Form 2 Responsibility & Success Plan
Date: The table below is designed to outline a plan for success and to clarify our expectations and your responsibilities, if you are to continue to pursue a MAT in your program for licensure at NLU.
Course #: __________
Initiated by: ________________________________
Role: _________________________
Candidate Name: _______________________________ (If applicable) School: ___________________________________
NLU ID: __________________
Program: __________
District: _____________________
Grade Level: __________
Seminar Instructor: _________________________________
University Supervisor: __________________________
Cooperating Teacher: ________________________________
Academic Advisor: ___________________________
A. Concern(s)
B. Standard(s)
C. Expectations & Candidate Responsibilities
D. Timeline/Date
32 / MAT Special Education Handbook
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