Cooperating Teacher Stipend Verification Form

Cooperating Teacher Stipend Verification Form

Teachers who are supervising EIU student teachers should complete this form to receive stipends and tuition waivers. FOR FALL 2016 SUPERVISION, PLEASE SUBMIT THIS FORM BY NOVEMBER 15, 2016

  • Enter the student teacher's name here.

  • Enter the subject(s) and/or grade(s) the student teacher is teaching with you.

  • Indicate the number of weeks the student teacher is working under your supervision.

  • Include the name of the EIU coordinator who is working with you and the student teacher.

  • Enter your EIU E-Number, if you have one. If you do not have one or do not know your EIU E-Number, you may skip this line.

  • Enter your address.

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  • Enter the name of your school.

  • Enter the name of your principal.

  • Enter the address of your school.

  • You must check this box to verify that all information is correct. If you have questions, contact the Student Teaching office at 217-581-2620.