===== PAGE 1 ===== # Kentucky State University School of Education and Human Development P-12 Field Experience Verification ## Teacher Candidate For every field experience, fill in the setting, date and time, education activity(ies), and course assignment before you ask the supervising professional at the field site to verify the information, with his/her signature, at the end of your visit. When the entire form is complete, submit copy to your instructor, and scan and keep copy for your records. You will need to have proof of field hours when you apply for the Teacher Education Program (TEP) and when you apply for student teaching, you will need verification of 200 field hours. Teacher Candidate Student ID: ___ Semester & Year Course: ___ 〜〜 Required Hours: 〓
School/LocationDate & TimeActivity(ies)Verification Signature & DateTime Subtotals
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