Hattie Strong Reference Form - 26/27 Question Title * 1. Name of Mentor Teacher Question Title * 2. Name of Intern/Applicant for Hattie Strong Scholarship Question Title * 3. Intern displays professional demeanor and dresses appropriately. Unacceptable Acceptable Competent Exemplary N/A Criterion Criterion Unacceptable Criterion Acceptable Criterion Competent Criterion Exemplary Criterion N/A Other (please specify) Question Title * 4. Intern shows appropriate judgement in decision-making. Unacceptable Acceptable Competent Exemplary N/A criterion criterion Unacceptable criterion Acceptable criterion Competent criterion Exemplary criterion N/A Other (please specify) Question Title * 5. Intern demonstrates effective oral communication skills and is able to communicate ideas effectively. Unacceptable Acceptable Competent Exemplary N/A Criterion Criterion Unacceptable Criterion Acceptable Criterion Competent Criterion Exemplary Criterion N/A Other (please specify) Question Title * 6. Intern demonstrates effective written communication skills. Unacceptable Acceptable Competent Exemplary N/A Criterion Criterion Unacceptable Criterion Acceptable Criterion Competent Criterion Exemplary Criterion N/A Other (please specify) Question Title * 7. Intern demonstrates the ability to effectively relate to students and parents, and positively impact school-home connections. Unacceptable Acceptable Competent Exemplary N/A Criterion Criterion Unacceptable Criterion Acceptable Criterion Competent Criterion Exemplary Criterion N/A Other (please specify) Question Title * 8. Intern demonstrates a keen understanding of and ability to differentiate instruction. Unacceptable Acceptable Competent Exemplary N/A Criterion Criterion Unacceptable Criterion Acceptable Criterion Competent Criterion Exemplary Criterion N/A Other (please specify) Question Title * 9. Intern demonstrates classroom and behavior management and promotes positive student behavior. Unacceptable Acceptable Competent Exemplary N/A Criterion Criterion Unacceptable Criterion Acceptable Criterion Competent Criterion Exemplary Criterion N/A Other (please specify) Question Title * 10. Intern recognizes the critical role that teachers have in facilitating student achievement. Unacceptable Acceptable Competent Exemplary N/A Criterion Criterion Unacceptable Criterion Acceptable Criterion Competent Criterion Exemplary Criterion N/A Other (please specify) Question Title * 11. Intern shows concern about their own personal and professional growth. Unacceptable Acceptable Competent Exemplary N/A Criterion Criterion Unacceptable Criterion Acceptable Criterion Competent Criterion Exemplary Criterion N/A Other (please specify) Question Title * 12. Intern plans instructional activities that are developmentally appropriate and culturally sensitive. Unacceptable Acceptable Competent Exemplary N/A Criterion Criterion Unacceptable Criterion Acceptable Criterion Competent Criterion Exemplary Criterion N/A Other (please specify) Question Title * 13. Intern uses multiple forms of assessment to evaluate student progress. Unacceptable Acceptable Competent Exemplary N/A Criterion Criterion Unacceptable Criterion Acceptable Criterion Competent Criterion Exemplary Criterion N/A Other (please specify) Question Title * 14. Intern demonstrates proficiency in the effective use of instructional technology. Unacceptable Acceptable Competent Exemplary N/A Criterion Criterion Unacceptable Criterion Acceptable Criterion Competent Criterion Exemplary Criterion N/A Other (please specify) Question Title * 15. Intern demonstrates competence in basic skills and has a strong command of the subject matter. Unacceptable Acceptable Competent Exemplary N/A Criterion Criterion Unacceptable Criterion Acceptable Criterion Competent Criterion Exemplary Criterion N/A Other (please specify) Question Title * 16. Please include additional comments as needed. Thank you. Done