COLLEGE OF
Classroom Visitation Summary
Faculty Member Observed __________________________________________________
Department __________________________________________________
Course Number/Name __________________________________________________
Instructional Mode __________________________________________________
Number of Students __________________________________________________
Visitation Date/Time __________________________________________________
Follow Up Discussion Date/Time __________________________________________________
Observation __________________________________________________
__________________________________________________
__________________________________________________
I have read the following classroom visitation evaluation and understand that it will be placed in my
Personnel Action File (PAF) in the dean’s office, and I have received a copy.
_______________________________________ ________________________________
Faculty Member’s Signature Date
_______________________________________ ________________________________
Reviewer’s Name Date
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