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Field Experience Request Submission Instructions

Submitting Field Experience Request

Step 1: Instructor Completes the Field Experience Form


  • Use black ink only.
  • Complete one form per class section for each school campus placement i.e. each individual school campus will have a separate field experience form
  • Complete all sections on the form (see below). Incomplete forms will not be processed and will be returned for completion.
    • Rubric/Course title – list the course rubric and class name.
    • Class day/time – list when the class meets on the school campus.
    • Total number of candidates – list how many students are enrolled in the class.
    • Suite Secretary – list suite secretary’s name.
    • Field Experience/Activities/Duties should describe what tasks the student will be performing on the school campus i.e. observing one time, teaching four times, etc.
    • School District must be listed.
    • Campus name must be listed.
    • Grade level – list grade level at which the experience will take place.
    • Dates of visits – dates on which the students will be on the school campus.  DO NOT WRITE “TBD”.  Request forms submitted without an approximate start date will not be processed.
    • Times of visits – Approximate times at which the students will be on the school campus
    • Number of students per visit – list the number of students to be placed at the school campus.
    • Employee information – any student employed with the district should be listed, including their position title and employee ID#, if applicable.
    • NOTE: students employed with the district are still required to complete a background information form and undergo a criminal background check. 

Step 2: Attach Class Roster

  • Print roster in a large font to be easily read.
  • If students listed on the roster are attending different districts or school campuses, please mark their names out on the roster.
  • Rosters should indicate only those students for which the request is being submitted.

Step 3: Program Verification Letter

  • Include verification letter if required per district instructions.
  • The Program Verification Letter (Sample), if required by the district, must contain the following information:
    • On university/program letterhead
    • Student’s name
    • Semester and year
    • Course name and number
    • Instructor
    • Instructor’s telephone number
    • Instructor’s email
    • District requested
    • Campus requested
    • Statement of need to complete observation hours or field experience
    • Signed by instructor and dated

Step 4: Syllabus

Include a syllabus if required per district instructions

Step 5: Submission to CPDT Office

Submit the following documents to the CPDT Office who will obtain approval from the district and notify you when students may proceed. 

  • Field Experience Request Form
  • Class Roster
  • Verification Letter (if required by district)
  • Course Syllabus (if required by district)

Please cc: your suite secretary on all field experience communication to the CPDT Office. 

Step 6: Instructors 

  • Keep a copy of submitted field experience request forms.
  • DO NOT retain a copy of a student's criminal history form, doing so is both unacceptable and illegal. 
  • Inform students when school district approvals have been obtained. 
  • Inform students of where to go, whom to contact, time to report, etc. 


  • Center for Professional Development of Teachers

    Phone: 281-283-3612

    Bayou Building 1231
    2700 Bay Area Blvd, Box 517
    Houston, TX 77058-1002