{"id":2919,"date":"2019-08-07T15:05:15","date_gmt":"2019-08-07T22:05:15","guid":{"rendered":"https:\/\/test-inside.ewu.edu\/educationprograms\/?page_id=2919"},"modified":"2023-08-28T08:49:10","modified_gmt":"2023-08-28T15:49:10","slug":"teacher-education-professional-disposition-assessment-form","status":"publish","type":"page","link":"https:\/\/test-inside.ewu.edu\/educationprograms\/teacher-education-professional-disposition-assessment-form\/","title":{"rendered":"Teacher Education: Professional Disposition Assessment Form"},"content":{"rendered":"<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});<\/script>\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_86' style='display:none'><form method='post' enctype='multipart\/form-data'  id='gform_86'  action='\/educationprograms\/wp-json\/wp\/v2\/pages\/2919' data-formid='86' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_86' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_86_32\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_32\" ><h2 class=\"gsection_title\">Overview of Dispositions and Expectations<\/h2><\/li><li id=\"field_86_1\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_1\" >You are preparing for a profession that requires the highest norms of conduct. P-12 students will often emulate the professional beliefs and behaviors of their teachers who spend a large part of the day with them. Professional dispositions are the values, actions, attitudes, and beliefs of educators as they interact with students, families, community members, and professional colleagues.  Professional dispositions are a vital element of professional preparation and are the expected behaviors of all educators. <br><br>\nThe expectations outlined in the Professional Dispositions Form apply to those you interact with in your placement community, as well as with faculty, staff and employees at Eastern Washington University. The Education faculty is committed to preparing you to enter the teaching profession. While our coursework focuses on content information and instructional methodology, successful teaching requires more than just academic knowledge. <br><br>\nThe following are the candidate dispositions required by the EWU School of Education initial teaching programs:  <\/li><li id=\"field_86_19\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_19\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Please check each item as reviewed:<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_86_19'><li class='gchoice gchoice_86_19_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.1' type='checkbox'  value='1. Participate actively and enthusiastically in your learning. This includes, but is not limited to being an active participant in class discussions (whether online or in-person), using your computer only for classwork during class, having your camera turned on for online classes, etc. (InTasc 2.1.m)'  id='choice_86_19_1'   aria-describedby=\"gfield_description_86_19\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_86_19_1' id='label_86_19_1' class='gform-field-label gform-field-label--type-inline'>1. Participate actively and enthusiastically in your learning. This includes, but is not limited to being an active participant in class discussions (whether online or in-person), using your computer only for classwork during class, having your camera turned on for online classes, etc. (InTasc 2.1.m)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_86_19_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.2' type='checkbox'  value='2. Demonstrate punctuality: come to class\/placement on time and stay for the entire scheduled time. Notify those involved when you are unable to meet those expectations prior to your absence. (WAC 181-78A-232)'  id='choice_86_19_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_86_19_2' id='label_86_19_2' class='gform-field-label gform-field-label--type-inline'>2. Demonstrate punctuality: come to class\/placement on time and stay for the entire scheduled time. Notify those involved when you are unable to meet those expectations prior to your absence. (WAC 181-78A-232)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_86_19_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.3' type='checkbox'  value='3. Demonstrate a positive attitude of commitment and professionalism toward the goal of becoming an effective teacher: complete work on time, come to class\/placement classroom prepared, and seek help when needed.  (InTasc 2.1.l, WAC 181-78A-220)'  id='choice_86_19_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_86_19_3' id='label_86_19_3' class='gform-field-label gform-field-label--type-inline'>3. Demonstrate a positive attitude of commitment and professionalism toward the goal of becoming an effective teacher: complete work on time, come to class\/placement classroom prepared, and seek help when needed.  (InTasc 2.1.l, WAC 181-78A-220)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_86_19_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.4' type='checkbox'  value='4. Be flexible and receptive toward new ideas and differing opinions. You should expect to be stretched in your thinking. (InTasc 9.2&amp;3.m)'  id='choice_86_19_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_86_19_4' id='label_86_19_4' class='gform-field-label gform-field-label--type-inline'>4. Be flexible and receptive toward new ideas and differing opinions. You should expect to be stretched in your thinking. (InTasc 9.2&amp;3.m)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_86_19_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.5' type='checkbox'  value='5. Engage in reflective and higher-level thinking. This means thinking about what you are learning by making connections between what you know and have experienced as a learner and what you are learning in your coursework and field placements. You must consistently consider how current course information connects to previously learned material and how it applies to classroom students. (CCDEI 1, 2, 3, 4, SEL, STI-A)'  id='choice_86_19_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_86_19_5' id='label_86_19_5' class='gform-field-label gform-field-label--type-inline'>5. Engage in reflective and higher-level thinking. This means thinking about what you are learning by making connections between what you know and have experienced as a learner and what you are learning in your coursework and field placements. You must consistently consider how current course information connects to previously learned material and how it applies to classroom students. (CCDEI 1, 2, 3, 4, SEL, STI-A)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_86_19_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.6' type='checkbox'  value='6. Demonstrate professionalism and proficiency in all communication and consider how your communication impacts others. (WAC 181-78A-232)'  id='choice_86_19_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_86_19_6' id='label_86_19_6' class='gform-field-label gform-field-label--type-inline'>6. Demonstrate professionalism and proficiency in all communication and consider how your communication impacts others. (WAC 181-78A-232)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_86_19_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.7' type='checkbox'  value='7. Respond positively to feedback and follow through with corrective action. (InTasc 1.1.k)'  id='choice_86_19_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_86_19_7' id='label_86_19_7' class='gform-field-label gform-field-label--type-inline'>7. Respond positively to feedback and follow through with corrective action. (InTasc 1.1.k)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_86_19_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.8' type='checkbox'  value='8. Refrain from disruptive behavior during class\/placement (talking when others are speaking, using cell phones, texting, etc.).(WAC 181-78A-232.c.1)'  id='choice_86_19_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_86_19_8' id='label_86_19_8' class='gform-field-label gform-field-label--type-inline'>8. Refrain from disruptive behavior during class\/placement (talking when others are speaking, using cell phones, texting, etc.).(WAC 181-78A-232.c.1)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_86_19_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.9' type='checkbox'  value='9. Treat peers, instructors, mentor teachers, parents, supervisors, administrators and staff with respect and courtesy. (WAC 181-78A-232)'  id='choice_86_19_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_86_19_9' id='label_86_19_9' class='gform-field-label gform-field-label--type-inline'>9. Treat peers, instructors, mentor teachers, parents, supervisors, administrators and staff with respect and courtesy. (WAC 181-78A-232)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_86_19_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.11' type='checkbox'  value='10. Work collaboratively with peers, instructors, and cooperating teachers. (WAC 181-78A-232.c.ii)'  id='choice_86_19_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_86_19_11' id='label_86_19_11' class='gform-field-label gform-field-label--type-inline'>10. Work collaboratively with peers, instructors, and cooperating teachers. (WAC 181-78A-232.c.ii)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_86_19_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.12' type='checkbox'  value='11. Dress appropriately and professionally (i.e., no blue jeans or flip-flops), and demonstrate appropriate grooming, e.g., cleanliness.(WAC 181-78A-220)'  id='choice_86_19_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_86_19_12' id='label_86_19_12' class='gform-field-label gform-field-label--type-inline'>11. Dress appropriately and professionally (i.e., no blue jeans or flip-flops), and demonstrate appropriate grooming, e.g., cleanliness.(WAC 181-78A-220)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_86_19_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.13' type='checkbox'  value='12. Demonstrate responsible use and interaction on social media platforms. (WAC 181-78A-220)'  id='choice_86_19_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_86_19_13' id='label_86_19_13' class='gform-field-label gform-field-label--type-inline'>12. Demonstrate responsible use and interaction on social media platforms. (WAC 181-78A-220)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_86_19_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.14' type='checkbox'  value='13. Respond promptly and professionally to emails, phone calls, and other correspondence from instructors, mentor teachers, field supervisors, etc.(WAC 181-78A-232.c.i)'  id='choice_86_19_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_86_19_14' id='label_86_19_14' class='gform-field-label gform-field-label--type-inline'>13. Respond promptly and professionally to emails, phone calls, and other correspondence from instructors, mentor teachers, field supervisors, etc.(WAC 181-78A-232.c.i)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_86_19_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.15' type='checkbox'  value='14. Respect the confidentiality of your mentor teacher, students and their parents, peers, and faculty in all written and oral communication. (WAC 181-78A-220.1.b.iii)'  id='choice_86_19_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_86_19_15' id='label_86_19_15' class='gform-field-label gform-field-label--type-inline'>14. Respect the confidentiality of your mentor teacher, students and their parents, peers, and faculty in all written and oral communication. (WAC 181-78A-220.1.b.iii)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_86_19_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_19.16' type='checkbox'  value='15.  Adhere to ethics and policies of EWU, the School of Education, and the profession of teaching.  This includes demonstrating truthfulness, honesty, and integrity.  Cite resources according to course syllabi, which may include lesson supports, ideas, and research (including Artificial Intelligence).(WAC 181-87)'  id='choice_86_19_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_86_19_16' id='label_86_19_16' class='gform-field-label gform-field-label--type-inline'>15.  Adhere to ethics and policies of EWU, the School of Education, and the profession of teaching.  This includes demonstrating truthfulness, honesty, and integrity.  Cite resources according to course syllabi, which may include lesson supports, ideas, and research (including Artificial Intelligence).(WAC 181-87)<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_86_19'>Note: Each item must be checked to submit this form. <\/div><\/li><li id=\"field_86_20\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_20\" ><br>\nThe Professional Dispositions Assessment Form is a pro-active communication instrument that may be used to guide preservice teachers' growth as professionals. If an issue of professional disposition arises, the education faculty will submit a referral form to the Committee for Admission, Recruitment, Retention and Transition (CARRT) team. A conference will be scheduled with the candidate and the CARRT team to discuss the issue(s). Plans for addressing or solving the issue(s) will be completed. If the problem has not been satisfactorily addressed, the candidate may fail the course in which the issue(s) arose, be removed from his\/her placement or be dismissed from the program. <\/li><li id=\"field_86_2\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_2\" ><h2 class=\"gsection_title\">Candidate Agreement<\/h2><\/li><li id=\"field_86_37\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_37\" ><label class='gfield_label gform-field-label' for='input_86_37'>EWU ID#<\/label><div class='ginput_container ginput_container_number'><input name='input_37' id='input_86_37' type='number' step='any'   value='' class='small'      aria-invalid=\"false\" aria-describedby=\"gfield_description_86_37\" \/><\/div><div class='gfield_description' id='gfield_description_86_37'>Please enter your EWU ID#<\/div><\/li><li id=\"field_86_5\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_5\" >I understand that if any concerns around disposition arise in my coursework and\/or I lose my field placement due to disposition issues, I may be suspended from my placement for a minimum of one quarter, removed from the course for the quarter, or removed from the Education Program. <br><br>\nI have read the Professional Dispositions Assessment Form and understand its use and purpose in the Department of Education. <\/li><li id=\"field_86_6\" class=\"gfield gfield--type-name gfield--input-type-name gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_6\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Candidate Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_86_6'>\n                            \n                            <span id='input_86_6_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_6.3' id='input_86_6_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_86_6_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_86_6_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_6.6' id='input_86_6_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_86_6_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_86_21\" class=\"gfield gfield--type-email gfield--input-type-email gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_21\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Candidate Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_86_21_container'>\n                                <span id='input_86_21_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_21' id='input_86_21' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_86_21' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_86_21_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_21_2' id='input_86_21_2' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_86_21_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/li><li id=\"field_86_36\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_36\" ><label class='gfield_label gform-field-label' for='input_86_36'>Select Course<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_36' id='input_86_36' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Application Orientation' >Application Orientation<\/option><option value='EDUC 201' >EDUC 201<\/option><option value='EDUC 300' >EDUC 300<\/option><option value='EDUC 303\/309\/341\/413\/386A' >EDUC 303\/309\/341\/413\/386A<\/option><option value='EDUC 304' >EDUC 304<\/option><option value='EDUC 310\/338\/340\/303\/386A' >EDUC 310\/338\/340\/303\/386A<\/option><option value='EDUC 344\/444\/454' >EDUC 344\/444\/454<\/option><option value='SPED 363' >SPED 363<\/option><option value='EDUC 386B' >EDUC 386B<\/option><option value='EDUC 386E' >EDUC 386E<\/option><option value='EDUC 390' >EDUC 390<\/option><option value='EDUC 403' >EDUC 403<\/option><option value='EDUC 423' >EDUC 423<\/option><option value='EDUC 426' >EDUC 426<\/option><option value='EDUC 427' >EDUC 427<\/option><option value='EDUC 451' >EDUC 451<\/option><option value='EDUC 464' >EDUC 464<\/option><option value='SPED 488' >SPED 488<\/option><option value='EDUC 494' >EDUC 494<\/option><option value='MIT Fall' >MIT Fall<\/option><option value='MIT Winter' >MIT Winter<\/option><option value='MIT Spring' >MIT Spring<\/option><option value='Transition to Teaching' >Transition to Teaching<\/option><\/select><\/div><\/li><li id=\"field_86_7\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gf_left_half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_7\" ><label class='gfield_label gform-field-label' for='input_86_7'>Date<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_7' id='input_86_7' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_86_7_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_86_7_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_86_7' class='gform_hidden' value='https:\/\/test-inside.ewu.edu\/educationprograms\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_86_38\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_38\" ><h2 class=\"gsection_title\">Leave the rest of the form blank if you are filling this out for Orientation, SPED 363, EDUC 201, EDUC 304, or EDUC 390<\/h2><\/li><li id=\"field_86_12\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_12\" ><h2 class=\"gsection_title\">Placement Information<\/h2><div class='gsection_description' id='gfield_description_86_12'>The following information along with your name, email and current course enrollment will be sent to your mentor teacher for their reference when completing required forms. <\/div><\/li><li id=\"field_86_29\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  data-js-reload=\"field_86_29\" ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label gfield_label_before_complex' >Long Distance<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_86_29'><li class='gchoice gchoice_86_29_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_29.1' type='checkbox'  value='This is a long distance learning placement.'  id='choice_86_29_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_86_29_1' id='label_86_29_1' class='gform-field-label gform-field-label--type-inline'>This is a long distance learning placement.<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_86_9\" class=\"gfield gfield--type-name gfield--input-type-name gf_left_half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_9\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Mentor Teacher Name<\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_86_9'>\n                            \n                            <span id='input_86_9_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_9.3' id='input_86_9_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_86_9_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_86_9_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_9.6' id='input_86_9_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_86_9_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_86_10\" class=\"gfield gfield--type-email gfield--input-type-email gf_right_half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_10\" ><label class='gfield_label gform-field-label' >Mentor Teacher Email<\/label><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_86_10_container'>\n                                <span id='input_86_10_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_10' id='input_86_10' value=''     aria-invalid=\"false\"  \/>\n                                    <label for='input_86_10' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_86_10_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_10_2' id='input_86_10_2' value=''     aria-invalid=\"false\"  \/>\n                                    <label for='input_86_10_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/li><li id=\"field_86_22\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_22\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Additional Mentor<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_86_22'><li class='gchoice gchoice_86_22_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.1' type='checkbox'  value='I have a second mentor teacher.'  id='choice_86_22_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_86_22_1' id='label_86_22_1' class='gform-field-label gform-field-label--type-inline'>I have a second mentor teacher.<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_86_23\" class=\"gfield gfield--type-name gfield--input-type-name gf_left_half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_23\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Second Mentor Teacher Name<\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_86_23'>\n                            \n                            <span id='input_86_23_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_23.3' id='input_86_23_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_86_23_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_86_23_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_23.6' id='input_86_23_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_86_23_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_86_24\" class=\"gfield gfield--type-email gfield--input-type-email gf_right_half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_24\" ><label class='gfield_label gform-field-label' >Second Mentor Teacher Email<\/label><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_86_24_container'>\n                                <span id='input_86_24_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_24' id='input_86_24' value=''     aria-invalid=\"false\"  \/>\n                                    <label for='input_86_24' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_86_24_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_24_2' id='input_86_24_2' value=''     aria-invalid=\"false\"  \/>\n                                    <label for='input_86_24_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/li><li id=\"field_86_25\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_25\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Additional Mentor<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_86_25'><li class='gchoice gchoice_86_25_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_25.1' type='checkbox'  value='I have a third mentor teacher.'  id='choice_86_25_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_86_25_1' id='label_86_25_1' class='gform-field-label gform-field-label--type-inline'>I have a third mentor teacher.<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_86_26\" class=\"gfield gfield--type-name gfield--input-type-name gf_left_half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_26\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Third Mentor Teacher Name<\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_86_26'>\n                            \n                            <span id='input_86_26_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_26.3' id='input_86_26_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_86_26_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_86_26_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_26.6' id='input_86_26_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_86_26_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_86_27\" class=\"gfield gfield--type-email gfield--input-type-email gf_right_half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_27\" ><label class='gfield_label gform-field-label' >Third Mentor Teacher Email<\/label><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_86_27_container'>\n                                <span id='input_86_27_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_27' id='input_86_27' value=''     aria-invalid=\"false\"  \/>\n                                    <label for='input_86_27' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_86_27_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_27_2' id='input_86_27_2' value=''     aria-invalid=\"false\"  \/>\n                                    <label for='input_86_27_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/li><li id=\"field_86_11\" class=\"gfield gfield--type-select gfield--input-type-select gf_left_half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_11\" ><label class='gfield_label gform-field-label' for='input_86_11'>Supervisor for Course<\/label><div class='ginput_container ginput_container_select'><select name='input_11' id='input_86_11' class='large gfield_select'     aria-invalid=\"false\" ><option value='I have not yet been assigned a supervisor.' >I have not yet been assigned a supervisor.<\/option><option value='Boughter, Stephanie' >Boughter, Stephanie<\/option><option value='Brazil, Alissa' >Brazil, Alissa<\/option><option value='Cicero, Leslie' >Cicero, Leslie<\/option><option value='Clifton, Carrie' >Clifton, Carrie<\/option><option value='Cunningham, Richelle' >Cunningham, Richelle<\/option><option value='Duren, Rob' >Duren, Rob<\/option><option value='Evern, Dale' >Evern, Dale<\/option><option value='Fredrickson, Serena' >Fredrickson, Serena<\/option><option value='Hendrickson, Jennifer' >Hendrickson, Jennifer<\/option><option value='Gary, Clive' >Gary, Clive<\/option><option value='Landstrom, Lisa' >Landstrom, Lisa<\/option><option value='Lepisi, Ashley' >Lepisi, Ashley<\/option><option value='Montocucco, Kim' >Montocucco, Kim<\/option><option value='Nelson, Jamie' >Nelson, Jamie<\/option><option value='Rudd, Cara' >Rudd, Cara<\/option><option value='Warner, Lisa' >Warner, Lisa<\/option><option value='Other' >Other<\/option><\/select><\/div><\/li><li id=\"field_86_30\" class=\"gfield gfield--type-name gfield--input-type-name gf_left_half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_30\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Supervisor Name (leave blank if unplaced)<\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_86_30'>\n                            \n                            <span id='input_86_30_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_30.3' id='input_86_30_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_86_30_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_86_30_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_30.6' id='input_86_30_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_86_30_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_86_18\" class=\"gfield gfield--type-email gfield--input-type-email gf_right_half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_18\" ><label class='gfield_label gform-field-label' >Supervisor Email (use OFEEDU@ewu.edu if unplaced)<\/label><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_86_18_container'>\n                                <span id='input_86_18_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_18' id='input_86_18' value=''     aria-invalid=\"false\"  \/>\n                                    <label for='input_86_18' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_86_18_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_18_2' id='input_86_18_2' value=''     aria-invalid=\"false\"  \/>\n                                    <label for='input_86_18_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/li><li id=\"field_86_31\" class=\"gfield gfield--type-name gfield--input-type-name field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_31\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Supervisor Name<\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_86_31'>\n                            \n                            <span id='input_86_31_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_31.3' id='input_86_31_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_86_31_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_86_31_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_31.6' id='input_86_31_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_86_31_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_86_13\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_13\" ><label class='gfield_label gform-field-label' >Program<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_86_13'>\n\t\t\t<li class='gchoice gchoice_86_13_0'>\n\t\t\t\t<input name='input_13' type='radio' value='Elementary (K-8)'  id='choice_86_13_0'    \/>\n\t\t\t\t<label for='choice_86_13_0' id='label_86_13_0' class='gform-field-label gform-field-label--type-inline'>Elementary (K-8)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_86_13_1'>\n\t\t\t\t<input name='input_13' type='radio' value='Secondary (5-12)'  id='choice_86_13_1'    \/>\n\t\t\t\t<label for='choice_86_13_1' id='label_86_13_1' class='gform-field-label gform-field-label--type-inline'>Secondary (5-12)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_86_13_2'>\n\t\t\t\t<input name='input_13' type='radio' value='Early Childhood (P-3)'  id='choice_86_13_2'    \/>\n\t\t\t\t<label for='choice_86_13_2' id='label_86_13_2' class='gform-field-label gform-field-label--type-inline'>Early Childhood (P-3)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_86_13_3'>\n\t\t\t\t<input name='input_13' type='radio' value='Dual Elem Ed\/Special Education'  id='choice_86_13_3'    \/>\n\t\t\t\t<label for='choice_86_13_3' id='label_86_13_3' class='gform-field-label gform-field-label--type-inline'>Dual Elem Ed\/Special Education<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_86_13_4'>\n\t\t\t\t<input name='input_13' type='radio' value='Blended Special Education and Early Childhood'  id='choice_86_13_4'    \/>\n\t\t\t\t<label for='choice_86_13_4' id='label_86_13_4' class='gform-field-label gform-field-label--type-inline'>Blended Special Education and Early Childhood<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_86_14\" class=\"gfield gfield--type-select gfield--input-type-select gf_left_half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_14\" ><label class='gfield_label gform-field-label' for='input_86_14'>Elementary Major<\/label><div class='ginput_container ginput_container_select'><select name='input_14' id='input_86_14' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Art' >Art<\/option><option value='Children&#039;s Studies' >Children&#039;s Studies<\/option><option value='Early Childhood Education' >Early Childhood Education<\/option><option value='Elementary Education' >Elementary Education<\/option><option value='English' >English<\/option><option value='French' >French<\/option><option value='Health\/Fitness' >Health\/Fitness<\/option><option value='Literacy' >Literacy<\/option><option value='Mathematics' >Mathematics<\/option><option value='Middle Level Mathematics' >Middle Level Mathematics<\/option><option value='Natural Science' >Natural Science<\/option><option value='Music' >Music<\/option><option value='Social Studies' >Social Studies<\/option><option value='Spanish' >Spanish<\/option><option value='Other' >Other<\/option><\/select><\/div><\/li><li id=\"field_86_15\" class=\"gfield gfield--type-select gfield--input-type-select gf_right_half field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_86_15\" ><label class='gfield_label gform-field-label' for='input_86_15'>Second Elementary Major<\/label><div class='ginput_container ginput_container_select'><select name='input_15' id='input_86_15' class='medium gfield_select'  aria-describedby=\"gfield_description_86_15\"   aria-invalid=\"false\" ><option value='' ><\/option><option value='Art' >Art<\/option><option value='Children&#039;s Studies' >Children&#039;s 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