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Hattie Strong Reference Form Fall 2019

Thank you for taking the time to complete this reference on behalf of your student intern. When rating this intern, you are encouraged to provide additional comments as you deem appropriate. Again, thank you!

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* 1. Name of Mentor Teacher Completing this Reference

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* 2. Name of Intern/Applicant for Hattie Strong Scholarship

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* 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

Additional Comments

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* 4. Intern shows appropriate judgment in decision-making.

	Unacceptable	Acceptable	Competent	Exemplary	N/A
criterion	criterion Unacceptable	criterion Acceptable	criterion Competent	criterion Exemplary	criterion N/A

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* 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

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* 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

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* 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

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* 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

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* 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

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* 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

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* 11. Intern shows concern about his/her own personal and professional growth.

	Unacceptable	Acceptable	Competent	Exemplary	N/A
Criterion	Criterion Unacceptable	Criterion Acceptable	Criterion Competent	Criterion Exemplary	Criterion N/A

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* 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

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* 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

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* 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

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* 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

Additional Comments

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* 16. Please include additional comments as needed. Thank you.