Cooperating Teacher Training Confirmation

Cooperating Teacher Training Confirmation

This form is to indicate the completion of all requirements for cooperating teacher training required by 16 KAR 5:040 and the Boyce College Educator Preparation Program.
  • Please use the email associated with the school/organization for which you work.
  • Please indicate the school/organization through which you are employed.
  • Please indicate the date that all training requirements were completed.
    MM slash DD slash YYYY
  • According to 16 KAR 5:040 Section 1, all cooperating teachers are required to hold valid teaching certificates or licenses for all grade levels and subjects taught. Please list certificates and licenses as well as their expiration dates below.
  • By checking the following boxes, I am confirming that I have completed in full the cooperating teacher training required by 16 KAR 5:040 and the Boyce College Educator Preparation Program. I understand that all items listed below must be complete in order to be eligible to serve as a cooperating teacher.
  • I have agreed to submit this confirmation of training by electronic means. By completing this form and typing my name below, I certify that I understand the questions and statements on this form and that my answers are correct and complete to the best of my knowledge.