Summer 2024 Faculty of Education - Field Experiences FOIP Statement Protection of Privacy - The personal information requested on this form is collected under the authority of Section 33 (c) of the Alberta Freedom of Information and Protection of Privacy Act (“Act”) and will be protected under Part 2 of the Act. The information is collected for the purpose of identifying practicum and internship placements for students. If you have any inquiries in regards to the collection of your personal information, please direct those inquiries to: FOIP Coordinator, University of Lethbridge, 4401 University Dr. West, Lethbridge, Alberta T1K 3M4, telephone: 403-332-4620, email: foip@uleth.ca. Section 1: General Teacher Information Salutation: Given: * Surname: * Former Surname: E-mail: * School Name: * School City: * Permanent Certificate: * Yes No Years of teaching experience: * Grade(s)/Subjects (May - June): * Section 2: Placement Information Agree * I have made my school administrator aware of my interest in hosting a U of L Ed 2500 student teacher for Summer 2024, and understand that my school administrator will be contacted to discuss specific placements in a school prior to practicum. Submitted requests do not guarantee that a student will be placed with a teacher, but rather are an indication of interest and support. The information you provide will facilitate the assignment of practicum students in the coming school year. Leave this field blank Submit