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Allen County Schools Teacher- Post-Observation Conference Form

Teacher
School
Grade Level(s)
Evaluator
Date of Conference

Evaluator’s Formative Observation Rating: Other professionals may request the evaluator provide
examples of evidence used to support the rating

Domain 2: The Environment	Rating	Domain 3: Delivery of Service	Rating
A: Creating an Environment of / Respect and Rapport		A: Communicating with Students
B. Establishing a Culture for / Learning		B. Using Questioning and Discussion Techniques
C. Managing Classroom Procedures		C: Engaging Students in Learning
D: Managing Student Behavior		D: Using Assessment in Instruction
E. Organizing Physical Space		E: Demonstrating Flexibility

I	D	A	E	NA
I	D	A	E	NA
I	D	A	E	NA
I	D	A	E	NA
I	D	A	E	NA

I	D	A	E	NA
I	D	A	E	NA
I	D	A	E	NA
I	D	A	E	NA
I	D	A	E	NA

Domain 1: Planning and Preparation	Comments / Ratings:

Domain 4: Professional Responsibilities	Comments / Ratings:

_____________________________________ _____________________ _____________________________________ _____________________
Teacher’s Signature Date Evaluator’s Signature Date
*Denotes sharing of results, not necessarily agreement with the formative rating. The teacher may submit a response in writing to all ratings by the evaluator.

Opportunities for an appeal are part of the Allen County School District evaluation plan
A copy of the completed form must be provided to the teacher