TEACHER INDUCTION FORM

Teacher Induction Form

Team Members

Teacher's Name______________________ School____________________________________

School Address_________________________________________________________________

City________________________________ State________________ Zip__________________

Day Phone (____)____________________ Night Phone (____)_________________________

Mentor's Name ________________________________________________________________

Day Phone (____)____________________ Night Phone (____)_________________________

Content Expert/Mentor __________________________________________________________

Day Phone (____)____________________ Night Phone (____)__________________________

Instructional Supervisor __________________________________________________________

Day Phone (____)____________________ Night Phone (____)__________________________

University Consultant ____________________________________________________________

Day Phone (____)____________________ Night Phone (____)__________________________

First Team Meeting

Date:_______________________________ Members Present:__________________________

_____________________________________________________________________________

Challenges(s) as identified by instructor: Strengths:

1._____________________________________ 1._____________________________________

2._____________________________________ 2._____________________________________

3._____________________________________ 3._____________________________________

4._____________________________________ 4._____________________________________

Goals set by new instructor:

1.____________________________________________________________________________

2.____________________________________________________________________________

3.____________________________________________________________________________

4.____________________________________________________________________________

5.____________________________________________________________________________

Other comments: ______________________________________________________________

_____________________________________________________________________________

Second Team Meeting

Date:_______________________________ Members Present:__________________________

_____________________________________________________________________________

Implementation or progress toward goals: Newly identified strengths/challenges:

1._____________________________________ 1._____________________________________

2._____________________________________ 2._____________________________________

3._____________________________________ 3._____________________________________

4._____________________________________ 4._____________________________________

Revised goals (if necessary):

1.____________________________________________________________________________

2.____________________________________________________________________________

Other comments: ______________________________________________________________

_____________________________________________________________________________

Third Team Meeting

Date:_______________________________ Members Present:__________________________

_____________________________________________________________________________

Implementation or progress toward goals: Newly identified strengths/challenges:

1._____________________________________ 1._____________________________________

2._____________________________________ 2._____________________________________

3._____________________________________ 3._____________________________________

4._____________________________________ 4._____________________________________

Revised goals (if necessary):

1.____________________________________________________________________________

2.____________________________________________________________________________

Other comments: ______________________________________________________________

_____________________________________________________________________________

Fourth Team Meeting

Date:_______________________________ Members Present:__________________________

_____________________________________________________________________________

Implementation or progress toward goals: Newly identified strengths/challenges:

1._____________________________________ 1._____________________________________

2._____________________________________ 2._____________________________________

3._____________________________________ 3._____________________________________

4._____________________________________ 4._____________________________________

Revised goals (if necessary):

1.____________________________________________________________________________

2.____________________________________________________________________________

Other comments: ______________________________________________________________

_____________________________________________________________________________

Log of Secondary Meetings and/or Observations