PALM BEACH STATE COLLEGE Academic Services

Field Observation at PBSC

A Guide for Students

August 2012 http://www.palmbeachstate.edu/academicservices/curriculum-and-programs/field-observation/default.aspx

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Introduction As a part of the requirements for completing EDF2005, Introduction to the Teaching Profession and EDF2085, Introduction to Diversity for Educators, students are required to complete 15 hours of field observation (FO) for each course. It is also a requirement for some courses in the EPI program (limited access). The purpose of the field observation is to provide meaningful learning experiences for pre-service educators in accordance with state mandated guidelines for teacher preparation. Through the field observation, students should have an opportunity to:

• Observe best practices and techniques for effective classroom management • Connect theory with practice • Assist students in career decisions • Develop personal skills and values

Course Descriptions: EDF 2005 Introduction to the Teaching Profession – 3 credits (3 lecture hours) This course provides a survey of historical sociological and philosophical foundations of education; governance and finance of education; educational policies; legal, moral, and ethical issues; and the professionalism of teaching. Students will be provided exposure to the Florida Educator Accomplished Practices, Sunshine State Standards, and the Professional Educator Competencies. Students are required to complete a minimum of 15 hours of field observation in a K-12 setting. EDF 2085 Introduction to Diversity for Educators – 3 credits (3 lecture hours) This course provides the opportunity to explore issues of diversity, including an understanding of the influence of exceptionalities, culture, family, gender, socioeconomic status, religion, language of origin, ethnicity, and age upon the educational experience. Students will explore personal attitudes toward diversity and exceptionalities. Students will be provided exposure to the Florida Educator Accomplished Practices, Sunshine State Standards, and the Professional Educator. A minimum of 15 hours of field-based observation working with diverse populations of children and youth in schools or similar settings is required. EPI – Some EPI courses require field observation (limited access program). Contact the Institute of Teacher Education for further information on placement requirements.

Overview of Field Observation Process

STEP 1 STUDENT ORIENTATION

STEP 2 SELECT PLACEMENT VENUE

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STEP 3 (A or B) SECURITY AND BACKGROUND CHECK

STEP 4 REQUEST PLACEMENT

STEP 5 REPORTING FOR ASSIGNMENT

STEP 6 FIELD OBSERVATION COMPLETION

Field Observation consists of observing a class (student does not teach nor is left alone with the students). Field Observation can be completed in a public school setting, charter school setting, private school or other setting approved by the instructor. The process for the Student Observer is as follows: STEP 1 - STUDENT ORIENTATION PBSC faculty member explains the Field Observation process to student, including requirements of the assignment and expectations of the faculty member for student to satisfy the assignment. STEP 2 – SELECTING PLACEMENT VENUE Students who select a SDPBC (School District of Palm Beach County) public school placement must go through Level 2 security clearance which includes fingerprinting and FBI background check. Students who select a charter or private school setting must go to the Other Field Observation Opportunities link and follow those placement procedures (Many of these do not necessarily require Level 2 security clearance). Students who want to use another venue of their own must have that venue approved by their instructor before placement. Placement selection should be based on the student’s career goals in education. Some schools do not participate in Field Observation. If the desired school does not accept Field Observations, student should seek other school locations.

STEP 3A – SECURITY CLEARANCE IN A SDPBC PUBLIC SCHOOL CLASSROOM

The School District of Palm Beach County requires all students placed in public school classrooms to have Level 2 security clearance which includes fingerprinting and a FBI background check. To be placed in a SDPBC public school classroom, they must:

• Complete a Pre-service Program Packet, a Background Information Check form, and an Applicant Security Check Form. These forms should be filled in completely, printed out and signed.

• Purchase a money order for $99. Cash, check or credit cards are not accepted. Money orders are available at Publix, Walmart, banks and the U.S. Post Office among other places.

• File the required forms with the SDPBC Police in person, have fingerprints taken and a background check done. This process can only be done by the SDPBC Fingerprinting Office. Results will be mailed to the student in approximately 10 business days (in the form of a student security badge or a letter outlining any problem that has been found. The student will

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need to follow the directions provided by the SDPBC School Police as to whether or not they will be allowed to appeal the decision in the case of a problem.)

STEP 3B – OBSERVATION CLEARANCE IN AN ALTERNATIVE CLASSROOM LOCATION (CHARTER SCHOOLS, PRIVATE SCHOOLS OR OTHER VENUE)

Students who chose to complete their field observation in another location other than a SDPBC public school, will need to contact that location (contact information available under Other Field Observation Placement Opportunities) for placement availability, obtain course instructor approval to use this location for field observation and meet the security requirements of the location.

STEP 4 – REQUEST PLACEMENT Once a student obtains their security badge for the SDPBC public school, they will need to fill in a placement application form, print it out and give it to their instructor. (sample in Appendix) This information is turned into Academic Services who requests the placement for the student through the SDPBC Placement Office. This process takes about 10 days. Students requesting charter or private school placement will need to adhere to the procedures outlined on the Other Field Observation Opportunities website. Those students who have other venues in mind will need to adhere to the placement procedures of those sites. Placements at these locations need to be approved by the course instructor and authorized in writing by the desired location administrator. STEP 5 - REPORTING FOR ASSIGNMENT Public school placement assignments will be sent to the student via their PBSC email. Students need to contact the designated administrator at the school assigned and report as directed. When they arrive, the student will be asked to sign required release forms that are kept on file at the placement school.(Sample in Appendix) Reporting to charter, private and other placement locations will be done as outlined on the Other Field Observation Opportunities website. At all venues, students will be required to keep a log of their observation hours at the school, which is turned into the instructor at the end of the course. (Sample log in Appendix) STEP 6 - FIELD OBSERVATION COMPLETION Field Observation will be complete when all activities, associated assignments, observation log or PBSC Record of Field Observation Hours and other required documentation are submitted to the instructor.

Overview of Security Process and Placement* Effective August 2012, the School District of Palm Beach County requires all PBSC students who wish to be placed in a public school setting to have Level 2 security clearance and their Field Observation assignment made by the School District Placement Office. The purpose of the Security Clearance procedure is to comply with Chapter 1012.56 of the Florida Statutes under section 9 (a) and (b) which explains procedures and standards that must be followed by Florida School Districts when certifying school personnel. *Students who chose to be placed in a Palm Beach County Charter School or Palm Beach County Private School will need to comply with the security requirements of those schools, which are managed separately from the public schools. The security requirements vary from institution to institution and are outlined at Other Field Observation Opportunities. If a student chooses one of these settings, it is the choice of the chosen institution to accept the student for placement and the course instructor to approve

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this placement as meeting the Field Observation requirement of the course. If at any time the selected school denies placement, the student must select another venue. In response to the School District of Palm Beach County (SDPBC) requirements for pre-service teachers to be screened and fingerprinted before being placed for employment and/or field observation assignment in a public school, PBSC has developed the following procedures. Security Clearance Procedures for SDPBC Public Schools To assist Palm Beach State College students with the field placement experience, the School District of Palm Beach County has established a well-defined process that must be followed by all students who are interested in completing the 15 hour component in any of the Palm Beach County public schools. To facilitate and expedite the process, please follow the directions given very carefully as this is the only process for gaining security clearance and field placement to complete the 15 hours component. All fingerprinting MUST be done by the School District of Palm Beach County Police. Fingerprints taken by other agencies, counties and or states will not be accepted by the School District of Palm Beach County. (No exceptions) Follow STEPS 1-7 to obtain a security clearance from the School District of Palm Beach County for public school placement.

STEP 1 Fill-out and Sign Pre-service Program Packet

STEP 2

Fill-out and Sign Background Information Check Form

STEP 3 Fill-out and Sign Applicant Security Check Form

STEP 4 File Paperwork with Palm Beach County School District

STEP 5 Fingerprinting at School District

STEP 6 Police Clearance and Badge Distribution

STEP 7

Register with PBSC Faculty for Placement

Placement Information Emailed to Student from PBSC Academic Services

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STEP 1 – FILL-OUT AND SIGN Pre-service Program Packet GO to the SDPBC FINGERPRINTING AND BADGE RENEWAL INFORMATION webpage and complete one copy of the Pre-service Program Packet by writing in and/or typing in the required information. Make sure to include a social security number and that you check the box "Field observation Checklist." This form can be downloaded from http://www.palmbeachschools.org/schoolpolice/documents/field_experience_checklist.pdf Be sure to sign and date the form. Figure 1 – Pre-service Program Packet

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STEP 2 – FILL-OUT AND SIGN Background Information Check Form GO to the SDPBC FINGERPRINTING AND BADGE RENEWAL INFORMATION webpage and complete one copy of Background Information Check Form by writing in and/or typing in the required information. The information contained in this form will be used, along with your fingerprints, for a comprehensive background check through local, state and national law enforcement agencies. No entry on the form may be left blank. If you have never had any legal names, other than the ones you are currently using, please indicate "Not Applicable" (N/A) in the blank areas provided. False information or information not disclosed may be grounds for security clearance failure. This form can be downloaded at http://www.palmbeachschools.org/schoolpolice/documents/BackgroundInformationCheckForm.pdf Be sure to sign and date the form. Figure 2 – Example of Background Information Check Form

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STEP 3 – FILL-OUT AND SIGN Applicant Security Check Form GO to the SDPBC FINGERPRINTING AND BADGE RENEWAL INFORMATION webpage and complete one copy of Applicant Security Check Form by writing in and/or typing in the required information. Pages 1 and 2 of this form MUST be completed and signed before you may be considered for field observation placement. Read ALL instructions very carefully- failure to fully disclose information will result in problems processing the form or denial of placement. Make sure to include your social security number or the School Police Office will not proceed with the clearance. This form can be downloaded from http://www.PBSC.edu/documents/academic_services/security_check_form.pdf . Be sure to sign and date the form. Figure 2 – Example of Applicant Security Check Form

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STEP 4 - FILE PAPERWORK WITH PALM BEACH COUNTY SCHOOL DISTRICT The School District of Palm Beach County is in the Fulton Holland Educational Center at 3300 Forest Hill Blvd., West Palm Beach. Bring the following five items to the School District Administrative Center:

Completed and signed Pre-service Program Packet Completed and signed Background Information Check form Completed and signed Applicant Security Check form Valid government-issued picture ID (such as a driver's license, Florida Identification card or

passport)* Social Security Card Number – (you MUST have a social security number) Money order in the amount of $99.00. Checks, cash or credit cards are NOT accepted.

*Foreign students should bring a copy of their passport and valid visa for identification.

STEP 5 - FINGERPRINTING AT THE SCHOOL DISTRICT Upon arrival at the School District offices, enter through the front doors and sign-in with the receptionist where you will receive a visitor's pass. The receptionist will give you directions to the School Police Office. The School Police Office will obtain fingerprints from you and stamp your money order receipt as proof that you submitted the appropriate documents required for fingerprinting and background check. You will fill out a self addressed envelope in which the security badge and the results of your background screening will be mailed to you. (Process takes about a week to 10 days). Keep the stamped receipt for your records. Once clearance is done, the School Police will inform the Field Observation Office of the results and placement process will proceed.

STEP 6 - POLICE CLEARANCE AND BADGE DISTRIBUTION The School Police Office will notify the student and the SDPBC Field Placement Office of the fingerprinting results. If the results of the fingerprints analysis do not discover any problems with your background, you will be sent a SDPBC Student Security badge that is good for one academic year. If problems are found, a letter from Employee Relations Office at the School District of Palm Beach County will be sent to the student outlining the appeal process. Placement will not take place until issues have been cleared. Once you have been cleared, the SDPBC will keep a record of this clearance until the PBSC Academic Services Office sends a list of students to be placed. The copy of the badge submitted with the placement request will be matched up with the list of cleared students and placement will be made. (See STEP 7)

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STEP 7 – REGISTER WITH PBSC FACULTY FOR PLACEMENT* Once you have obtained a security badge, you must register your placement request for a public school setting with your instructor. 1. The placement form may be downloaded at Logon to the web address at:

http://www.palmbeachstate.edu/academicservices/Documents/PlacementApplication.doc You can access this form on your home computer or a PBSC computer for this process. Fill-in the form, print it out and give it to your instructor.

2. The placement form includes the following information: Last Name First Name Date (M/D/YY) PBSC Student Number PBSC Email Address @my.palmbeachstate.edu

(this email will be used for all communications with student.) Course (Select One) Reference Number Term/Year (Select one) Type of Placement (Select One) Placement Area Request (Select one) Level of Placement Subject Area of Interest (Select one) If other, specify: SDPBC Student Badge Expiration Date A copy of the badge must be turned into instructor or scanned and emailed to

Academic Services (You can take a picture of the badge with your phone and email it to Academic Services as well.)

EPI Students Certification (Fill in) Current Full-time Teacher Yes No

If yes, school If yes, place in same school? Yes No Any Special Considerations? *If you selected Palm Beach County Charter School, Palm Beach County Private School, or Other location, please go to Other Placement Opportunities and follow the directions there for placement in your choice of location.

Explanation of Fields:

1. Last Name – The name under which you are registered at PBSC 2. First Name – Your first name 3. Date – Date form is submitted to instructor 4. PBSC Student Number – this is your PBSC student ID, NOT your social security number 5. Student email address – this is an email address assigned to you by Palm Beach State College.

This is the only email that will be used for communication concerning Field Observation. 6. Course Number – choose EDF2005, EDF2085 or EPI 7. Reference Number – choose the class reference number from your schedule – 6 digit number

beginning with “16”. 8. Level of Placement – Elementary, Middle or High School 9. Placement Area Request – Central, North, South or West (West means Belle Glade Area;

Wellington and Royal Palm Beach are Central). 10. Badge expiration date – Expiration date printed on your badge

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11. EPI Students-Certification-teacher certification currently held 12. EPI Students-a.) If you are currently teaching, location of school and b) if you want to be placed

in that school

A scanned copy of the student badge must be submitted along with the placement request.

TIMELINE FOR PLACEMENT (IN SDPBC PUBLIC SCHOOLS)* Placement requests for the SDPBC public schools are sent to the SDPBC Placement Office by the PBSC Office of Academic Services in batch request spreadsheet.

• Each term the spreadsheet will be sent four times: the second week of the 16 week course, the second week of the 12 week course, the 2nd week of the 8 week course and one last time before the end of the term. Go to timeline for specific dates for each term.

• Only student placement requests which include a valid SDPBC student badge will be submitted. (The badge can be photocopied and submitted to the course instructor along with the placement request or scanned or photographed with a cell phone and emailed to Academic Services).

• If a student does not meet these spreadsheet deadlines, they will need to choose another placement location from the Other Field Observation Opportunities link.

*Students who plan to use another placement location than a SDPBC public school should go to the Other Field Observation Opportunities link and follow the placement requirements listed there. CURRENT SDPBC EMPLOYEES WHO NEED TO PARTICIPATE IN FIELD OBSERVATION All Palm Beach State students currently employed by the School District of Palm Beach County must adhere to the SDPBC Security Clearance process and complete the required forms to obtain a student badge. (Employee records are not accessible to the School District Placement Office.) If they have been continuously employed, they will not have to pay the $99 fingerprint fees. They need only pay the $6.00 renewal fee. (Money order only.) Employees who are employed by the SDPBC with no recent break in employment will need to submit a badge renewal form, the student/intern form titled Pre-Service Program Packet, pay a $6 renewal fee and show your employee badge at the SDPBC Fingerprinting Office to obtain the student badge. The student badge will be issued at that time (it is not mailed to the student as with non-employees.) School assistant principals and principals can help expedite employee requests for field observation placement by requesting the employee by name in the SDPBC SHAREPOINT System under the Pre-Service Program PD Notes. There is no exception to this process for current SDPBC Employees. IMPORTANT NOTES:

• Dual Enrollment student enrolled in courses requiring field observation should register in the VIPS system at their school or the school they would like to observe at and then fill in a placement request form, which is turned into their course instructor or emailed to Academic Services. The placement request is submitted to the SDPBC Placement Coordinator and she sends confirmation of the placement to Academic Services who notifies the student. Clearance through the VIPS system can take three weeks and placement is not confirmed until VIPS clearance is verified.

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• The 90 Day Rule - Allows PBSC students who have been previously fingerprinted and who have been approved for observation to remain in active status providing they maintain continuous enrollment with PBSC and/or FAU. If the break is longer than 90 days, the student will have to begin the process again and pay for new fingerprints. State Law Statute Chapter 1012.56.

• The $99.00 fee is paid to the School District of Palm Beach County. Palm Beach State College does not receive any proceeds from these fees.

• Students desiring to complete the field observation at the public schools must have a valid social

security number to obtain fingerprints and security clearance at the School District of Palm Beach County.

Directions to the School District of Palm Beach County Offices The Palm Beach School District (SDPBC) is in the Fulton-Holland Education Center at 3372 Forest Hill Blvd., West Palm Beach, FL 33406 The Administration Center is located on Forest Hill Boulevard west of 1-95. • Exit 1-95 (Forest Hill Blvd. exit) • Proceed west past Congress Avenue • The School District of Palm Beach County, Fulton-Holland Educational Services Center is located on the south side of Forest Hill Blvd. • Park in areas designated for visitors. • Enter through the front doors and sign in with the receptionist. You will receive a "Visitor's Pass" to wear in the building. • The receptionist will give you directions to the School Police office for fingerprinting. Fingerprinting Hours: Monday, Tuesday and Thursday 8:00 A.M. - 11:30 A.M., 1:00 P.M. - 3:30 P.M. Wednesday and Friday 1:00 P.M. - 3:30 P.M. How to obtain a Money Order All students interested in completing the 15 hour field observation component in the public schools, must obtain fingerprints and security clearance from the School District Police Office. This office requires fees to be paid in the form of money order only in the amount of $99.00. You MUST purchase the money order before going to the School District Building to start the fingerprinting and security background process. A money order can be purchased at various places such as commercial banks, U.S. Post Offices, Western Union, supermarkets such as Publix, Wal-Mart, Winn Dixie, and convenience stores in local areas. PRE-SERVICE TEACHER CODE OF ETHICS State Board of Education Chapter 6B-1 of the Administrative Rules explains the Code of Ethics and Principles of Professional Conduct for the Education Profession in Florida. Therefore, and in addition to observing the mandated code, PBSC students are strongly advised to respect the internal rules of the school in which they are placed.

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To prepare students for a successful Field Placement experience, the following standards are recommended: 1. Attendance and Punctuality

• Public schools run on a very tight daily schedule, so be mindful of their time. • Arrive at the school 10-15 minutes early to check in the main office. • Follow the cooperating teacher’s directions at all times and do not become a distraction in the

classroom. • Notify the cooperating teacher if a personal emergency arises. Leave a message if necessary.

2. Appearance

• Follow the school dress code and dress professionally. Avoid revealing and provocative clothing and jewelry. Leave, sandals, sneakers, shorts, jeans, sleeveless shirts and flashy and facial jewelry at home.

• Maintain a clean and neat appearance all times. Make a good impression. 3. Conduct

• Demonstrate professional behavior at all times. • Avoid negative comments about the college, school staff, students, and/ or the cooperating

teacher. • Ask the cooperating teacher what to do to help out.

The 2004 Florida Statutes: K-20 Education Code - Chapter 1012 1012.56 Educator certification requirements.-- (9) BACKGROUND SCREENING REQUIRED, INITIALLY AND PERIODICALLY.-- (a) Each person who seeks certification under this chapter must meet level 2 screening requirements as described in s. 1012.32 unless a level 2 screening has been conducted by a district school board or the Department of Education within 12 months before the date the person initially obtains certification under this chapter, the results of which are submitted to the district school board or to the Department of Education. (b) A person may not receive a certificate under this chapter until the level 2 screening has been completed and the results have been submitted to the Department of Education or to the district school superintendent of the school district that employs the person. Every 5 years after obtaining initial certification, each person who is required to be certified under this chapter must meet level 2 screening requirements as described in s. 1012.32, at which time the school district shall request the Department of Law Enforcement to forward the fingerprints to the Federal Bureau of Investigation for the level 2 screening. If, for any reason after obtaining initial certification, the fingerprints of a person who is required to be certified under this chapter are not retained by the Department of Law Enforcement under s. 1012.32(3)(a) and (b), the person must file a complete set of fingerprints with the district school superintendent of the employing school district. Upon submission of fingerprints for this purpose, the school district shall request the Department of Law Enforcement to forward the fingerprints to the Federal Bureau of Investigation for the level 2 screening, and the fingerprints shall be retained by the Department of Law Enforcement under s. 1012.32(3)(a) and (b). The cost of the state and federal criminal history check required by level 2 screening may be borne by the district school board or the employee. Under penalty of perjury, each person who is certified under this chapter must agree to inform his or her employer within 48 hours if convicted of any disqualifying offense while he or she is employed in a position for which such certification is required.

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Frequently Asked Questions (FAQ) Q: How do I apply for a Field Placement assignment? A: You must follow the process outlined in the Field Observation Student Guide, and a) submit a placement request form with your instructor to obtain placement in a SDPBC public school or b) follow the location requirements of selected location listed on the Other Field Observation Opportunities link. Q: How do I know when I am cleared to be placed at a public school? A: Your student security badge will be mailed to you in an envelope you will fill-out at the time of the fingerprinting and background check . Q: What happens if I do not get cleared by the School District Police? A: The School District Police will send you a notification explaining the cause and it is strongly recommended that you seek further advice to try to resolve the issues because without a police clearance it would be almost impossible to continue on to teaching. Q: Once I am notified of my field observation, what should I do? A: First, make sure you know the name and phone number of the school, the contact person and be on time. Schools run on a very tight schedule and so do teachers and administrators. Respect their rules. Q: What if I am unable to keep a scheduled appointment? A: You should always call the school and let the contact person know or leave a message for the teacher. Remember if you make a good impression, that school may be your next employer. Q: Do I have to adhere to the school’s dress code when reporting for Field observation at the schools. A. Most definitely yes! You want to project yourself as a professional so dress appropriately. Leave the jeans, shorts, sleeveless shirts, T-shirts, sandals and any flashy jewelry at home. Q. Do I have to get new fingerprints if I am currently employed by the School District? A. No. Recent changes now allow employees who have been cleared to use that clearance for field placement. You will need to submit the student/intern forms and pay a $6 renewal fee to obtain the student badge. If you have any questions, please email Academic Services.

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APPENDIX

Placement Registration Form Affiliation Release Forms EXHIBIT A: RELEASE/ WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT EXHIBIT B: CONFIDENTIALITY AGREEMENT EXHIBIT C: Consent to and Permission for Criminal Background Check and Drug Screening Field Observation Log Sheet

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Palm Beach State College

Field Observation Placement Request

Last Name First Name Date (M/D/YY) PBSC Student Number PBSC Email

Address @my.palmbeachstate.edu

Course (Select One) EDF2005 Reference Number Term/Year (Select

one) Fall Term

Type of Placement (Select One) Field Observation (EDF) Placement Area Request

(Select one) North

Level of Placement 9th-12th Grade (High School) Subject Area of Interest

(Select one) English

If other, specify:

SDPBC Student Badge Expiration Date A copy of the badge must be turned into

instructor or scanned and emailed to Academic Services

EPI Students

Certification (Fill in) Current Full-time Teacher

Yes No

If yes, school

If yes, place in same school?

Yes No

Any Special Considerations?

Starting Fall 2012 (20131), Palm Beach State College Field Observation/Experience students are required to complete a Level 2 Security Clearance (includes fingerprinting and background check) prior to being placed in a Palm Beach County Public school classroom for observation. Go to Field Observation to see details.

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EXHIBIT A

RELEASE/ WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT

1. In consideration for being permitted to participate in a field experience, practicum, or internship/ student teacher preparation program under the direction of a certified educator employed with the School Board of Palm Beach County, Florida (“School Board”), I hereby voluntarily RELEASE, WAIVE, DISCHARGE, COVENANT NOT TO SUE AND RELINQUISH against the School Board, its officers, agents, servants or employees (herein after the “RELEASEES”) from any and all actions or causes of action for personal injury, property damage, or wrongful death occurring to me as a result of my participating in such field experience, practicum, or internship/student teacher preparation program WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES, or otherwise, while participating in such activity, or while in, on or upon the premises where the activity is being conducted.

2. I, for myself, my heirs, executors, administrators, and assigns hereby release, waive, discharge, and relinquish any action or causes of action, aforesaid, which may hereafter arise for me and/or for my estate, and agree that under no circumstances will I or my heirs, executors, administrators, and assigns prosecute, or present any claim for personal injury, property damage or wrongful death against School Board.

3. I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS OF LOSS, PROPERTY DAMAGE OR PERSONAL INJURY, INCLUDING DEATH, that may be sustained by me, or any loss or damage of property owned by me, as a result of being engaged in a field experience, practicum, or internship/ student teacher preparation program with the School Board, WHETHER CAUSED BY THE NEGLIGENCE OF RELEASEES OR OTHERWISE. I understand that I am responsible for obtaining and pay the cost of treatment for any injuries sustained while participating in a field experience, practicum, or internship/ student teacher preparation program with the School Board.

4. I further hereby AGREE TO INDEMNIFY AND HOLD HARMLESS the RELEASEES from any loss, liability, damage or costs, including court costs and attorneys’ fees, that they may incur due to my participation in a field experience, practicum, or internship/ student teacher preparation program with the School Board, WHETHER CAUSED BY NEGLIGENCE OF RELEASEES or otherwise.

5. It is my express intent that this Waiver of Liability and Hold Harmless Agreement shall bind the members of my family, if I am alive, and my heirs, assigns and personal representative, if I am deceased, and shall be deemed as a RELEASE, WAIVER, DISCHARGE AND COVENANT NOT TO SUE the above-named RELEASEES. I hereby further agree that this Waiver of Liability and Hold Harmless Agreement shall be construed in accordance with the laws of the State of Florida, and venue for any legal proceeding or lawsuit relating to this RELEASE shall be in Palm Beach

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County, Florida. I expressly acknowledge that this RELEASE is intended to be as broad and inclusive as permitted by the laws of the State of Florida.

6. I agree that in any event that any clause or provision of this RELEASE shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this RELEASE, which shall continue to be enforceable.

7. IN SIGNING THIS RELEASE/WAIVER, I ACKNOWLEDGE AND REPRESENT THAT I have read the foregoing RELEASE/WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT, understand it and sign it voluntarily as my own free act and deed; no oral representations, statements, or inducements, apart from the foregoing written agreement, have been made; I am at least eighteen (18) years of age and fully competent; and I execute this Release for full, adequate and complete consideration fully intending to be bound by same.

Signed on this _______ day of ________ , 20___. PARTICIPANT _______________________ Signature _______________________ Printed Name

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EXHIBIT B

CONFIDENTIALITY AGREEMENT

Field Experience Students, Practicum Students, and Interns/Student Teachers

I, ______________, as a student enrolled in a state-approved teacher preparation program in a postsecondary education institution, acknowledge that in order for me to perform a field experience, practicum, or internship/ student teacher preparation program under the direction of a regular employed and certified educator with the School Board of Palm Beach County, Florida (“School Board”), I may become privy to certain Sensitive and/or Confidential Information discussed or created, owned, and maintained by the School Board or its employees or agents. Sensitive and Confidential Information may be in the form of conversations, documents, computer files, e-mails or various forms of record keeping. Examples of Confidential Information include, but are not limited to, personally identifiable student information or other information specifically exempt from public disclosure under Florida law. A list of relevant information exempt from disclosure may be viewed in School Board Policies 2.041 and 5.50. Examples of Sensitive Information include District employee personnel or payroll information not specifically exempt from public disclosure by the School Board, but which may be of a personal and sensitive nature.

As a condition precedent to receiving Sensitive and/or Confidential Information, I warrant and agree that:

• I undertake and accept the obligation to use reasonable care to protect the secrecy and confidentiality of the information received from the School Board or its designee; and

• I will limit the use of or access to the Sensitive or Confidential Information to the scope actually needed to perform a field experience, practicum, or internship/ student teacher preparation program; and

• I have reviewed School Board Policies 2.041 and 5.50; and

• I will not copy the Sensitive and Confidential Information and will not disclose such information to any person or entity, or use it for any purpose other than as set forth herein; and

• I will avoid accessing the information, except for the legitimate purposes recognized under this Agreement; and

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• I will not include any Sensitive and/or Confidential Information in any report, document, presentation, or paper relating to any assignment required of my college/university professors; and I shall dispose of all Sensitive and Confidential Information disclosed to me by the School Board or its designee (and any copies thereof), after the purpose for which the information is disclosed has been served to prevent possible recovery of information, and by totally erasing and over-writing (or physically destroying) any electronic media such as computer files, tapes, or diskettes, or physically destroyed; and I acknowledge that the confidentiality obligations of this Agreement will survive any expiration or

termination of this Agreement; and

• I acknowledge that failure to comply with this confidentiality requirement can and may result in personal liability or disciplinary action up to and including termination of the placement and future placements and/or denial of employment with the Palm Beach County School District; and

• In the event that I am requested or required by law or court proceeding to disclose any of the Sensitive or Confidential Information, I agree that I will provide the School Board with prompt notice in writing of such request(s) sufficiently before responding so that it may seek an appropriate protective order or other appropriate remedy and/or waive my compliance with the provisions of this Agreement; and

• I agree to indemnify and hold harmless the School Board from any damage, loss, cost or liability (including legal fees and the cost of enforcing this indemnity) arising out of or resulting from any unauthorized use or disclosure by me of the Sensitive and Confidential Information. I also acknowledge that money damages would be both incalculable and an insufficient remedy for any breach of this Agreement by me and that such breach would cause irreparable harm to the School Board. Accordingly, I agree that in the event of any breach or threatened breach of this Agreement, the School Board, in addition to any other remedy at law or in equity it may have, shall be entitled, without the requirement of posting a bond or other security, to equitable relief, including injunctive relief and specific performance; and

• The invalidity or enforceability of any provision of this Agreement shall not affect the validity or enforceability of any other provision of this Agreement, which shall remain in full force and effect; and

• This Agreement shall be governed by and construed in accordance with the laws of the State of Florida. In the event of a dispute regarding the terms herein, exclusive venue shall lie in Palm Beach County, Florida; and

• I certify that I understand and acknowledge these confidentiality requirements contained herein.

Field Observation

20 August 2012

IN WITNESS WHEREOF, the parties hereto have executed this Agreement:

[Legal name of the Student]: The School Board of Palm Beach County, Florida By: ________________________________ By:__________________________________ Student Print:_______________________________ Print: _________________________________ Date: ______________________________ Date: ________________________________ ___________________________________ College/University Attending ___________________________________ District Placement School

Field Observation

21 August 2012

EXHIBIT C

Consent to and Permission for Criminal Background Check and Drug Screening I _______________________________________ acknowledge and am aware that state law and the School Affiliation Agreement between the secondary institution in which I am enrolled and The School Board of Palm Beach County, Florida (“School District”), require that all students that desire to perform a field experience, practicum, or internship/ student teacher preparation program under the direction of a regular employed and certified educator with the School Board of Palm Beach County, Florida, must undergo a criminal background check and drug screening. I may not commence a field experience, practicum, internship or any teacher preparation program under the direction of a regular employed and certified educator with the School Board of Palm Beach County, Florida until after I have received notice of clearance from the School District and have provided a copy of my current clearance badge to the School District placement officer. I must undergo:

• A Level II background check consists of fingerprinting and a background check, as set forth in section 1012.32, Florida Statutes, including but not limited to fingerprinting by the School District’s Police Department, at the sole cost to me or my secondary institution, and a criminal background check of the Florida Violent Offender and Sexual Predator Registry, and

• Drug screening. Neither the School District, nor its Board Members, officers, employees, nor agents shall be liable to any student or his or her parent(s) or guardian(s) under any legal theory for any claim whatsoever based upon the results of the criminal background checks or drug screenings. I understand that the names of students undergoing criminal background checks and drug screenings and the results of same will only be shared with appropriate school officials who have a legitimate educational interest in such information. I further understand that after the results of the criminal background checks and drug screenings have been obtained by an appropriate school official, the School District will notify the secondary institution of the names of the Participating Students have been cleared to participate in field experience, practicum, or internship/ student teacher preparation program.

Field Observation

22 August 2012

Signed on this _______ day of ________ , 20___. IN WITNESS WHEREOF, the parties hereto have executed this Agreement: [Legal name of the Student]: By: ________________________________ Student Print:_______________________________ Date: ______________________________ ___________________________________ College/University Attending ___________________________________ District Placement School

Field Observation

23 August 2012

PALM BEACH STATE COLLEGE

RECORD OF FIELD OBSERVATION HOURS

Course:______________________________________ Seq. (Ref..)#________________

Student’s Name: __________________________________________________________

SDPBC School: __________________________________________________________

Field Observation Cooperating Teacher: Please confirm student’s service hours by initialing and signing after each Field Observation to verify attendance.

Date Time In Time Out Clock Hours Cooperating Teacher’s

Signature

*Students should return signed log sheet to their instructor for documentation.