Editable PDF Certification of Teaching Capacity

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This form is to be initiated and filled out by the University Supervisor in collaboration with the Mentor Teacher and Student Teacher at the end of the clinical practice experience. This form is signed by all parties, including the principal or their designee and submitted to DPI.  Students must have “mets” for all criteria to be licensed by DPI.  Please discuss your intern’s progress toward meeting all standards at the midterm point.   

Though this form is only due at the end of the clinical practice internship in the spring, please review this form at midterm and discuss as a clinical practice team if there are concerns about a student not projected to meet the criteria.