University Supervisor Resources

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

Block/Methods Evaluation Forms:

Secondary Education Block Form (PDF)

Mid-Level Block Evaluation Form (PDF)

ECH 1-4 Block Evaluation Form (PDF)

Modern Language Block Form (PDF)

Special Education Form (PDF)

University Supervisor Information:

University Supervisor Guide for Student Teaching Supervision

University Supervisor Evaluation Checklist

Student Teaching Forms:

CPAST Evaluation Fillable Form

Attendance and Grade Form
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 (STPP)
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.
Student Teaching Performance Profiles (STPP)

Early Childhood

Secondary Mathematics

Middle Level Education

Secondary Science

Secondary English (PDF)

Social Studies Education

Special Education (PDF)

Special Education Reading (PDF)

Rubric for grading all STPPs (PDF)

Teacher Candidate Work Sample

This Work Sample is only required for the following majors - elementary, early childhood, modern language, and social studies education.

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.

ECH Work Sample Rubric

Secondary Work Sample Rubric

General Information:

Pennsylvania Department of Education
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

  • PDE 430 Evaluation Form
  • PDE 430A Evaluation Form
  • PDE 430A Supplement Worksheet
  • 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
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

Travel Log Form
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.

Host Schools Mileage
When using your personal vehicle, you claim the lesser distance to the field site calculating from your home or from the University. Attached is a mileage chart to host school’s district office from Clarion. (Google Maps) There may be slight variations in mileage when a district has multiple schools in different parts of the district – some closer and some further away. You may want to set your trip odometer for more accurate mileage recording.

Video Instructional Points (VIP) Seminar

This information may be used to help structure video lessons if this is desired to help the student teacher. 

List of Pre-Student Teacher/Student Teacher Placements:

Achievement House Cyber, Allegheny Clarion Valley, Ambridge Area, Avonworth School, Armstrong Co., Big Beaver Falls Area, Brockway Area, Brookville Area, Broward County (Florida), Butler, Cameron County, Canon-McMillan, Carlynton, Central Valley (Beaver), Clarion, Clarion Immaculate Conception, Clarion-Limestone Area, Cranberry Area, Deer Lakes, DuBois Area, Dubois Central Catholic,, East Allegheny, Farrell Area, Forest Area (East Forest/West Forest), Franklin Area, Freedom Area, Highlands, Hopewell, Jeff Tech, Johnsonburg, Kane, Karns City Area, Keystone, Kiski Area, Leechburg Area, McKeesport Area, Moniteau, Moon Area, Mt. Lebanon,  New Kensington-Arnold, North Clarion County, Oil City Area, Punxsutawney, Quaker Valley, Redbank Valley, Riverside Beaver County, Riverview IU #6, Rochester Area, Shaler Area,  St. Mary's Area, St. Patrick's, St. Stephen's, Sto Rox, Titusville Area, Union, Valley Grove, Venango Catholic, West Allegheny, Western Beaver County, West Mifflin

*Schools underlined are not K-12 public
Last Updated 1/11/18