Directions: Indicate the rating in the appropriate column that best describes the interns performance at this time.

A
midterm conference (MC) and a final conference (FC) must be completed during the internship semester. At this
conference, the mentor teacher, supervisor, and intern should discuss the interns performance and overall rating in
the categories of Professionalism, Communication Skills, and Work with Students.

Major/Minor:
School/Grade:
Class Observed:

Professionalism
To successfully complete the internship experience, the intern must not earn more than two (2)
Unacceptable ratings in a specific category. For each unacceptable rating, a written plan of improvement
must be created, signed by the mentor teacher, the supervisor, and the intern and approved by the
Director of Educational Field Experiences (with copies of the improvement plans placed in the interns file).
During the FC, the intern may not earn any unacceptable ratings.
I. Professionalism
Criterion Performance Rating

Not Observed Unacceptable Acceptable Target Score
Displays a
caring
demeanor
0
The
knowledge,
skills, or
dispositions
are not
observed.
There is no
basis for
determination.
1
The intern exhibits
some knowledge,
skills, or dispositions
that are
inappropriate or
ineffective for PreK-
12 student learning.
Remediation is
necessary if the
intern is to continue
in the teacher
preparation program.
2
The intern is
developing the
knowledge, skills,
or dispositions for
effective PreK-12
student learning,
but has not yet
attained a level of
proficiency
appropriate for a
pre-service teacher
at this level.
3
The intern exhibits
knowledge, skills or
dispositions that are
proven to be
appropriate and
effective for PreK-12
student learning.
The level of
proficiency is that
expected of pre-
service teacher at
this level.
3
Is in
attendance
and on time,
informs
mentor
teacher of
absence
and/or
tardiness
0
The
knowledge,
skills, or
dispositions
are not
observed.
There is no
basis for
1
The intern exhibits
some knowledge,
skills, or dispositions
that are
inappropriate or
ineffective for PreK-
12 student learning.
Remediation is
2
The intern is
developing the
knowledge, skills,
or dispositions for
effective PreK-12
student learning,
but has not yet
attained a level of
3
The intern exhibits
knowledge, skills or
dispositions that are
proven to be
appropriate and
effective for PreK-12
student learning.
The level of
3
determination. necessary if the
intern is to continue
in the teacher
preparation program.
proficiency
appropriate for a
pre-service teacher
at this level.
proficiency is that
expected of pre-
service teacher at
this level.
Is well
groomed and
suitably
dressed
0
The
knowledge,
skills, or
dispositions
are not
observed.
There is no
basis for
determination.
1
The intern exhibits
some knowledge,
skills, or dispositions
that are
inappropriate or
ineffective for PreK-
12 student learning.
Remediation is
necessary if the
intern is to continue
in the teacher
preparation program.
2
The intern is
developing the
knowledge, skills,
or dispositions for
effective PreK-12
student learning,
but has not yet
attained a level of
proficiency
appropriate for a
pre-service teacher
at this level.
3
The intern exhibits
knowledge, skills or
dispositions that are
proven to be
appropriate and
effective for PreK-12
student learning.
The level of
proficiency is that
expected of pre-
service teacher at
this level.
3
Works
collaboratively
and
respectfully
with mentor
teacher
and/or other
school staff
0
The
knowledge,
skills, or
dispositions
are not
observed.
There is no
basis for
determination.
1
The intern exhibits
some knowledge,
skills, or dispositions
that are
inappropriate or
ineffective for PreK-
12 student learning.
Remediation is
necessary if the
intern is to continue
in the teacher
preparation program.
2
The intern is
developing the
knowledge, skills,
or dispositions for
effective PreK-12
student learning,
but has not yet
attained a level of
proficiency
appropriate for a
pre-service teacher
at this level.
3
The intern exhibits
knowledge, skills or
dispositions that are
proven to be
appropriate and
effective for PreK-12
student learning.
The level of
proficiency is that
expected of pre-
service teacher at
this level.
3
Takes
initiative in
the classroom
and provides a
supportive
role
0
The
knowledge,
skills, or
dispositions
are not
observed.
There is no
basis for
determination.
1
The intern exhibits
some knowledge,
skills, or dispositions
that are
inappropriate or
ineffective for PreK-
12 student learning.
Remediation is
necessary if the
intern is to continue
in the teacher
preparation program.
2
The intern is
developing the
knowledge, skills,
or dispositions for
effective PreK-12
student learning,
but has not yet
attained a level of
proficiency
appropriate for a
pre-service teacher
at this level.
3
The intern exhibits
knowledge, skills or
dispositions that are
proven to be
appropriate and
effective for PreK-12
student learning.
The level of
proficiency is that
expected of pre-
service teacher at
this level.
3
Expresses a
desire to
improve and is
0
The
knowledge,
1
The intern exhibits
some knowledge,
2
The intern is
developing the
3
The intern exhibits
knowledge, skills or
3
receptive and
open to
suggestions
skills, or
dispositions
are not
observed.
There is no
basis for
determination.
skills, or dispositions
that are
inappropriate or
ineffective for PreK-
12 student learning.
Remediation is
necessary if the
intern is to continue
in the teacher
preparation program.
knowledge, skills,
or dispositions for
effective PreK-12
student learning,
but has not yet
attained a level of
proficiency
appropriate for a
pre-service teacher
at this level.
dispositions that are
proven to be
appropriate and
effective for PreK-12
student learning.
The level of
proficiency is that
expected of pre-
service teacher at
this level.
Reflects on
and adjusts
teaching
performance
based on
constructive
criticism and
feedback
0
The
knowledge,
skills, or
dispositions
are not
observed.
There is no
basis for
determination.
1
The intern exhibits
some knowledge,
skills, or dispositions
that are
inappropriate or
ineffective for PreK-
12 student learning.
Remediation is
necessary if the
intern is to continue
in the teacher
preparation program.
2
The intern is
developing the
knowledge, skills,
or dispositions for
effective PreK-12
student learning,
but has not yet
attained a level of
proficiency
appropriate for a
pre-service teacher
at this level.
3
The intern exhibits
knowledge, skills or
dispositions that are
proven to be
appropriate and
effective for PreK-12
student learning.
The level of
proficiency is that
expected of pre-
service teacher at
this level.
3
Acts in an
ethical
manner
0
The
knowledge,
skills, or
dispositions
are not
observed.
There is no
basis for
determination.
1
The intern exhibits
some knowledge,
skills, or dispositions
that are
inappropriate or
ineffective for PreK-
12 student learning.
Remediation is
necessary if the
intern is to continue
in the teacher
preparation program.
2
The intern is
developing the
knowledge, skills,
or dispositions for
effective PreK-12
student learning,
but has not yet
attained a level of
proficiency
appropriate for a
pre-service teacher
at this level.
3
The intern exhibits
knowledge, skills or
dispositions that are
proven to be
appropriate and
effective for PreK-12
student learning.
The level of
proficiency is that
expected of pre-
service teacher at
this level.
3
Total Score 24.0
Comments:

Communication Skills
To successfully complete the internship experience, the intern must not earn more than two (2)
Unacceptable ratings in a specific category. For each unacceptable rating, a written plan of improvement
must be created, signed by the mentor teacher, the supervisor, and the intern and approved by the
Director of Educational Field Experiences (with copies of the improvement plans placed in the interns file).
During the FC, the intern may not earn any unacceptable ratings.
II. Communication Skills
Criterion Performance Rating

Not Observed Unacceptable Acceptable Target Score
Communicates
clearly with
mentor
teacher,
students, and
other school
personnel
0
The
knowledge,
skills, or
dispositions
are not
observed.
There is no
basis for
determination.
1
The intern exhibits
some knowledge,
skills, or dispositions
that are
inappropriate or
ineffective for PreK-
12 student learning.
Remediation is
necessary if the
intern is to continue
in the teacher
preparation program.
2
The intern is
developing the
knowledge, skills,
or dispositions for
effective PreK-12
student learning,
but has not yet
attained a level of
proficiency
appropriate for a
pre-service teacher
at this level.
3
The intern exhibits
knowledge, skills or
dispositions that are
proven to be
appropriate and
effective for PreK-12
student learning.
The level of
proficiency is that
expected of pre-
service teacher at
this level.
3
Adjusts oral
language use
according to
context and
situation
0
The
knowledge,
skills, or
dispositions
are not
observed.
There is no
basis for
determination.
1
The intern exhibits
some knowledge,
skills, or dispositions
that are
inappropriate or
ineffective for PreK-
12 student learning.
Remediation is
necessary if the
intern is to continue
in the teacher
preparation program.
2
The intern is
developing the
knowledge, skills,
or dispositions for
effective PreK-12
student learning,
but has not yet
attained a level of
proficiency
appropriate for a
pre-service teacher
at this level.
3
The intern exhibits
knowledge, skills or
dispositions that are
proven to be
appropriate and
effective for PreK-12
student learning.
The level of
proficiency is that
expected of pre-
service teacher at
this level.
3
Writing is clear
and coherent
0
The
knowledge,
skills, or
dispositions
are not
observed.
There is no
basis for
determination.
1
The intern exhibits
some knowledge,
skills, or dispositions
that are
inappropriate or
ineffective for PreK-
12 student learning.
Remediation is
necessary if the
intern is to continue
in the teacher
preparation program.
2
The intern is
developing the
knowledge, skills,
or dispositions for
effective PreK-12
student learning,
but has not yet
attained a level of
proficiency
appropriate for a
pre-service teacher
at this level.
3
The intern exhibits
knowledge, skills or
dispositions that are
proven to be
appropriate and
effective for PreK-12
student learning.
The level of
proficiency is that
expected of pre-
service teacher at
this level.
3
Writing
adheres to
0
The
1
The intern exhibits
2
The intern is
3
The intern exhibits
3
conventions
expected of
context and
situation
knowledge,
skills, or
dispositions
are not
observed.
There is no
basis for
determination.
some knowledge,
skills, or dispositions
that are
inappropriate or
ineffective for PreK-
12 student learning.
Remediation is
necessary if the
intern is to continue
in the teacher
preparation program.
developing the
knowledge, skills,
or dispositions for
effective PreK-12
student learning,
but has not yet
attained a level of
proficiency
appropriate for a
pre-service teacher
at this level.
knowledge, skills or
dispositions that are
proven to be
appropriate and
effective for PreK-12
student learning.
The level of
proficiency is that
expected of pre-
service teacher at
this level.
Total Score 12.0
Comments:

Work with Students
To successfully complete the internship experience, the intern must not earn more than two (2)
Unacceptable ratings in a specific category. For each unacceptable rating, a written plan of improvement
must be created, signed by the mentor teacher, the supervisor, and the intern and approved by the
Director of Educational Field Experiences (with copies of the improvement plans placed in the interns file).
During the FC, the intern may not earn any unacceptable ratings.
III. Work with Students
Criterion Performance Rating

Not Observed Unacceptable Acceptable Target Score
Displays
enthusiasm
0
The
knowledge,
skills, or
dispositions
are not
observed.
There is no
basis for
determination.
1
The intern exhibits
some knowledge,
skills, or dispositions
that are
inappropriate or
ineffective for PreK-
12 student learning.
Remediation is
necessary if the
intern is to continue
in the teacher
preparation program.
2
The intern is
developing the
knowledge, skills,
or dispositions for
effective PreK-12
student learning,
but has not yet
attained a level of
proficiency
appropriate for a
pre-service teacher
at this level.
3
The intern exhibits
knowledge, skills or
dispositions that are
proven to be
appropriate and
effective for PreK-12
student learning.
The level of
proficiency is that
expected of pre-
service teacher at
this level.
3
Establishes
high
expectations
for students
0
The
knowledge,
skills, or
1
The intern exhibits
some knowledge,
skills, or dispositions
2
The intern is
developing the
knowledge, skills,
3
The intern exhibits
knowledge, skills or
dispositions that are
3
dispositions
are not
observed.
There is no
basis for
determination.
that are
inappropriate or
ineffective for PreK-
12 student learning.
Remediation is
necessary if the
intern is to continue
in the teacher
preparation program.
or dispositions for
effective PreK-12
student learning,
but has not yet
attained a level of
proficiency
appropriate for a
pre-service teacher
at this level.
proven to be
appropriate and
effective for PreK-12
student learning.
The level of
proficiency is that
expected of pre-
service teacher at
this level.
Demonstrates
awareness and
respect for
diversity and a
sensitivity to
issues of
equity
0
The
knowledge,
skills, or
dispositions
are not
observed.
There is no
basis for
determination.
1
The intern exhibits
some knowledge,
skills, or dispositions
that are
inappropriate or
ineffective for PreK-
12 student learning.
Remediation is
necessary if the
intern is to continue
in the teacher
preparation program.
2
The intern is
developing the
knowledge, skills,
or dispositions for
effective PreK-12
student learning,
but has not yet
attained a level of
proficiency
appropriate for a
pre-service teacher
at this level.
3
The intern exhibits
knowledge, skills or
dispositions that are
proven to be
appropriate and
effective for PreK-12
student learning.
The level of
proficiency is that
expected of pre-
service teacher at
this level.
3
Gives
thoughtful
consideration
for alternative
and/or
contradictory
opinions
0
The
knowledge,
skills, or
dispositions
are not
observed.
There is no
basis for
determination.
1
The intern exhibits
some knowledge,
skills, or dispositions
that are
inappropriate or
ineffective for PreK-
12 student learning.
Remediation is
necessary if the
intern is to continue
in the teacher
preparation program.
2
The intern is
developing the
knowledge, skills,
or dispositions for
effective PreK-12
student learning,
but has not yet
attained a level of
proficiency
appropriate for a
pre-service teacher
at this level.
3
The intern exhibits
knowledge, skills or
dispositions that are
proven to be
appropriate and
effective for PreK-12
student learning.
The level of
proficiency is that
expected of pre-
service teacher at
this level.
3
Applies
management
strategies that
are respectful
of students
and their
developmental
needs
0
The
knowledge,
skills, or
dispositions
are not
observed.
There is no
basis for
determination.
1
The intern exhibits
some knowledge,
skills, or dispositions
that are
inappropriate or
ineffective for PreK-
12 student learning.
Remediation is
necessary if the
intern is to continue
in the teacher
preparation program.
2
The intern is
developing the
knowledge, skills,
or dispositions for
effective PreK-12
student learning,
but has not yet
attained a level of
proficiency
appropriate for a
pre-service teacher
at this level.
3
The intern exhibits
knowledge, skills or
dispositions that are
proven to be
appropriate and
effective for PreK-12
student learning.
The level of
proficiency is that
expected of pre-
service teacher at
this level.
3
Maintains a
positive and
safe learning
environment
0
The
knowledge,
skills, or
dispositions
are not
observed.
There is no
basis for
determination.
1
The intern exhibits
some knowledge,
skills, or dispositions
that are
inappropriate or
ineffective for PreK-
12 student learning.
Remediation is
necessary if the
intern is to continue
in the teacher
preparation program.
2
The intern is
developing the
knowledge, skills,
or dispositions for
effective PreK-12
student learning,
but has not yet
attained a level of
proficiency
appropriate for a
pre-service teacher
at this level.
3
The intern exhibits
knowledge, skills or
dispositions that are
proven to be
appropriate and
effective for PreK-12
student learning.
The level of
proficiency is that
expected of pre-
service teacher at
this level.
3
Is sensitive to
verbal and
nonverbal
cues from
students
0
The
knowledge,
skills, or
dispositions
are not
observed.
There is no
basis for
determination.
1
The intern exhibits
some knowledge,
skills, or dispositions
that are
inappropriate or
ineffective for PreK-
12 student learning.
Remediation is
necessary if the
intern is to continue
in the teacher
preparation program.
2
The intern is
developing the
knowledge, skills,
or dispositions for
effective PreK-12
student learning,
but has not yet
attained a level of
proficiency
appropriate for a
pre-service teacher
at this level.
3
The intern exhibits
knowledge, skills or
dispositions that are
proven to be
appropriate and
effective for PreK-12
student learning.
The level of
proficiency is that
expected of pre-
service teacher at
this level.
3
Offers
students
adequate
support for
the context
and situation
0
The
knowledge,
skills, or
dispositions
are not
observed.
There is no
basis for
determination.
1
The intern exhibits
some knowledge,
skills, or dispositions
that are
inappropriate or
ineffective for PreK-
12 student learning.
Remediation is
necessary if the
intern is to continue
in the teacher
preparation program.
2
The intern is
developing the
knowledge, skills,
or dispositions for
effective PreK-12
student learning,
but has not yet
attained a level of
proficiency
appropriate for a
pre-service teacher
at this level.
3
The intern exhibits
knowledge, skills or
dispositions that are
proven to be
appropriate and
effective for PreK-12
student learning.
The level of
proficiency is that
expected of pre-
service teacher at
this level.
3
Total Score 24.0
Comments: Lauren is an extraordinary teaching candidate. She is very strong with small groups
as well as large groups. She paces her lessons carefully and keeps the students on
task.
Her future students will be very lucky to have her as a teacher.