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Mentor Teacher Observation Form
Candidate Name:
*
First Name
Last Name
Candidate Program:
*
Undergraduate ITLU
Master of Education MEdITL
Candidate Endorsement Area:
*
Elementary, K-5
Elementary + ELL, K-5
Biology, 6-12
Business, 6-12
Chemistry, 6-12
English, 6-12
History, 6-12
Math, 6-12
Art, K-12
Music, K-12
Physical Education, K-12
Special Education Comprehensive, K-12
Special Education Interventionist, K-8,
Special Education Interventionist, 6-12
Please identify the clinical practice of your candidate.
traditional undergraduate student teacher
2 plus 2 (undergraduate student teacher)
job embedded (graduate)
GYO/Apprentice
traditional graduate student teacher
Cooperating Teacher:
*
First Name
Last Name
For which month are you submitting this observation?
*
Please Select
January
February
March
April
May
August
September
October
November
December
Other
Date:
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2028
2027
2026
2025
2024
2023
2022
2021
2020
Year
Year:
*
Please Select
2021
2022
2023
2024
2025
2026
2027
2028
School Site:
*
Grade:
*
Subject
*
Time:
Time of Day - From When to When
Designing and Planning Instruction
Designing and Planning Instruction
*
Rows
Significantly Above Expectations (5)
(4)
At Expectations (3)
(2)
Significantly Below Expectations (1)
N/A - No Evidence
Instructional Plans (IP)
Student Work (SW)
Assessment (AS)
Learning Environment
*
Rows
Significantly Above Expectations (5)
(4)
At Expectations (3)
(2)
Significantly Below Expectations (1)
N/A - No Evidence
Expectations (EX)
Managing Student Behavior (MSB)
Environment (ENV)
Respectful Culture (RC)
Instruction
*
Rows
Significantly Above Expectations (5)
(4)
At Expectations (3)
(2)
Significantly Below Expectations (1)
N/A - No Evidence
Standards and Objectives (SO)
Motivating Students (MS)
Presenting Instructional Content (PIC)
Lesson Structure and Pacing (LS)
Activities and Materials (ACT)
Questioning (QU)
Academic Feedback (FEED)
Grouping Students (GRP)
Teacher Content Knowledge (TCK)
Teacher Knowledge of Students (TKS)
Thinking (TH)
Problem Solving (PS)
Areas of Strength (Reinforcement Objective)
Areas to Strengthen (Refinement Objective)
Comments on Observation (OPTIONAL)
Cooperating Teacher Signature
Submit
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