Appendice: Sample Evaluation Forms

The forms gathered on this page illustrate a handful of formats used for teacher evaluation. If your district plans to revise its evaluation forms, these samples might serve as a reference collection. The forms were gathered from hundreds we found on school district Web sites and in other sources.

General Education Evaluation Domains and Indicators (archived copy)
General Education Performance Standards: Domains And Indicators With Measurement Statements (archived copy)
Many districts/states build their teacher evaluation forms based on documents that establish their detailed missions or their documented "domains of teaching." Such is the case with the two forms above from the Tennessee Department of Education. The General Domains document lists six domains (Planning, Teaching Strategies, Assessment and Evaluation, Learning Environment, Professional Growth, and Communication) and two or three indicators for each. The second form presents something of a checklist that spells out specific indicators of a teacher's success in each domain.

Oxnard School District Evaluation Rubrics for Permanent Teachers
Rubrics are popular with teachers for evaluating student performance on projects, so why not adapt the format to the evaluation of teachers? This form rates teachers at four levels (Inconsistent Practice, Developing Practice, Maturing Practice, and Exemplary Practice) on a wide variety of elements under five performance standards: Engaging and Supporting All Students in Learning (click EVALRUBRICSTD1a.pdf), Creating and Maintaining Effective Environments for Student Learning (click EVALRUBRICSTD2a.pdf), Understanding and Organizing Subject Matter for Student Learning, Planning Instruction and Designing Learning Experiences for All Students, and Assessing Student Learning. This rubric is based on Oxnard's Performance Responsibilities for Classroom Teachers as Prescribed by Board Policy.

The Independent School District of Boise City -- Teacher Evaluation
This is the district's certified teacher evaluation form. It is used to rate teachers as having unsatisfactory, basic, or proficient grasp in 17 areas of performance. This form can be used in conjunction with the district's Administrative Observation of Teachers form.

Adams County (Ohio) Teacher Evaluation
This teacher evaluation form (scroll down to pages 4-6) allows evaluators to rate teacher performance in 14 carefully defined areas of four domains (Organization, Creating an Environment for Student Learning, Teaching for Student Learning, and Teacher Professionalism).

PUSD Rubric for Teacher Performance Summative Evaluation
This combination rubric/checklist from the Prescott, Arizona, school district is used to rate teachers on 22 objectives in four domains (Planning and Preparation, Classroom Environment, Instruction, and Professional Responsibilities).

Instructional I to Instructional II Assessment Form
This form from Pennsylvania's Department of Education is used for evaluating experienced teachers. It presents four categories of achievement (Planning/Preparation, Classroom Environment, Instructional Delivery, and Professionalism).

Prince William County Public Schools Observation Form
This form is used for formal and informal observations. It presents a laundry list of performance indicators in the categories of Planning & Assessment; Instruction; Safety and the Learning Environment; Communication and Community Relations; and Professionalism.

North Carolina Teacher Performance Appraisal Instrument (TPAI) -- Experienced Teachers
This form measures teacher performance in eight major functions: Management of Instructional Time, Management of Student Behavior, Instructional Presentation, Instructional Monitoring, Instructional Feedback, Facilitating Instruction, Communicating Within the Educational Environment, and Performing Non-Instructional Duties. The form is based loosely on North Carolina's Standards for Teacher Evaluation.

ADDITIONAL RESOURCES

Self-Assessment Checklist
This resource from Scholastic is intended to be a self-assessment checklist, but it could easily serve as the basis for a teacher evaluation form. It presents measurable target behaviors in the areas of Classroom Environment, Routines and Procedures, Parent-Teacher Relationship, Planning for a Substitute Teacher, Reaching All Students, Assessment, Teaching Kids to Care, Teacher Collaboration, and Professional Development.

Teacher Evaluation
This form is a little more streamlined than many others. It comes from the State Education Department of New York, Office of Higher Education.

Article by Gary Hopkins
Education World® Editor-in-Chief
Copyright © 2009 Education World