West Chester University’s Evaluation Sheet for the PDE 430 Form ___ Mid
*Electronic Version* ___ Final
_________________________ _________________________ _________________________ ____________________
Student/Candidate’s Last Name First Name Middle Name WCU Student ID Number
Year: ________________ Term: _______________ Major: ______________________ *If Dual Major List Both: ______________
Subject (s) Taught: __________________________ Grade Level: _________________ Interview/Conference Date: ___B_______
District/IU: ________________________________ School: __________________________________________________________
Category I: Planning & Preparation Rating: 3 Exemplary 2 Superior 1 Satisfactory 0 Unsatisfactory
Justification for Evaluation Rating (Be specific & give examples):
Sources of Evidence (Check all that apply & append any supplementary documentation for unsatisfactory rating).
Lesson/Unit Plans
Resources/Materials/Technology
Assessment Materials
Information About Students (Including IEPs)
Student Teacher Interviews
Classroom Observations
Resource Documents
Other:
Category II: Classroom Environment Rating: 3 Exemplary 2 Superior 1 Satisfactory 0 Unsatisfactory
Justification for Evaluation Rating (Be specific & give examples):
Sources of Evidence (Check all that apply & append any supplementary documentation for unsatisfactory rating).
Classroom Observations
Informal Observations/Visits
Student Teacher/Candidate Interviews
Visual Technology
Instructional Resources/Materials/Technology/Space
Other:
Category III: Instructional Delivery Rating: 3 Exemplary 2 Superior 1 Satisfactory 0 Unsatisfactory
Justification for Evaluation Rating (Be specific & give examples):
Sources of Evidence (Check all that apply & append any supplementary documentation for unsatisfactory rating).
Classroom Observations
Informal Observations/Visits
Assessment Materials
Student Teacher/Candidate Interviews
Student Assignment Sheets
Student Work
Instructional Resources/Materials/Technology
Other:
Category IV: Professionalism Rating: 3 Exemplary 2 Superior 1 Satisfactory 0 Unsatisfactory
Justification for Evaluation Rating (Be specific & give examples):
Sources of Evidence (Check all that apply & append any supplementary documentation for unsatisfactory rating).
Classroom Observations
Informal Observations/Visits
Assessment Materials
Student Teacher Interviews
Written Documentation
Student Assignment Sheets
Student Work
Instructional Resources/Materials/Technology
Other:
Overall Rating
Category Exemplary (Min. of 12 pts.) Superior (Min. of 8 pts.) Satisfactory (Min. of 4 pts.) Unsatisfactory (0 pts.)
Rating (Indicate )
Note: A satisfactory rating (1) in each of the 4 categories, resulting in a minimum total of at least (4) points, must be achieved on
the final summative rating to favorably complete this assessment.
Justification for Overall Rating (Be specific & give examples):
Our signatures below signify that the complete 5-page PDE 430 document including the performance criteria, which appear in the Student Teacher
Handbook, was reviewed and made part of the evaluation which is summarized above.
Required Signatures
Signature Supervisor: _____________________________________ Print Name: ________________________ Date: BBBBBBBBB
Signature Student/Teacher Candidate: ________________________ Print Name: ________________________ Date: BBBBBBBBB
*The signed original document goes to the Teacher Certification Office. It is the Student Teacher Supervisor’s responsibility to make copies
for Themselves, the Student, and the Student’s Academic Department.*
