U of L PS II Practicum Recognition Option Form (PROF) Spring 2021

Thank you for hosting a PS II student this semester. In order to issue your recognition option, please complete and submit this survey prior to March 31, 2021.

NOTE: If the PROF is not submitted, a donation will be made to the “Teacher Fund”.

There are four recognition options available that are described in detail in the email attachment.

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.

Demographics

First Name: *

Surname: *

School Name: *

Student Teacher Name: *

Options Available: *

Cash Option

U of L ID (if known):

Birthdate (Day/Month/Year) *

Month

Day

Year

Social Insurance Number: *

Home Address: *

City: *

Province: *

Postal Code: *

Tuition Option

U of L ID (if known):

Birthdate (Day/Month/Year) *

Month

Day

Year

Social Insurance Number: *

Home Address: *

City: *

Province: *

Postal Code: *

One-half day voucher Option

Grant Permission: *

Yes I hereby grant permission to the University of Lethbridge, Faculty of Education, to use my name for the purpose of publicly recognizing and thanking teachers for the work they contribute to the development of student teachers. This information is collected under authority of the Post-secondary Learning Act, which mandates the provision of programs and service by the University of Lethbridge. If you have any questions about the collection or use of this information, please contact Robin Bright, University of Lethbridge, Faculty of Education, Lethbridge, Alberta, T1K 3M4.

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U of L PS II Practicum Recognition Option Form (PROF) Spring 2021

Students

Information for

Campus