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                    "text": "SCHOOL OF EDUCATION AND HUMAN DEVELOPMENT\nUndergraduate Student Teaching Application\nInformation",
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                            "text": "Student Teaching Applicant Data and Agreements",
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                            "text": "Assessment of Professional Dispositions, Values, and Behaviors form\n1 filled out by you and 2 more by individuals indicated on the form",
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                            "text": "Medical exam with TB test (can be obtained from Betty White Health Center for free)",
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                    "text": "Other requirements",
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                    "text": "200 field hours recorded in KFETS and proof of 200 field hours (field verification forms)",
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                    "text": "Once you are placed in school system, you will have to go to the district Human Resources office to get a state and federal background check. You must provide a copy of the report to the School of Education and Human Development office.",
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                    "text": "Updated 2/8/18",
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                    "text": "KSU School of Education & Human Development Supervised Teaching Applicant Data and Agreements",
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                        "embedded_text": "Full name: DOB:\nStudent ID #: Social Security #:\nLocal address:\nPermanent address:\nHome phone: Other phone:\nKSU e-mail: Personal e-mail:\nTelephone # of someone who always will be able to reach you:\nAcademic Area of teacher certification:\nGrade level of teacher certification sought:\nPraxis II exam names, numbers, dates, and scores:"
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                    "text": "I understand that the Teacher Education Committee (TEC) has the authority to support or deny my admission to Supervised Teaching, based on my application and performance, and to withdraw me from Supervised Teaching if I do not attain or maintain the required standards for admission and continuation.",
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                    "text": "I authorize the Coordinator of Supervised Teaching to review my grades, Praxis II scores, medical exam, and criminal history and to report and discuss relevant information concerning me with the Teacher Education Committee. I understand that information discussed in TEC meetings is confidential. It is my responsibility to notify the Coordinator of Supervised Teaching, in writing, of any exceptions to this authorization.",
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                    "text": "I understand that I am expected to follow the public school district calendar and all district policies, during Supervised Teaching, unless otherwise instructed. It is anticipated that Supervised Teaching in spring or fall will begin on the district's first teacher day. This date may be prior to the first day of KSU classes. The last day for Supervised Teaching is anticipated to be the last day of classes for KSU seniors.",
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                                "field_kind": "text",
                                "label": "eyes/vision",
                                "source": "blank_line",
                                "label_source": "parent_text",
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                    "type": "text",
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                    "text": "___ nervous system ___ circulatory system",
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                            "id": "p3.12.2",
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                            "reading_order": 1
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                    "reading_order": 11
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                {
                    "id": "p3.13",
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                    "type": "text",
                    "bbox": {
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                    "text": "___ digestive system ___ musculoskeletal system",
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                        {
                            "id": "p3.13.1",
                            "order": 29,
                            "type": "form_field",
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                                "l": 41.4,
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                                "b": 375.249
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                                "field_kind": "text",
                                "label": "___ digestive system ___ musculoskeletal system",
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                            "reading_order": 0
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                            "id": "p3.13.2",
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                    "reading_order": 12
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                {
                    "id": "p3.14",
                    "order": 31,
                    "type": "text",
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                    "text": "___dental respiratory system",
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                            "id": "p3.14.1",
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                                "field_kind": "text",
                                "label": "___dental respiratory system",
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                            "reading_order": 0
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                    ],
                    "reading_order": 13
                },
                {
                    "id": "p3.15",
                    "order": 33,
                    "type": "text",
                    "bbox": {
                        "l": 333.84,
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                    "text": "___endocrine system",
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                            "id": "p3.15.1",
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                                "label": "___endocrine system",
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                },
                {
                    "id": "p3.16",
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                    "type": "text",
                    "bbox": {
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                        "b": 336
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                    "text": "Tuberculin skin test or x-ray: date administered ___ date read: ___ results: ___",
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                        {
                            "id": "p3.16.1",
                            "order": 36,
                            "type": "form_field",
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                                "l": 36,
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                                "r": 524.1912,
                                "b": 335.989
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                                "field_kind": "text",
                                "label": "Tuberculin skin test or x-ray: date administered ___ date read: ___ results: ___",
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                    ],
                    "reading_order": 15
                },
                {
                    "id": "p3.17",
                    "order": 37,
                    "type": "text",
                    "bbox": {
                        "l": 33.6,
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                        "r": 575.76,
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                    "text": "I certify that I have examined this individual and find him/her free of any medical problem or communicable disease that could interfere with his/her performing the duties of student teaching except as follows:",
                    "children": [
                        {
                            "id": "p3.17.1",
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                                "r": 574.6789,
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                            "text": "",
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                                "field_kind": "text",
                                "source": "blank_line",
                                "label": "I certify that I have examined this individual and find him/her free of any medical problem or communicable disease that could interfere with his/her performing the duties of student teaching except as follows:",
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                            "id": "p3.17.2",
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                                "r": 574.5813,
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                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "source": "blank_line",
                                "label": "I certify that I have examined this individual and find him/her free of any medical problem or communicable disease that could interfere with his/her performing the duties of student teaching except as follows:",
                                "label_source": "parent_text",
                                "label_ref": "p3.17"
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                            "id": "p3.17.3",
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                                "b": 120.799
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                                "field_kind": "text",
                                "source": "blank_line",
                                "label": "I certify that I have examined this individual and find him/her free of any medical problem or communicable disease that could interfere with his/her performing the duties of student teaching except as follows:",
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                                "label_ref": "p3.17"
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                            "reading_order": 2
                        },
                        {
                            "id": "p3.17.4",
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                                "r": 515.9496,
                                "b": 120.799
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                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "source": "blank_line",
                                "label": "I certify that I have examined this individual and find him/her free of any medical problem or communicable disease that could interfere with his/her performing the duties of student teaching except as follows:",
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                                "label_ref": "p3.17"
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                            "reading_order": 3
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                    ],
                    "reading_order": 16
                },
                {
                    "id": "p3.18",
                    "order": 42,
                    "type": "text",
                    "bbox": {
                        "l": 34.32,
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                    "text": "Printed Name",
                    "reading_order": 17
                },
                {
                    "id": "p3.19",
                    "order": 43,
                    "type": "text",
                    "bbox": {
                        "l": 250.32,
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                        "r": 300.96,
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                    "text": "Signature",
                    "reading_order": 18
                },
                {
                    "id": "p3.20",
                    "order": 44,
                    "type": "heading",
                    "bbox": {
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                    "text": "Date:",
                    "level": 3,
                    "reading_order": 19
                },
                {
                    "id": "p3.21",
                    "order": 45,
                    "type": "footer",
                    "bbox": {
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                    "text": "Updated 2/8/18",
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                    "reading_order": 20
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            ]
        }
    ]
}