School-based Site Coordinator Interview Form

Site Coordinator use this form during School-based Interview. Please provide a short introduction and write your responses to the prompts/questions.

Applicant Name

First	Last
First	Last

Site Coordinator Name

Site Coordinator First Name	Site Coordinator Last Name
Site Coordinator First Name	Site Coordinator Last Name

Date

Please indicate date as mm/dd/yyyy

1. Explain why you are interested in this site for an internship.

2. If interviewed for a teaching position in this school, what strengths do you bring to the faculty and staff?

3. What experiences have you had working with culturally diverse individuals and groups?

4. What teaching knowledge and skills do you think this setting can offer you?

5. Describe a current issue in education and your position on it, e.g. standards, school funding, charter schools, online learning.

Selection

Based upon the applicant's responses, please select one of the options above. If you select Recommend with reservation or Do not recommend moving forward, please provide your rationale for this decision

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School-based Site Coordinator Interview Form