1 Start 2 Section 1 Page Break 3 Section 2 Page Break 4 Section 3 Page Break 5 Section 4 Page Break 6 Complete Page 1 of 6 Students requesting a Spring 2023 PS II practicum placement should complete this online form by 4:30 p.m. on Wednesday, February 1, 2023. Students who have dependent children, marital or health considerations, or those who are involved in University sanctioned activities will need to provide the necessary supporting documentation in order to have those situations taken into consideration for practicum placements. Students wishing to have these situations considered for their practicum placement, MUST provide the required supporting documentation to Field Experiences. (Unsupported situations will not be taken into consideration, and previously submitted supporting documents will not need to be sent again). Students should note however, that providing supporting documentation will not be a guarantee that a student will be placed locally, or within a commutable distance based on the above. Employment will not be a guarantee of a local (Lethbridge) practicum placement; students must be prepared to travel. PLEASE NOTE: Acceptance of an Offer of Admission to the Faculty of Education indicates your acceptance of the possibility of having to commute daily to and from practicum placements (where applicable) within Zone 6 (Zone 6 map). Students who provide incomplete or false information may be required to withdraw from the practicum and reapply for admission to resume their studies in a subsequent year. Should you have any questions, please contact Jaime Iwaasa via email at jaime.iwaasa@uleth.ca; or via phone 403-329-2448. SECTION I: CONTACT INFORMATION U of L ID Number * Last Name * First Name * Preferred Name Please enter preferred name if different from legal name. U of L Email Address * Address Please provide the address of the residence that you will be living at while attending university for the Spring 2023 term. NOTE: This is the address that will be used in making your Zone 6 Professional Semester II practicum placement - please update Field Experiences if your address changes. City Province Postal Code Phone number (use 403-123-4567 format) Emergency Contact Name Emergency Contact Phone Number (use 403-123-4567 format) Emergency Contact Relationship To You Leave this field blank Next Page >