UNIVERSITY OF WISCONSIN
P L A T T E V I L L E
PRE-STUDENT TEACHING MIDTERM
EVALUATION
Semester:
Year:
Grade
Taught:
Hours Credit:
Student:
Subject Taught:
Key:
P = Proficient
B = Basic
U = Unsatisfactory (Inc.)
NO = Not Observed
Performs as a competent,
successful beginning pre-
student teacher
Performs with minimal
competency, regular
supervision required
Requires more
education/practice SEE RUBRIC
P
B
U
NO
Domain 1: Planning and Preparation
Domain 2: The Classroom Environment
Domain 3: Instruction
Domain 4: Professional Responsibilities
OVERALL COMPETENCE: (Circle one) A B Incomplete
P
lease make comments concerning this student's strongest attributes and/or areas of needed improvement/concern.
(This information will be reviewed in the Clinical Experiences Office, in the academic department office, and by the
academic advisor.)
Signature of Cooperating Teacher ___________________________________________________________
School District __________________________________________________________________________
Signature of Pre-Student Teacher ___________________________________________________________
Date __________________________________________________________________________________
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