                \n                                                                                                    <div class=\"text\">\n                                                        <p>These modules provide a foundation for mentoring and offer suggested ways to create a quality experience. Upon successful completion, you will receive a certificate for 45 units of professional development. Access the modules here.<\/p>\n                                                    <\/div>\n                                                \n                                                                                                                                                        <span role=\"none\" class=\"panel-link panelLinkTypeArrow\"><\/span>\n                                                                                            <\/div>\n                                        <\/div>\n\n                                    \n                                                                    <\/a>\n                                \n                                                        <\/div>\n                                                <\/div>\n\n                    <\/div>\n    <\/div>\n<\/section>\n\n\n<section  \n    class=\"nau-block nau-block-panels   \" \n    data-layout_mobile=\"groupLayout-Stack gutter_Default panelLayoutPhotoTextVertical  photoAspect-4-1\"\n        data-layout_tablet=\"groupLayout-Stack gutter_Default panelLayoutPhotoTextVertical  photoAspect-4-1\"\n        data-layout_desktop=\"groupLayout-Stack gutter_Default panelLayoutPhotoTextVertical  photoAspect-4-1\"\n        data-layout_xl=\"groupLayout-Stack gutter_Default panelLayoutPhotoTextVertical  photoAspect-4-1\">\n\n    <div class=\"background-wrapper\">\n        <div class=\"block-main-content\">\n            \n            \n            \n            \n            \n            <div class=\"panel-wrapper\">\n                \n                                \n                        <div class=\"panel bg-gold  panelTypePhotoText   \"\n                            data-role=\"tabpanel\"\n                            data-panel=\"panel--0\"\n                            id=\"panel--0\">\n\n                            \n                                                                    <picture>\n                                            <source srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/06\/8522_Sara_Abercrombie_20221012-2000x500.jpg\" media=\"(min-width: 1650px)\" \/><!-- xl -->\n                                            <source srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/06\/8522_Sara_Abercrombie_20221012-2000x500.jpg\" media=\"(min-width: 1100px)\" \/><!-- desktop -->\n                                            <source srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/06\/8522_Sara_Abercrombie_20221012-1200x300.jpg\" media=\"(min-width: 768px)\" \/><!-- tablet -->\n                                            <source srcset=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/06\/8522_Sara_Abercrombie_20221012-800x200.jpg\" media=\"(min-width: 0px)\" \/><!-- mobile --><img decoding=\"async\" src=\"https:\/\/in.nau.edu\/wp-content\/uploads\/sites\/359\/2023\/06\/8522_Sara_Abercrombie_20221012.jpg\" alt=\"N A U faculty member reads book next to book shelf and smiles.\"  \/>                                        <\/picture>\n                                        <div class=\"content\">\n                                            <div class=\"text-wrapper\">\n                                                \n                                                                                                    <h3 class=\"h3-tab-index h4\">Affiliation agreements<\/h3>\n                                                \n                                                \t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"text alt-link-caret\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p>Affiliation agreements are used to establish affiliate relationships between NAU and other institutions (the \u201chost\u201d) that allow students to participate in academic credit-bearing educational experiences, including supervised clinical opportunities, internships, or other fieldwork experiences, at the host affiliate\u2019s location. Affiliation agreements define the applicable terms and conditions and the respective roles and responsibilities of each party.<\/p>\n<p>PEP standard student placement agreements\u00a0should be completed for the following programs: Student Teaching, Supervised Practicum for Teaching and Learning, Educational Specialties, STEM Education, Supervised School Psychology Practicum, School Counseling, and Educational Leadership internships.<\/p>\n<p>Complete a\u00a0request for affiliation agreement below when a new PEP standard agreement is needed. This internal form should be completed by NAU personnel only.<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t                                            <\/div>\n                                            \n                                                                                    <\/div>\n                                    \n                                \n                                                        <\/div>\n                                                <\/div>\n\n                    <\/div>\n    <\/div>\n<\/section>\n\n\n<div style=\"height:30px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p>Please complete this form if an affiliation agreement is needed for a student internship, student teaching, or practicum. This assists in initiating the process as early as possible. A placement cannot begin until an agreement is finalized. <strong>You must use your official NAU email for the information in this form to be received.&nbsp;Only NAU faculty and students should utilize this form.<\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"request\">Request for Affiliation Agreement<\/h3>\n\n\n<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in 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class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_9'  action='\/college-education\/wp-json\/wp\/v2\/pages\/280' data-formid='9' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_9_17\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_17'>X\/Twitter<\/label><div class='gfield_description' id='gfield_description_9_17'>This field is for validation purposes and should be left unchanged.<\/div><div class='ginput_container'><input name='input_17' id='input_9_17' type='text' value='' autocomplete='new-password'\/><\/div><\/div><div id=\"field_9_14\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_14'>Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_14' id='input_9_14' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_2\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_2'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_2' id='input_9_2' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_9_3\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_3'>Your Department (Ed Psych, Ed Leadership, Teaching and Learning, PEP, Ed Specialties, etc.)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_9_3' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_15\" class=\"gfield gfield--type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_15'>Please select the type of placement this is for<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_15' id='input_9_15' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Student Teaching' >Student Teaching<\/option><option value='Supervised Practicum (Teaching &amp; Learning and Ed Specialties departments only)' >Supervised Practicum (Teaching &amp; Learning and Ed Specialties departments only)<\/option><option value='Supervised School Psychology Practicum' >Supervised School Psychology Practicum<\/option><option value='School Counseling' >School Counseling<\/option><option value='Ed Leadership Internship' >Ed Leadership Internship<\/option><option value='School Psychology Internship' >School Psychology Internship<\/option><option value='Clinical Mental Health Counseling' >Clinical Mental Health Counseling<\/option><option value='Clinical Psychology PsyD Practicum' >Clinical Psychology PsyD Practicum<\/option><option value='Combined School Psychology and Counseling PhD' >Combined School Psychology and Counseling PhD<\/option><option value='Other (if selected, you can leave additional notes at the end of the form)' >Other (if selected, you can leave additional notes at the end of the form)<\/option><option value='ESE 695 Internship' >ESE 695 Internship<\/option><option value='ECI 551' >ECI 551<\/option><option value='PITAS Program' >PITAS Program<\/option><\/select><\/div><\/div><fieldset id=\"field_9_6\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Is this placement request for an in-state facility or out-of-state facility?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_9_6'><div class='gchoice gchoice_9_6_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_6.1' type='checkbox'  value='In-state'  id='choice_9_6_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_6_1' id='label_9_6_1' class='gform-field-label gform-field-label--type-inline'>In-state<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_9_6_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_6.2' type='checkbox'  value='Out-of-state'  id='choice_9_6_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_6_2' id='label_9_6_2' class='gform-field-label gform-field-label--type-inline'>Out-of-state<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_9_7\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_7'>Name of facility where an Affiliation Agreement is needed (please include district AND school, charter, or private facility)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_7' id='input_9_7' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_8\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_8'>Address of facility where an Affiliation Agreement is needed<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_8' id='input_9_8' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_9\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_9'>Facility contact name AND title (person who could review and sign the agreement)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_9_9' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_10\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_10'>Facility contact email AND phone number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_9_10' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_9_11\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_11'>Name of NAU student(s) requesting a placement in this facility (put &quot;don&#039;t know yet&quot; if you do not have this information at this time)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_11' id='input_9_11' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_9_13\" class=\"gfield gfield--type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_9_13'>Please provide any additional information I need to be aware of<span class=\"gfield_required\"><span class=\"gfield_required 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