Name: ____________________________________

School: _____________________________

Subject: _____________________________

Cooperating Teacher: ____________________

University Supervisor: ___________________

Date: ______________________________

Time:______________________________

Circle the appropriate numeral that corresponds to the student teacher’s level of performance.

1= Unsatisfactory, 2 = needs improvement, 3 = proficient, 4 = very good, 5 = distinguished, N/A = not applicable

Classroom Environment:

a. Created an Environment of Respect and Rapport 1 2 3 4 5 N/A

b. Established a Culture for Learning 1 2 3 4 5 N/A

c. Managed Classroom Procedures 1 2 3 4 5 N/A

d. Managed Student Behavior 1 2 3 4 5 N/A

e. Organized Physical Space 1 2 3 4 5 N/A

Instruction:

f. Communicated Clearly and Accurately 1 2 3 4 5 N/A

g. Engaged Students in Learning 1 2 3 4 5 N/A

h. Provided Feedback to Students 1 2 3 4 5 N/A

i. Demonstrated Flexibility and Responsiveness 1 2 3 4 5 N/A

Directions for the Evaluator: Comment specifically on the student teacher’s strengths, weaknesses and areas that need improvement. Comments may reference the letter of the items above, e.g. B is “Establishing a Culture for Learning.”

WHAT WAS DONE WELL	WHAT NEEDS IMPROVEMENT
COMMENTS OR SUGGESTIONS