School Partner Request Form School Partner Request Form School Partner Request Form THIS FORM SHOULD BE COMPLETED BY SCHOOL ADMINISTRATION. Name* First Last Phone (best number to reach you)*Email* Administrative Title*School Name*District Name (NA if not applicable)*School Website*Grade Levels (select all that apply)*PreschoolKindergarten1-3 lower primary4-5 upper primary6-8 middle school9-12 high schoolAcademic field programs you are interested in hosting (select all that apply)*Child and Adolescent Mental HealthDeaf EducationEarly Childhood EducationElementary EducationEnglish EducationEnglish as a Second LanguageMath EducationPhysical EducationReading EducationSchool Adjustment CounselorSchool CounselingScience EducationSocial Studies EducationSpecial EducationWorld Languages EducationStudent level you are interested in hosting at your school (undergraduate; graduate)? (select from dropdown)*Undergraduate studentGraduate studentEither/OrPracticum type you are interested in hosting at your school (practicum; pre-practicum)? (select from dropdown)*Full practicumPre-practicumEither/OrDoes your school have language specific requirements?*YesNoPlease describe (if applicable).Are you an alum of BU or Wheelock?*YesNoHow many teachers on your staff are alum of BU or Wheelock?*NA/not sure1-34-5more than 5Does your school host students from other universities or colleges?*YesNoPlease list which ones (if applicable)Does your school have parking available to students?*YesNoIs your school MBTA accessible from BU Wheelock?*YesNoTell us why you are interested in hosting BU Wheelock students at your school.*Is there anything else you would like to share with us about your school?PLEASE NOTE: Supervising Practitioners must have at least three full years of experience under an appropriate Initial or Professional license and an evaluation rating of proficient or higher, under whose immediate supervision the candidate for licensure practices during a practicum.