Spring Branch Independent School District

Student Teacher Application / Request

Student Teaching Procedures and Guidelines

1. Student teachers are to abide by the Code of Ethics, Spring Branch ISD policies and guidelines.
2. Be respectful of the campus’ ultimate purpose, educating the students that attend the campus and serving the needs of those families.
3. Student teacher placements are arranged by Human Resources. Please do NOT contact the campus for a placement.
4. Professional dress is required for all student teachers. Admittance to a campus may be denied if attire is deemed inappropriate by an administrator.
5. Follow the daily schedule of the cooperating teacher. This includes arrival, departure, and after school meetings as needed. Punctuality and regular attendance is expected.
6. Communicate absences to the mentor teacher in advance.
7. All cell phone use for any purpose during student teaching is prohibited.
8. Remember all information concerning students is confidential.
9. Follow all procedures for signing in and out at the campus. This may include providing the campus with your driver’s license to run through the RAPTOR system for a background check.
10. Remember you are a guest of SBISD, please be respectful of the expectations of the campus and the cooperating teacher.

My signature indicates that I have read the procedures and instructions for the Spring Branch ISD student teaching. I understand and will comply with these guidelines. I understand that it is not a requirement of Spring Branch ISD to allow me to student teach on any campus. I will provide all the requested documentation and information before I am given further direction on the process of student teaching. I will respect the confidentiality of students, teachers, and the campus during my student teaching.

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CRIMINAL HISTORY RECORDS FORM

CONSENT TO PERFORM CRIMINAL HISTORY BACKGROUND CHECK AND ADVISING OF RIGHTS UNDER THE FAIR CREDIT REPORTING ACT

The Spring Branch Independent School District is required by state law to obtain criminal history record information of all applicants for employment with the district (Texas Education Code Section 21.917 or as subsequent revised).

The Spring Branch Independent School District is an equal opportunity employer that maintains a policy of nondiscrimination with respect to all employees and applicants for employment. All personnel actions, such as recruitment, hiring, training, promotion, transfer, compensation and benefits, discipline and termination are administered without regard to race, sex, color, religion, national origin, age or disability of otherwise qualified individuals. SBISD does not discriminate on the basis of membership or application for membership in the uniformed services.

The information will be used solely for the purpose of assisting SBISD in conducting a criminal history check (local, state and national). The information below, i.e. race, sex and birth date will not be used for employment purposes, but is required for identification purposes for the criminal records check. A report showing a record of conviction will not automatically eliminate you from employment consideration or offer of contract, but it may do so. The district will consider the nature of the offense, the date of the offense and the relationship between the offense and the position for which you are applying.

Please complete the following:

I certify that the information contained in this application is true, correct and complete. I understand that any misstatement, omission, falsification or misrepresentation of fact in this application may disqualify me from consideration for employment or, if I am hired, may result in disciplinary action up to and including termination.

If I am hired, SBISD has the right to obtain criminal history record information on me at any time during my employment. I also understand that SBISD is obligated to notify the State Board for Educator certification if I have a reported criminal history.

I have been informed by the district that I have the right to review and challenge any negative information that would adversely impact the district’s decision to offer employment. I have also been advised that the district will give me a reasonable opportunity to clear up any mistaken information reported. However, I do understand that time is of the essence and reasonableness of time is within the sole discretion of the district. I understand that under the Fair Credit Reporting Act, I have certain rights concerning my review of the information reported. If requested, I will be provided the name, address and telephone number of the reporting agency as well as the nature and substance of all information and the source.

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STUDENT TEACHER INFORMATION

Legal Name
* First	Middle	* Last
Maiden and/or Other Name Previously Used
* Date of Birth	* Gender	* Ethnicity
(ex. 01/01/1965)	Male Female	Asian African-American Hispanic Caucasian Other
* Social Security Number
(ex. ###-##-####)
* Drivers License or State ID Num		* State Issued
		Select a State... Texas Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming
Other states in which you have been licensed to drive
ADDRESS INFORMATION
* Address		Apt Number
* City	* State	* Zip Code
	Select a State... Texas Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming	(ex. 77024 or 77024-2803)
* Home Phone	Alt. Phone	* Email Address
(ex. 713-464-1511)	(ex. 713-464-1511)
EMERGENCY CONTACT INFORMATION
* Name	* Phone Number
	(ex. 713-464-1511)
ACP/UNIVERSITY INFORMATION
* ACP/University

CRIMINAL HISTORY INFORMATION
1. Have you ever been charged or arrested for any felony, class A or class B misdemeanor? (¿Ha sido acusado o detenido alguna vez por algún delito grave, o delito menor clase A o clase B?) YES NO
If yes, please specify (Si la respuesta es sí, por favor especifique)
Date (Fecha)	Place (Lugar)
(ex. 01/01/1965)
Name & Level of Offense (Nombre y la gravedad de la ofensa)
Explanation (Explicación)
2. Have you ever plead guilty or nolo contender to any criminal offense (excluding minor traffic offenses)? (¿Alguna vez se declaró culpable o nolo contendere por algún delito? (excluyendo ofensas de tráfico menores)) YES NO
If yes, please specify (Si la respuesta es sí, por favor especifique)
Date (Fecha)	Place (Lugar)
(ex. 01/01/1965)
Name & Level of Offense (Nombre y la gravedad de la ofensa)
Explanation (Explicación)
3. Have you ever been placed on probation, received deferred adjudication, pretrial diversion, intervention, suspended sentence, community supervision, probation without adjudication of guilt? (¿Alguna vez ha sido puesto en libertad condicional, recibió un fallo suspendido, un programa de desviación previo al juicio, una intervención, una sentencia suspendida, una supervisión por la comunidad, una libertad condicional sin fallo de culpabilidad?) YES NO
If yes, please specify (Si la respuesta es sí, por favor especifique)
Date (Fecha)	Place (Lugar)
(ex. 01/01/1965)
Name & Level of Offense (Nombre y la gravedad de la ofensa)
Explanation (Explicación)
4. Have you ever been convicted of any offense (excluding minor traffic offenses)? (¿Ha sido condenado alguna vez por algún delito? (excluyendo delitos de tráfico menores)) YES NO
If yes, please specify (Si la respuesta es sí, por favor especifique)
Date (Fecha)	Place (Lugar)
(ex. 01/01/1965)
Name & Level of Offense (Nombre y la gravedad de la ofensa)
Explanation (Explicación)

Electronic Signature

Please enter your full legal name and today's date below.
By signing this application, you certify that the information contained in this application is true, correct and complete.

Signature	Signature Date
	(ex. 8/8/2024)