Student Field Experience & Clinical Practice Application 2024-2025

Student Field Experience & Clinical Practice Application Form 2024-2025

Last Name

First Name

Preferred Name

OSU Student ID #

I identify my gender as

Street Address, City, State, and Zip Code

Phone Number

OSU Email Address

Other Email Address

Our P-12 partners require us to inform them of accommodations to assist students. In order to determine the best field placement for you, please indicate any additional documented accommodations or other factors you need. For example, a service animal, mobility impairment, sign language interpreter, etc.

Do you have transportation?

Yes
No