Office of Teacher Certification

Directions for Retrieving Forms

1. Go to the forms page
2. Once the forms page has loaded, scroll down and click on either Student Teacher Observation Form, or for a midterm or final, click on the Evaluation of Student Teaching Experience form that is appropriate for your specific program. These forms are all located under the heading of Forms for Clinical Faculty, Cooperating Teachers and Student Teachers.
3. The form will open on another page.
4. Click on the save icon located in the upper left corner of the document. You must save the form on your computer to either your desktop or documents folder.
5. Click Save.

Directions to fill out Forms

1. Once the file has been saved to your computer, highlight or underline all pertinent information ensuring to:
   • Select Clinical Faculty or Cooperating Teacher or Student Teacher Self-Evaluation
   • Specify the form you are submitting:
     • Observation 1 or Observation 2 (Observations are for Clinical Faculty only)
     • Midterm
     • Final
   • Put in all other requested information (students name, your name, date, school, etc.)
2. Continue on to fill out all other sections of the form, ensuring to highlight or underline whether the student teacher is Target, Approaching Target or Does Not Meet Target.
   • Midterm Reminder: A student can be in more than one category (ie: Approaching Target and Target) at the time of the midterm observation. You must highlight or underline all aspects of the supporting criteria under each category, as well as selecting the sources of evidence.
   • Final Reminder: A student can be in only one category (ie: Approaching Target or Target) at the time of the final observation. Be sure to highlight or underline all sources of evidence. (It is not necessary to highlight or underline the supporting criteria under each category for the final).

Directions to Electronically Submit Forms

• Submit the form via an e-mail attachment to: teacher_cert@plymouth.edu
• In order to send attachments go to compose message and click on “add attachments”. Then browse for the file name and click “add.”
• Under subject line state what form is being sent (ie: Student’s Name-Observation #1 or #2, or Student’s Name-Midterm or Final)
• Click send

Criteria for Cooperating Teacher

• Must be recommended by his/her principal.
• Bachelors or master’s degree.
• Must be certified.
• Minimum three years certified teaching experience (preferably teaching in certification area).

Cooperating Teacher Tuition Voucher or Remuneration for Mentoring/Supervising Student Teachers

A Cooperating Teacher who mentors/supervises a teacher candidate during the student teaching clinical experience/internship is eligible for a non-transferable Plymouth State University (PSU) tuition voucher, or $500 in remuneration.  The payment option is up to you, but it must be decided prior to the beginning of the student teaching semester.

 Conditions for PSU Tuition Voucher Use:

•  Has no cash value
• Non-transferable
• Valid for one graduate course up to 3-credits
• Valid for one-year from date of issuance (expiration date will be indicated on voucher)
• Valid only for 5000-7000 graduate level courses
• Covers tuition only (all non-tuition fees are the responsibility of the registrant.)
• Only one voucher can be redeemed per graduate term
• Does NOT guarantee a seat/space in a course
• Voucher cannot be replaced if lost
• Cannot be used for a course that is already being paid by another non-federal aid-funding source.

Conditions for PSU $500 Remuneration:

•  A I-9 form and a W4 form must be filled out prior to the beginning of the student teaching semester
• Payment will be processed through PSU payroll at the end of the student teaching semester 

 Undergraduate Cooperating Teachers

Please contact Kelsey Donnelly at Office of Teacher Certification at (603) 535-2224 or krdonnelly@plymouth.edu to obtain your tuition voucher or request a payment.

 Graduate Cooperating Teachers

Please contact Jim Kuras at the College of Graduate Studies (603) 535-3344 or jmkuras@plymouth.edu to obtain your tuition voucher or request a payment.

 Graduate Courses Contact Information

Contact the College of Graduate Studies at (603) 535-2636 or forgrad@plymouth.edu for your graduate course registration questions.

 Thank you for your continued support of our Teacher Education Students.