Resident and Student Observer Application from Cleveland ISD

Resident and Student Observer Application

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Resident and Student Observer Application

Thank you for your interest in conducting the observation hours required by your Educator Preparation Program in Cleveland ISD. Follow the instructions below to initiate a student observer criminal background check before reporting to a Cleveland campus.

REQUIRED: A signed approval form from either an ACP, college, or university program stating the need to complete observation hours or field experience is required.

Contact Information

Name (First, Middle, Last):	required
Other Names Used (if applicable):	required
Mailing Address:	required
City:	required
State:	required
Zip Code:	required
Email Address:	required
Phone Number:	required

Background Check Information

Cleveland Independent School District does not discriminate on any basis prohibited by applicable law including race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran’s status or genetic information. I consent for Cleveland ISD to obtain my background information, including any criminal history records. I understand this information will be used only for evaluation of my student observer application. I hereby authorize the Texas Department of Public Safety or any other entity authorized to access state or federal agency records to furnish Cleveland ISD, or its agent, my background records. I hereby certify that all information provided by me on this form is true, complete, and correct. I understand that any false statements made herein may void my application.

Social Security Number:	required
Government Issued ID Number:	required
Date of Birth:	required
Emergency Contact Name:	required
Emergency Contact Phone Number:	required

Campus Preference

Please select your campus preference:

College/University Information

Name of Program Contact:	required
Alternative Certification Program (if applicable):	required
Number of Hours Requested:	required
Degree Seeking:	required
Grade Request:	required
Special Programming:	required
Observation Window Requested:	required

Document Upload

Government Issued ID:

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A signed approval form from your ACP, college, or university program stating the need to complete observation hours or field experience:

Add a File

Additional Information and Guidelines

A CIeveland ISD Classroom Observer: A classroom observer is a college/university student or alternative certification candidate who needs to obtain field-based observation experience to fulfill a class or program requirement. The number of observation hours should not exceed 60 hours.

Classroom Observer Application Process:

Complete the application in it's entirety to ensure prompt processing.

No observations may occur until the application has been approved.

Upon approval, observers will be invited to visit the CISD Administration Building, 1901 E. Houston Street, Cleveland, Texas 77327, to obtain a Classroom Observer ID badge

Observers are responsible for coordinating and scheduling observation hours and schedule observation times.

Applications must be renewed each semester and include current syllabus or program acceptance letter.

Classroom Observer Guidelines:

Requests for observations must be associated with a college course or Alternative Certification Program Requirement

A current class syllabus or Alt. Program acceptance letter is required with the application

Observation hours must not exceed 60 hours

Observations are not permitted prior to the first six weeks of instruction per semester.

Direct student contact is prohibited.

Cell phone use and video recording are prohibited during observations.

No observations are permitted in Special Education settings.

Professional dress and decorum are required.

Observers must present and wear the district issued Classroom Observer identification badge.

Classroom observations requests are subject to availability and campus principals reserve the right to deny requests.

Observation Application Deadlines: Fall: The last week in September Spring: The last week in January Summer: The last week in May

Classroom Observation Windows: Fall: The first week in October – The first week in December Spring: The first week in February – The first week in May Summer: The first week in June – The last week in June

I agree to the terms and conditions of the student observer guidelines. I also understand that electronically signing this form constitutes a legal signature confirming that I acknowledge and agree to the above terms. I understand that my electronic signature is the legal equivalent of my manual signature and may not be denied legal effect or enforceability solely because it is in electronic form.

By typing in your name (your “eSignature”), you accept and consent to be legally bound by this document’s statements, terms and conditions as if this document was signed by you in writing with pen on paper. You agree that no third party or other means of verification is necessary to validate your eSignature and that the lack of such third party or other means of verification will not in any way affect the enforceability of this document.

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History

Step: Someone fills out the form
Sent To: User - tclark, On: 4/3/2025 9:51:58 AM Central Standard Time

Cleveland ISD - Resident and Student Observer Application