SINGLE SEMESTER STUDENT TEACHING TIMECARD TIT: y Lou Fulton. SU ichers College AaizOWA STATE UNIV ‘ASU Affi ‘STUDENT NAME (Last, First, Mi, Says Micah IN4as9eVe Prom ees Fl v Uh ‘Semesti Lifall Spring Year: 20/2 fergrea: Cecs CE snot Balt — ' oo Clarenmen lewereanpen Campus: [] Downtown [Poly [] Tempe [] west Grod: ()mac-ceo []mac-spe [] mac-sepisubject: Student Information: ‘Student's Email: Address 390A FE Sheroti la Re wares Ge OE She statoAz _zip_25OIB Phone GN 209_- COS. asrbys@50.2d0 Wentor Teachar's Name? Placement lnformation: District Poor Union High (oottiqae. Classroom Grade Level or Subject: = WED Cenlral Wisk Scho] ae Address 4595 A. Centeet Nver Supervisors Name: city Plenty state AZ zip 9501 Phone Gia. ) 124-750 ‘Supervisor Visits/Observations (5 requi ‘Supervisor's BL FLAK L trite RY LEE Way VISIT Supervisor Seminar (2 required) Date Topic Supervisor's initials iT ZB ee IZ LELE J AERTS Lofe 31Documentation of Attendance & Requirements ‘a a she Ph le 214 3 YU 10 [44 [12 [43 [44 5 a Number of Days Present Numbor of Days Absent Number of Days Came Late 0 © 0 BREE | 0 0 0 DLO|O ne ee «fs |r 50s || Ay lov LP la lone UM [plbue- Teacher Candidat wed my completed Performance Assessments in Tk20 or Dashboard. pat 1S paz [YS, pas_liS, easitappiicatie / 2 ‘The signatures below certify that the above information is accurate, rye vate: YIQ/6 —_ DATE: 4as]lle Number of Days Left & [ole lo filals 1 iF ys pe lS SG jolojol4 & S_S 1% [9I/c]oe N5\A5 3.0 iD) O O O {oe 5 PS | Slcloe a TEACHER CANDIDATE'S SIGNATURE: _‘[/(//77n_ , 0-77 MENTOR TEACHER'S SIGNATURE: Noise Eo 32