Practicum Forms

Required Forms (responsibility of the Add-On Candidate)

Add-On Program Acknowledgement (click to open)

You must provide a written acknowledgement with signatures from a Building Administrator and District Administrator/Designee who support you in your efforts to obtain a new teaching license through the EXCEL Center.

The Add-On Licensure Program Information should be  shared with the Building Administrator and District Administrator/Designee whose signatures you are obtaining.

Add-On Practicum Plan (pdf)  (click to open)

You must provide a detailed written plan explaining how you will meet the required hours described in the Add On Practicum information. Please note that your Practicum hours must be completed BEFORE the final paperwork is submitted.  For clarity in plan completion, please review the sample practicum plan.

**YOU MUST USE ADOBE ACROBAT 9 TO SAVE THESE FORMS** (Click to Download ACROBAT 9)

Submit all Add-On Practicum forms to:

• Email
• EC-MC; MC-EA: Penny Buckley at buckley.excel@gmail.com
• Secondary: Barb Herzog at herzog.excel@gmail.com
• Mail - UW Oshkosh, EXCEL Center, 800 Algoma Blvd, Oshkosh, WI 54901-8662
• Fax – 920 424-0858 (Attn: Penny Buckley or Barb Herzog)