Feedback of Substitute Teacher - Mesa Public Schools

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FEEDBACK OF SUBSTITUTE TEACHER
Your input is a valuable key to retaining quality substitutes.
Please make sure to complete a feedback form any time you have an extraordinary substitute
or any time you have a substitute whose performance is less than adequate. It is not necessary
to submit multiple feedback forms on the same substitute if their performance remains
consistent. Submit the completed form to Substitute Services.
NAME OF SUBSTITUTE: _________________________________________ JOB #: ____________________________________
SCHOOL:___________________________________________________________________________________________________
GRADE/SUBJECT: _____________________________________ DATE(S) WORKED: ___________________________________
(MM/DD/YY)
1. Did the substitute effectively follow lesson plans and procedures?
Yes
No
2. Did the substitute effectively follow classroom procedures?
Yes
No
3. Did the substitute utilize effective classroom management skills?
Yes
No
4. Did the substitute have knowledge of subject matter?
Unknown
Yes
No
5. Rate the overall effectiveness of the substitute:
Highly Effective
Effective
Developing
Ineffective
6. Would you like this substitute in the future?
Yes
No
If you select No, a reason will be required in the remarks section below.
7. Suggestions that might improve the substitute’s effort: __________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
8. Remarks: __________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
__________________________________________________
__________________________________________________
TEACHER NAME (PLEASE PRINT)
TEACHER SIGNATURE
Substitute teachers may request to view feedback forms at any time during their employment.
91-30-19 W (7/12)
FEEDBACK OF SUBSTITUTE TEACHER
Your input is a valuable key to retaining quality substitutes.
Please make sure to complete a feedback form any time you have an extraordinary substitute
or any time you have a substitute whose performance is less than adequate. It is not necessary
to submit multiple feedback forms on the same substitute if their performance remains
consistent. Submit the completed form to Substitute Services.
NAME OF SUBSTITUTE: _________________________________________ JOB #: ____________________________________
SCHOOL:___________________________________________________________________________________________________
GRADE/SUBJECT: _____________________________________ DATE(S) WORKED: ___________________________________
(MM/DD/YY)
1. Did the substitute effectively follow lesson plans and procedures?
Yes
No
2. Did the substitute effectively follow classroom procedures?
Yes
No
3. Did the substitute utilize effective classroom management skills?
Yes
No
4. Did the substitute have knowledge of subject matter?
Unknown
Yes
No
5. Rate the overall effectiveness of the substitute:
Highly Effective
Effective
Developing
Ineffective
6. Would you like this substitute in the future?
Yes
No
If you select No, a reason will be required in the remarks section below.
7. Suggestions that might improve the substitute’s effort: __________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
8. Remarks: __________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
__________________________________________________
__________________________________________________
TEACHER NAME (PLEASE PRINT)
TEACHER SIGNATURE
Substitute teachers may request to view feedback forms at any time during their employment.
91-30-19 W (7/12)

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