CONCORDIA COLLEGE
EDUCATION DEPARTMENT
SPECIAL METHODS CLINICAL OBSERVATIONS

Thank you for allowing this education candidate to observe your classes.  As part of an education candidates preparation, they are required by the Minnesota Board of Teaching to have completed 20 hours of teaching observations in their discipline.  At Concordia, this is normally done during their junior year as part of their special methods course and prior to student teaching.  This form is to verify that the student named below has completed some or all of these observation hours in your classroom.

TO BE FILLED OUT BY THE STUDENT:
Subject:    Health Education

Student’s Name:     __________________________________

School Name:    ____________________________       City:  _____________________________

Teacher’s Name:  __________________________        School Phone:  ____________________

Number of Hours/Classes Observed: _______

TO BE FILLED OUT BY THE TEACHER:
To provide feedback to the Department of Education and the student, will you please evaluate the student in each of the areas using the criteria below:
                                                        0 = No Opportunity to Observe
                                                        1 = Unacceptable/Inappropriate
                                                        2 = Acceptable/Appropriate
                                                        3 = Excellent/Exceeds Expectations

A.  Professional Appearance         0            1            2               3
B.  Punctuality                             0            1            2               3
C.  Dependability                         0            1            2               3
D.  Interest/Enthusiasm                 0            1            2               3

E.  Did this student have any opportunities to be involved in the classroom beyond observing?   If so, briefly describe them (use the back, if necessary):
 
 

F.  Based on your interactions with this student, do you have any reservations about them  becoming a teacher (use the back, if necessary)?
 
 

Please feel free to make any additional comments on the back of this form.  If you have questions or concerns, feel free to contact the Concordia College, Education Department, 901 S. 8th St., Moorhead, MN 56562, (218) 299-3910 or Larry Papenfuss, Health Education at (218) 299-4440.

__________         ________________________________________
Date                    Classroom Teacher’s Signature