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University Supervisor Resources

University Supervisors

This page provides the various documents used by University Supervisors during different field experiences.

Block/Methods Evaluation Forms:

  • Special Education Block Information (PDF)

  • Secondary Education Methods Evaluation Form (DOC)

  • Mid-Level Block Evaluation Form (DOC)

  • ECH 1-4 Block Evaluation Form: DOC

  • Library Science Block Form: PDF

  • Music Block Form: PDF

  • Modern Language Block Form: DOC

  • Performance Evaluation: PDF

  • Special Education Form: PDF


University Supervisor Guide:

University Supervisor's Guide to work with Student Teachers (PDF)

Lesson Plan Format

Student Teaching Forms:

Visitation Form: DOC

Attendance and Grade Form:
Student Teacher Attendance and Grade Form (PDF): This is the form to be used for the final grade report at the end of the student teacher's placement.

Student Teaching Performance Profile (STTP):
These evaluation forms, one for each major, are used to define student teacher's progress throughout the placement. It is often helpful to print one out and use it periodically to show the student teacher strengths and weaknesses and to document progress or the lack of progress if necessary. This is the final evaluation form.

        Map and List of Pre-Student Teacher/Student Teacher Placements:

Abraxas, Achievement House Cyber, Allegheny Clarion Valley, Ambridge Area, Anvonworth School, Armstrong Co., Baldwin-White Hall, Beaver Area, Brockway Area, Brookville Area, Broward County (Florida), Butler, Cameron County, Canon-McMillan, Carlynton, Clarion, Clarion Immaculate Conception, Clarion-Limestone Area, Cranberry Area, Deer Lake, DuBois Area, Dubois Central Catholic, East Allegheny, Elizabeth Forward, Farrell Area, Forest Area (East Forest/West Forest), Franklin Area, Freedom Area, Hampton Township, Highlands, Hopewell,  Imagine Penn Hills Charter, Jeff Tech, Johnsonburg, Kane, Karns City Area, Keystone, Kiski Area, Laurel, Leechburg Area, Mars Area, McKeesport Area, Moniteau, Moon Area, Mt. Lebanon, New Brighton, New Kensington-Arnold, North Clarion County, Oil City Area, Punxsutawney, Quaker Valley, Redbank Valley, Riverside Beaver County, Riverview IU#6, Rochester Area, Seneca Valley, Shaler Area, St. Mary’s Area, St. Patrick’s, St. Stephen’s, Sto Rox, Titusville Area, Union, Upper St. Clair, Valley Grove, Venango Catholic, Western Beaver County, West Mifflin, Woodland

*Schools underlined are not K-12 public


Color Map (PDF) of Clarion County and surrounding area

Color Map (PDF) of Allegheny County and surround area


Student Teaching Performance Profiles (STPP)

  • Early Childhood (DOC)

  • Elementary Education (DOC)

  • Library Science (DOC)

  • Mathematics (DOC)

  • Middle level Education (DOC)

  • Modern Language (DOC)

  • Music (DOC)

  • Secondary Science (DOC)

  • Secondary English (DOC)

  • Social Studies Education (DOC).

  • Special Education (DOC)

  • Special Education Reading (PDF)

  • Rubric for grading all STPPs (DOC)


Teacher Candidate Work Sample (PDF)

This Work Sample is only required for the following majors - elementary, early childhood, library science, modern language, music, and social studies education. It is required as one of the NCATE accreditation assessments.

This form is to be completed at the end of each placement and given to the University Supervisor. The form is used to review one of the student teacher's lesson plans to determine the plan's effectiveness. If applicable, good, fair, and poor examples of pupil work should be attached to show the results of the lesson. This is an exercise for the student teacher to become more aware of their lessons and their involvement with their pupils.


General Information:

  • Pennsylvania Department of Education (HTML)
    link to Title 22 and Chapter 235, "Code of Professional Practice and Conduct for Educators". Please review this information prior to and throughout the field experience to further develop your own professionalism.

  • PDE 430 and PDE 430A Evaluation Forms (HTML)

    • Please use the electronic links on this PDE Webpage.
      They are - PDE-430 (MS Word Electronic Form) and PDE-430A (MS Word Electronic Form) for additional information.

    • These forms are required to be completed twice during the student teaching semester, once for each placement.

    • Once completed electronically, the forms are to be printed, reviewed with the student teacher, signed, and submitted to the Office of Field Services.

    • A copy of the completed and signed form is to be given to the student teacher for their records.

  • Incident/Accident Form (PDF)
    This form is to be used whenever a student teacher is injured during the placement when the injury has resulted from any activity related to the student teaching assignment. Please contact the Associate Dean/Director of Field Services immediately when this form is required.

  • Travel Information (HTML)
    This page is the Travel Information in the Accounts Payable page on the university Website.

  • Travel Log Form (PDF)
    Although you are not required to use this form, the travel log form has been developed to help you with detail regarding your student teacher supervision travel. This form may be submitted with your travel voucher request form for mileage reimbursement.

  • Video Instructional Points (VIP) Seminar (PDF)
    This information may be used to help structure video lessons if this is desired to help the student teacher.

  • Professional Sharing Documents -
    This section lists various forms and related documentation that University Supervisors have used successfully. You are NOT REQUIRED to use any of this information. However, you may find something here that you may want to investigate further.

    • Sample Letter to a Student Teacher (HTML)

    • Student Teacher PDE 430 Sources of Evidence Chart (PDF)

    • PDE 430 Form Template (PDF)

    • PDE 430A Attachments Form Template (PDF)