Parent or Guardian Input Form Classroom Teacher Evaluation

1.	Teacher's Name* Select no more than 1.
	Heather Haroldsen    Karlene Hardy    Emily Rhoads    Chris Hoover    Rachel Davis    Michelle Peterson    Cindy Kimball    Jennifer Wanstrom    Phyl Day    Bonnie Fuller-Jewett    Mark Gross    Kerry Simmons    Charlotte Wells    Mercy Nelson    Tricia Rhead    Cami Barger    Trent VanLeuven    Kyline Hainline    Emily Womack    Susan Buescher

2.	The teacher engaged in frequent and informative communications with the parent about student progress, attendance, behavior, curriculum topics and objectives.* Rate from 1 to 5. 5 is Agree and 1 is Disagree. 0 is Don't know or not applicable.
	0   1   2   3   4   5 1

3.	The teacher provided adequate suggestions for home support of learning.* Rate from 1 to 5. 5 is Agree. 1 is Disagree. 0 is Don't Know or Not Applicable.
	0   1   2   3   4   5 1

4.	The teacher is approachable, open to parental communication and parental input.* Rate from 1 to 5. 5 is Agree and 1 is Disagree. 0 is Don't Know or Not Applicable.
	0   1   2   3   4   5 1

5.	The teacher is respectful of family's culture and the social expectations of the family for the child.* Rate from 1 to 5. 5 is Agree and 1 is Disagree. 0 is Don't Know or Not Applicable.
	0   1   2   3   4   5 1

6.	The teacher maintains a classroom in which my child feels physically and emotionally safe.* Rate from 1 to 5. 5 is Agree and 1 is Disagree. 0 is Don't Know or Not Applicable.
	0   1   2   3   4   5 1

7.	The teacher administers discipline fairly and consistently.* Rate from 1 to 5. 5 is Agree and 1 is Disagree. 0 is Don't Know or Not Applicable.
	0   1   2   3   4   5 1

8.	The teacher provides curriculum-based and developmentally appropriate homework.* Rate from 1 to 5. 5 is Agree and 1 is Disagree. 0 is Don't Know or Not Applicable.
	0   1   2   3   4   5 1

9.	The teacher has provided child and family with knowledge of class expectations.* Rate from 1 to 5. 5 is Agree and 1 is Disagree. 0 is Don't Know or Not Applicable.
	0   1   2   3   4   5 1

10.	Classroom work demonstrated the appropriate level of difficulty for my child.* Rate from 1 to 5. 5 is Agree and 1 is Disagree. 0 is Don't Know or Not Applicable.
	0   1   2   3   4   5 1

11.	The teacher knows the content area and how to teach it.* Rate from 1 to 5. 5 is Agree and 1 is Disagree. 0 is Don't Know or Not Applicable.
	0   1   2   3   4   5 1

12.	The teacher treated my child with respect, care and knowledge of my child's needs.* Rate from 1 to 5. 5 is Agree and 1 is Disagree. 0 is Don't Know or Not Applicable.
	0   1   2   3   4   5 1

13.	The teacher appropriately monitored and assessed student learning. Rate from 1 to 5. 5 is Agree and 1 is Disagree. 0 is Don't Know or Not Applicable.
	0   1   2   3   4   5 1

14.	The teacher provided appropriate individual assistance to my child.* Rate from 1 to 5. 5 is Agree and 1 is Disagree. 0 is Don't Know or Not Applicable.
	0   1   2   3   4   5 1

15.	You are satisfied with your child's overall school experience as provided by this teacher.* Rate from 1 to 5. 5 is Agree and 1 is Disagree. 0 is Don't Know or Not Applicable.
	0   1   2   3   4   5 1

16.	Did you attend parent/teacher conferences?*
	Did you attend parent/teacher conferences?* YesNo

17.	Did you attend Open House?*
	Did you attend Open House?* YesNo

18.	Were you provided with a timely copy of your child's report cards?*
	Were you provided with a timely copy of your child's report cards?* YesNo

19.	Did your child's teacher ever contact you via telephone?*
	Did your child's teacher ever contact you via telephone?* YesNo

20.	Did your child's teacher provide you information regarding your child and/or class activities via email?*
	Did your child's teacher provide you information regarding your child and/or class activities via email?* YesNo

21.	Did your child's teacher provide you information regarding your child and/or class activities via notes or newsletters sent home to you?*
	Did your child's teacher provide you information regarding your child and/or class activities via notes or newsletters sent home to you?* YesNo

22.	Did you ever visit your child's classroom?*
	Did you ever visit your child's classroom?* YesNo

23.	Did you ever volunteer in your child's classroom?*
	Did you ever volunteer in your child's classroom?* YesNo

24.	Please add any additional comments you wish to share.*

25.	What is your name? *

26.	What is today's date?*