STATE UNIVERSITY OF NEW YORK � URBAN TEACHER EDUCATION CENTER 
NEW YORK CITY DEPARTMENT OF EDUCATION OFFICE 
65 Court Street, Room 405 Brooklyn New York 11201 


University / College Request for Student Placement 
NEW YORK CITY STUDENT TEACHING 
 

Please list all students who are requesting a student teacher placement in the New York City Public School 
System. Also, identify the beginning and ending dates for the first and second sessions of the placement as 
well as the grade levels/subjects being requested. 


College / University: ____________________________________________     Fall _____ Spring _____ Year _______ 

Assignment #1: Begins: _______ Ends: _______        Assignment #2: Begins: _______  Ends: _______ 

 

Last Name	First Name 	Levels: 			Academic 		Borough Preferences
				Early Childhood 		Discipline
				Childhood 
				Middle Childhood 
				Adolescence 
				Specialty Subject (N-12) 


 



  

 
 



(Please copy this form and complete as necessary) 


Are students required to take SUTEC seminars? Yes ______ (weekly  or  bi-weekly)   No ______ 

Provide the date(s) above student teachers must be on campus during their student teaching term: __________ 

___________________________________________________________________________________________________________ 

 

___________________________________   ________________________________    __ __ __ / __ __ __ / __ __ __ __ 
(Name of Contact Person)	      (Title)				  (Telephone) 

 

__ __ __ / __ __ __ / __ __ __ __     ________________________________    _________________________________
(Fax #)				      (E-Mail Address)			  (Signature) 
 

Please return this information and SUTEC Student Teacher Application forms by mail, fax, or e-mail to:  

SUTEC (SUNY Urban Teacher Education Center) 
NYC Dept. of Education Office 
65 Court Street, Room 405 
Brooklyn, New York 11201 

Phone: (718) 935-5515    Fax: (718) 935-2798    E-mail: Natalie.Lukas@suny.edu