M STATE CONCURRENT MENTOR REPORT 2014-15
Mentor Name Mentor E-mail
Name of High School
Instructor Name
Year Term
Course No Course Name
Credits
Number of
Students
Check all that apply:
Repeat course/instructor/mentor
New course
New instructor
New mentor
SYLLABUS
The course syllabus/course outline should be reviewed for the following:
-Course Title
-Course Term
-Instructor Name
-Course Description
-Course Competencies
-Course Requirements and Grading Policies
-Accommodations for Students with Disabilities
*Approved course descriptions and competencies should be taken from www.minnesota.edu/?id=658
Attachment - Syllabus
*Required for a new course, or a new teacher
The course syllabus/course outline meets all requirements
Yes
No
Comments:
MENTOR MEETINGS
Repeat Course/Instructor/Mentor
*Please continue to the next page if your report is for a new offering and/or instructor.
For a repeat course, or a course that continues as part of a sequence, and/or with the same instructor, 3
meetings are required. At least 1 of these meetings needs to be an in-person classroom observation.
Please add your meeting notes in the boxes below, or upload an attachment at the end of this page.
Select File
Attachment - Teacher Orientation Checklist
*Optional for experienced teachers.
The Teacher Orientation Checklist can be found in the Employee Portal>Files & Forms>K-12 Collaborations
Classroom Observation
Class Observation Notes
Meeting 2
Meeting Notes
Meeting 3
Meeting Notes
Select File
Attachment - Meeting Notes
MENTOR MEETINGS
New Course and/or Instructor
*Please continue to the next page if your report is for a repeat offering and/or instructor.
For a first-time course, and/or first-time instructor, 6 meetings (1 pre-class meeting, 2 class observations, 3
instructor-mentor meetings) are required.
Please add your meeting notes in the boxes below, or upload an attachment at the end of this page.
Pre-Class Meeting
Meeting 1
Attachment - Teacher Orientation Checklist (Required for new teachers)
The Teacher Orientation Checklist can be found in the Employee Portal>Files & Forms>K-12 Collaborations
Notes
In-person Class Observations
Class Observation 1
Select File
Select File
Notes
Class Observation 2
Notes
Other Instructor Meetings (3)
Meeting Notes
Attachment - Meeting Notes
I am CONFIDENT this course and teacher meets all of M State requirements
Yes
No
I have QUESTIONS or CONCERNS that require follow-up
Yes
No
If you have questions or concerns, please explain
Select File