Internship Application Student Teacher Acceptance

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Orange County Public Schools agrees to accept the following intern for : Internship Application Student Teacher Acceptance Internship Type: Junior Senior Field Experience: ( Field Experience hours for semester) Dates of Internship (Start) (End) Student Name: Major University or College requesting the placement Hosting School Street Address City/State Zip Code Collaborating Teacher: First : Last: Grade Level: Area of Certification: Email: Signature Date: Principal: Date: Signature University Rep: Signature Date: District Rep: Date: Signature Please send one copy of this form to the district internship office.

Contact Information and Biography NAME: ADDRESS: CITY: STATE: ZIP CODE: PHONE NUMBER: (Cell) (Home) CAMPUS EMAIL: HOME EMAIL: BRIEF BIOGRAPHY of QUALIFICATIONS

Placement Sheet Information NAME: University/College Major: Internship Type: Junior Senior Field Experience: (Field Experience hours for semester) Dates of Internship: (Start) (End) (Week days in school) List of schools in which you have completed field experiences /or internships, semester and type (junior, senior, field experiences observation hours) School: Semester: Type: School: Semester: Type: School: Semester: Type: School: Semester: Type: List below your school choices* for placement:: School School School * School choices are not guaranteed and depend on availability, as well as principal and district approval/ Students may not be placed in school where family member attend or are employed. Additionally, Students may not be placed in a school where they have attended or are employed without permission from Clinical Experiences PRIOR to submitting application. Are you a school district employee? YES NO If yes, please list employee id number, school and position title Employee ID # School: Position: Special Needs: Use the space below to list any special needs that may affect your placement. Applicant Signature: Date:

/ PURPOSE OCPS STUDENT ACCEPTANCE FORM The purpose of internship is to develop professional educators who demonstrate excellence in the facilitation of student learning through a continual, lifelong, reflective process. The internship is the context for the application and demonstration of effective practices. CODE OF ETHICS ACCEPTANCE (see attached) DRESS CODE: Each intern is expected to dress appropriately for the job. Supervising teachers will share the guidelines of proper attire. Supervising teacher will uphold the safety requirements. Interns who fail to use safety devices or follow guidelines may be subject to dismissal. As with students attire, which advertises drugs or alcoholic beverages or which is vulgar or obscene is nature is not permitted. FINGERPRINT AND NATIONAL BACKGROUND CHECK: In Florida, an entire arrest record is revealed to school districts by the Florida Department of Law Enforcement and / or FBI, including sealed or expunged records, and military court proceedings. FLORIDA LAW REQUIRES THAT YOU MUST DISCLOSE this information even if you have been told differently by a lawyer, judge or other third party of law enforcement individuals. ALL criminal history must be provided regardless of the number of years since the arrest. All interns must be fingerprinted and a national background check performed. Interns must schedule an appointment by logging into http://schedule.fieldprint.com intern is responsible for cost of fingerprinting OCPS Finger print Information Sheet (see attached) OCPS Criminal Record Information Form (see attached) PERSONNEL HIRING GUIDELINES (see attached) My signature indicates I have read, understood, and will comply with all of the above Student intern Signature Date Print Name This form must be signed and returned to the OCPS Internship Department.

Applies to: Student teachers, Fingerprinting Information To schedule a fingerprinting appointment, please follow these simple instructions: 1. Visit https://schedule.fieldprint.com 2. Enter an e-mail address under NEW USERS/SIGN UP and click the SIGN UP button. Follow the instructions for creating a password and security question and then click SIGN UP AND CONTINUE 3. Enter the FieldPrint Code: FPSDOCInterns 4. Enter the contact and demographic information required by the FBI and schedule a fingerprint appointment at the location of your choosing. 5. At the end of the process, print the confirmation page. Take the confirmation page with you to your fingerprint appointment, along with two forms of identification. 6. If you have any questions or problems registering, you may contact our customer service team at 877-614- 4364 or customerservice@fieldprint.com. Note: Fingerprinting is completed for the purposes of doing an FBI national criminal history background check. Criminal history results are returned to Orange County Public Schools. All decisions concerning criminal history are made by the School Board of Orange County. After fingerprinting, all communication should be directed to the school district. Do not contact FieldPrint unless instructed to do so by Orange County Public Schools. DO NOT FINGERPRINT UNLESS YOU ARE AUTHORIZED TO DO SO BY YOUR COLLEGE OR UNIVERSITY. OCPS MUST HAVE YOUR INTERN APPLICATION PRIOR TO FINGERPRINTING.

Principles of Professional Conduct for the Education Profession in Florida 6A-10.081 Principles of Professional Conduct for the Education Profession in Florida. (1) Florida educators shall be guided by the following ethical principles: (a) The educator values the worth and dignity of every person, the pursuit of truth, devotion to excellence, acquisition of knowledge, and the nurture of democratic citizenship. Essential to the achievement of these standards are the freedom to learn and to teach and the guarantee of equal opportunity for all. (b) The educator s primary professional concern will always be for the student and for the development of the student s potential. The educator will therefore strive for professional growth and will seek to exercise the best professional judgment and integrity. (c) Aware of the importance of maintaining the respect and confidence of one s colleagues, of students, of parents, and of other members of the community, the educator strives to achieve and sustain the highest degree of ethical conduct. (2) Florida educators shall comply with the following disciplinary principles. Violation of any of these principles shall subject the individual to revocation or suspension of the individual educator s certificate, or the other penalties as provided by law. (a) Obligation to the student requires that the individual: 1. Shall make reasonable effort to protect the student from conditions harmful to learning and/or to the student s mental and/or physical health and/or safety. 2. Shall not unreasonably restrain a student from independent action in pursuit of learning. 3. Shall not unreasonably deny a student access to diverse points of view. 4. Shall not intentionally suppress or distort subject matter relevant to a student s academic program. 5. Shall not intentionally expose a student to unnecessary embarrassment or disparagement. 6. Shall not intentionally violate or deny a student s legal rights. 7. Shall not harass or discriminate against any student on the basis of race, color, religion, sex, age, national or ethnic origin, political beliefs, marital status, handicapping condition, sexual orientation, or social and family background and shall make reasonable effort to assure that each student is protected from harassment or discrimination. 8. Shall not exploit a relationship with a student for personal gain or advantage. 9. Shall keep in confidence personally identifiable information obtained in the course of professional service, unless disclosure serves professional purposes or is required by law. (b) Obligation to the public requires that the individual: 1. Shall take reasonable precautions to distinguish between personal views and those of any educational institution or organization with which the individual is affiliated. 2. Shall not intentionally distort or misrepresent facts concerning an educational matter in direct or indirect public expression. 3. Shall not use institutional privileges for personal gain or advantage. 3. Shall not use institutional privileges for personal gain or advantage. 4. Shall accept no gratuity, gift, or favor that might influence professional judgment. 5. Shall offer no gratuity, gift, or favor to obtain special advantages. (c) Obligation to the profession of education requires that the individual: 1. Shall maintain honesty in all professional dealings. 2. Shall not on the basis of race, color, religion, sex, age, national or ethnic origin, political beliefs, marital status, handicapping condition if otherwise qualified, or social and family background deny to a colleague professional benefits or advantages or participation in any professional organization.

Principles of Professional Conduct for the Education Profession in Florida (continued) 3. Shall not interfere with a colleague s exercise of political or civil rights and responsibilities. 4. Shall not engage in harassment or discriminatory conduct which unreasonably interferes with an individual s performance of professional or work responsibilities or with the orderly processes of education or which creates a hostile, intimidating, abusive, offensive, or oppressive environment; and, further, shall make reasonable effort to assure that each individual is protected from such harassment or discrimination. 5. Shall not make malicious or intentionally false statements about a colleague. 6. Shall not use coercive means or promise special treatment to influence professional judgments of colleagues. 7. Shall not misrepresent one s own professional qualifications. 8. Shall not submit fraudulent information on any document in connection with professional activities. 9. Shall not make any fraudulent statement or fail to disclose a material fact in one s own or another s application for a professional position. 10. Shall not withhold information regarding a position from an applicant or misrepresent an assignment or conditions of employment. 11. Shall provide upon the request of the certificated individual a written statement of specific reason for recommendations that lead to the denial of increments, significant changes in employment, or termination of employment. 12. Shall not assist entry into or continuance in the profession of any person known to be unqualified in accordance with these Principles of Professional Conduct for the Education Profession in Florida and other applicable Florida Statutes and State Board of Education Rules. 13. Shall self-report within forty-eight (48) hours to appropriate authorities (as determined by district) any arrests/charges involving the abuse of a child or the sale and/or possession of a controlled substance. Such notice shall not be considered an admission of guilt nor shall such notice be admissible for any purpose in any proceeding, civil or criminal, administrative or judicial, investigatory or adjudicatory. In addition, shall self-report any conviction, finding of guilt, withholding of adjudication, commitment to a pretrial diversion program, or entering of a plea of guilty or Nolo Contendere for any criminal offense other than a minor traffic violation within forty-eight (48) hours after the final judgment. When handling sealed and expunged records disclosed under this rule, school districts shall comply with the confidentiality provisions of Sections 943.0585(4)(c) and 943.059(4)(c), F.S. 14. Shall report to appropriate authorities any known allegation of a violation of the Florida School Code or State Board of Education Rules as defined in Section 1012.795(1), F.S. 15. Shall seek no reprisal against any individual who has reported any allegation of a violation of the Florida School Code or State Board of Education Rules as defined in Section 1012.795(1), F.S. 16. Shall comply with the conditions of an order of the Education Practices Commission imposing probation, imposing a fine, or restricting the authorized scope of practice. 17. Shall, as the supervising administrator, cooperate with the Education Practices Commission in monitoring the probation of a subordinate. Rulemaking Authority 1001.02, 1012.795(1)(j) FS. Law Implemented 1012.795 FS. History New 7-6-82, Amended 12-20-83, Formerly 6B- 1.06, Amended 8-10-92, 12-29-98, Formerly 6B-1.006, Amended 3-23-16. I have read the Principles of Professional Conduct for the Education Profession in Florida and recognize my right as a member of the education profession in Florida and accept the obligations and responsibilities place upon me. Student intern Signature Date Print Name This form must be signed and returned to the OCPS Internship Department.

/ Orange County Public Schools Employment Services Hiring Statement All candidates for employment with OCPS will be fingerprinted and a criminal history check completed. In Florida the entire arrest record is revealed to school districts, including sealed and/or expunged records and military court proceedings. Applicants must disclose this information even if told differently by a lawyer, judge, or other law enforcement individual. If you were given this information by a judge then those written instructions would need to be provided to OCPS. Prior criminal records may or may not result in disqualification for employment; however, failure to disclose this information will disqualify you for employment. Information that must be disclosed includes any offense that occurred whether as a juvenile or adult; therefore all adult and juvenile offenses must be listed. An applicant s criminal history includes any offense for which the applicant posted bail; entered a pre-trial diversion program, pre -trial intervention program, teen or drug court or juvenile program; had adjudication withheld, was convicted or found guilty; was placed on probation; pled guilty or no contest; was jailed or imprisoned; or appeared in court; as a juvenile or adult. Sealed records, expunged records and military court proceedings must be disclosed. Note: DUI and reckless driving are criminal offenses. The following guidelines apply: Will Not Hire Statutory felony convictions in Florida Statute 1012.315 (1) Statutory Misdemeanor convictions Florida Statute 1012.315 (2) Will Not Hire if Anyone Has Been Convicted of: Any felony offense within the past 25 years Any misdemeanor offense within the past 5 years Case by Case Basis Any applicant convicted of a felony of more than 25 years, except those convicted of crimes included in 1012.315 (1) Cases Pending Any applicant convicted of a misdemeanor of more than 5 years, except those convicted of crimes included in 1012.315 (2) Cases Pending Arrest or charges for: Any crime involving violence (domestic violence, battery, etc.) and/or drug offenses within the past 5 to 10 years OCPS defines conviction as a determination of guilt that is a result of a plea or a trial, regardless of whether adjudication is withheld. This includes entering a plea of guilty and nolo contendere or no contest.

Orange County Public Schools Employment Services Work Performance Hiring Statement When submitting an application to Orange County Public Schools applicants must answer a questionnaire in regard to their previous work history. Human Resources has the following guidelines in place to review work performance and determine eligibility: Will Not hire Review on a Case by Case Basis Terminated by OCPS for: Workers Compensation Settlement Misconduct Job abandonment Falsification (If determined willfull intent)* Performance Positive drug test results Frequent job changes Reasons for leaving previous job Pending litigation with a previous employer References that reflect no hire Status Previous evaluations that are comparable to SR or NI Job abandonment Previously dismissed or non-reappointed for performance or misconduct by another employer *OCPS defines willfull intent as the intent to intentionally, purposefully, or knowingly perform an act.

Student intern Signature Date Print Name