STUDENT OBSERVATION SITE
EVALUATION FORM

Kindly take a few moments to complete the checklist below.  Any comments you care to share with the instructor and/or coordinator would be welcome.  Your name is optional.


Yes	No		Did the teacher always exhibit a professional manner?


Yes	No		Was this teacher a good role model?


Yes	No		Did you gain some positive insights from this teacher?


Yes	No		Would you recommend this site be used again?  Why or why
			not? (Use comment section below)


Yes	No		Would you recommend this teacher to another student?  Why
			or why not? (Use comment section below)


Comments:








Student Observer Name (optional): ________________________________________

Host Site: ______________________________________________________________

Host Teacher: ___________________________________________________________

Host Site Age Group/Grade: _______________________________________________

Semester: _________________________ Course Number: ______________________




Revised 07/12/11