Online Internship Application

Have you ever been convicted of a felony? Yes No

If you are currently employed in a VA school division, including as a substitute teacher, please select the division from the list below.

If you are employed in another VA school division (ex. Substitute, etc.) other than the one you selected above, please type which additional schools districts:

Are you an instructional assistant (IA) or a para professional for your division? Yes No

No student initiated exchanges of internship placements or contact with schools/districts are permitted. All communication for internship placements are to be completed through the Office of Teacher Preparation and/or the academic program.

Conflicts of Interest: Per school district and university policy, candidates may not be placed in schools they have attended as a student, schools where family members are attending, or schools where family members are employed.

In the space below, please list any school(s), including school name and school district, where you have conflicts of interest for the following counties: Alexandria City, Arlington County, Falls Church City, Fairfax County, Loudoun County, Manassas City, Manassas Park, and Prince William County.

Please list your top three school district preferences for placement. Before making selections, please note:

Depending on your academic program, placement in some districts may not be possible due to program requirements or specific restrictions.
Smaller school districts (indicated with **) can only accommodate a very small number of placements due to size.
Placement preferences that are not included in this list should be discussed with the Clinical Practice Specialist and your academic program before submitting your application.
Placement preferences are not guaranteed and are subject to availability.

First Choice:

Other:
Have you had a field placement in this school district? Yes No
If yes, list the date of your last field placement (mo/yr):

Second Choice:

Other:
Have you had a field placement in this school district?'; Yes No
If yes, list the date of your last field placement (mo/yr):

Third Choice:

Other:
Have you had a field placement in this school district? Yes No
If yes, list the date of your last field placement (mo/yr):

Since you are an elementary education student, you will work with your program coordinator on your placements. Dr. Bean (for graduate) or Dr. Glaser (for undergrads) will be reaching out to you, if she hasn’t already, to place you in a school within the ELED PDS network.

I certify that all information provided on this application is correct to the best of my knowledge.

First name:	Last name:
G Number: G	GMU Login ID:
Current Address:	City:
State:	Zip:
Current Phone:
What is your anticipated graduation date (mo/yr)?

Online Internship Application

College of Education and Human Development

Spring 2025 Practicum/Internship Application: Part 1 General Information