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School of Education Professional Experience 2011
Special Consideration for Secondary Professional Experience Placement CONFIDENTIAL
I provide the following information for my Focus Day variation request:
Name:
Student ID:
I am currently enrolled in the Unit: (Please circle or highlight relevant unit.)
101704 Professional Experience I; or 100978 Professional Experience II
I am studying in one of the following modes: (Please circle or highlight relevant mode.)
• Accelerated (2 semesters) • Full time (3 semesters) • Part time (4+ semesters)
I provide the following reason for requesting special consideration during my in-school professional experience placement: I attach supporting documentation (if applicable), eg. a doctor’s certificate.
Pre-service Teacher’s signature:
Date:
OFFICE USE ONLY APPROVED/NOT APPROVED:__________________________________________
COMMENTS:_______________________________________________________
Name & Signature: _________________________________________________
Date:_________________
Action taken by PE Unit_________________________________________________________
Please submit to the Professional Experience assignment box 38.