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Noting that there are no standardized manual communication curricula or proficiency assessments available to teacher preparation programs, the author used a case study to describe how preservice teachers of the deaf are taught to incorporate American Sign Language and various forms of signed English as effective communication tools for students who are deaf and hard of hearing. An accredited undergraduate teacher preparation program located in a rural area was selected for the study. Eight curricular components were examined, and data were triangulated from observations, interviews, and document analyses. The author found (a) that manual communication was taught in three required courses making up 6.57% of the overall curriculum, (b) direct application to the classroom was limited, and (c) there was minor misalignment across the eight curricular components examined. The program did not require an exit-level proficiency exam.