Sample recording form for information about observations* Employee’s name: _____________________________________________________________________________ Date of Observation ______________________________________ Observer _______________________________________________ Grade __________Period/Time Was the observer present for full period? _____________________ If NO, _______________ time entered _______________ time left Course title _____________________________________________ Number of students: _________________ Absent ___________Late Total on roll ____________________________________________ Materials used: __________________________________________ Unusual occurrences during the observation, causing distraction: Abbreviated schedule Disturbance in hall Extended period Shortened period Weather Fire drill Presence of observer Fight in class Other (specify) __________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ What was the purpose of the lesson? _________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ What methods were used? _________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ Was homework assigned? YES NO If YES, what was assigned? _________________________________ _______________________________________________________ In your opinion was the lesson successful? YES NO Based on what? __________________________________________ _______________________________________________________ 60 – AR Handbook Would you present the lesson in the same manner in the future? _______________________________________________________ _______________________________________________________ _______________________________________________________ General ability of the class (in your opinion): _______________________________________________________ _______________________________________________________ _______________________________________________________ General conduct and cooperation of the class during the period observed: _______________________________________________________ Specify, in your opinion, any unusual characteristics of this class: _______________________________________________________ _______________________________________________________ _______________________________________________________ Description of the lesson: __________________________________ _______________________________________________________ _______________________________________________________ Employee comments: _____________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ Employee signature: ______________________________________ Received by (AR signature): ________________________________ Date: __________________________________________________ Date employee received written observation: __________________ Date conference was held with the observer: ___________________ Date signed observation (with teacher comments) was returned to the observer: _______________________________ Employee feels observation was fairly done. YES NO *Please note that this form is generic. It can be changed to apply to other certified and non-certified employees.
20333FG
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