Augsburg College

Service Learning Student Assessment Form

 

Student’s Name ________________________________Class(es) Taking________________________

Please rate the students’ performance by placing a check in the appropriate column. A n/o indicates not observed; 1 indicates low level or minimal and 5 indicates high level. Feel free to add any comments or explanations.

Professional Dispositions                                                                             n/o 1 2 3 4 5  

Is regular and prompt in attendance                                                              ____________________

Notifies teacher in case of absence                                                               ____________________

Behaves professionally                                                                              ____________________

Dresses appropriately                                                                                ____________________

Readily assumes assigned duties (MSEP 10.G)                                              ____________________

Takes initiative, as appropriate (MSEP 10.G)                                               ____________________

Plans adequately for instruction (MSEP 5.R)                                                ____________________

Follows directions willingly (MSEP 10.G)                                                  ____________________

Uses a satisfactory range and quality of

teaching strategies (MSEP 4.C)                                                      ____________________

Encourages the development of students’ critical thinking

and independent problem solving abilities (MSEP 4)                         ____________________

Is prepared to teach (MSEP 7)                                                                    ____________________

 

Personal dispositions within and beyond school

Is optimistic and enthusiastic                                                                     ____________________

Is patient and understanding                                                                       ____________________

Sees self as a role model and mentor for students                                           ____________________

Self-evaluates perceptively and willingly (MSEP 9.B, E; 5.Q)                         ____________________

Seeks advice and feedback as appropriate (MSEP 9.J; 10.G)                             ____________________

 

Dispositions towards children and youth

Uses positive class management (MSEP 5.E)                                               ____________________

Helps students work together cooperatively (MSEP 5. I,D)                              ____________________

Motivates students to learn (MSEP 5.F)                                                      ____________________

Is aware of students individual needs                                                            ____________________

Maintains positive climate and relationships with

students (MSEP 5.P,H)                                                                ____________________

Gains student acceptance                                                                           ____________________

Fosters self-esteem in students (MSEP 5.C)                                                 ____________________

Shows respect, care and concern for all students, & colleagues (MSEP 3)           ____________________

Willingly seeks help and resources in order to work with

all children (MSEP 7, 9, 10)                                                          ____________________

Values the learning needs of children when teaching content (MSEP 5)              ____________________

Affirms and celebrates the diversity of all students (MSEP 2,3)            ____________________

Sees the importance of building relationships with all students (MSEP 5)          ____________________

ADDITIONAL COMMENTS: (You may continue comments on the back)

 

 

 

Printed Name_____________________________ Phone Number___________________

Signature________________________________Position_________________________

School__________________________________ Hours Completed_________________

School District___________________________ Date____________________________

 

This completed form conforms to requirements of the Family Educational Rights and Privacy Act and to its amendments. *Items in parentheses correspond to the MN Standards of Effective Practice which are evaluated within the context of this field experience.                                                   Revised 1/20/04