Field-Based Internship Planning

Worksheet

Name: Will Brock

UEN B

Cohort: 2013

ISSL #1 Visionary Leadership

Standa
rd

1a

Visionary Leadership/Experience Area

(Condensed Criteria)

Uses data for Establishment of

Achievement Goals

E.C.
/Elem/Sec/Sp Ed
(Indicate Grade
Level)
Approximate
Hours
Elem 3 hrs
EC 2 hr
Sp. Ed 5 hrs
EC 4 hrs

1b

1c

Uses best practice in Program

Improvement

Articulates/Promotes High
Expectations for Teaching/Learning

Sp. Ed 5 hrs
Elm 3 hrs
Elem 2 hrs

DESCRIPTION

Comple
tion
Date

IS3 Spring Workshop

4/24/14

Mrs. Steggall Becker Elementary Shadow

Co-taught Classes

5/16/14
6/11/14

IS3 Conference

11/20/1
4

Co-taught Classes

6/11/14

Bomb Threat Team

11/14/1
3

IS3 Spring Workshop

4/24/14

EC 2 hrs
Sp. Ed 5 hrs
EC 3 hrs
1d

Aligns educational programs w/

District Vision and Goals

Sec 2 hrs
Sec 1 hr
Sec 1 hr
Sp.Ed 5 hrs
Sec 3 hrs

Mrs. Steggall Becker Elementary Shadow

Co-taught Classes

Provides Leadership for Major

Initiatives and Change Efforts

Sec 2 hrs
Elem 3 hrs
EC 2 hrs
Sec 1 hr
Sec 1 hr
EC 4 hrs

1f

Communicates effectively with

various stakeholders on progress

Sec 2 hrs
Elm 2 hrs
Sp. Ed 5 hrs

6/11/14

PBIS Meetings

12/17/1
3

District MTSS Discussion

5/15/14

MTSS Proposal
PBIS Set Visit
Co-taught Classes
Bomb Threat PD II

1e

5/16/14

Alternative Site Evacuation PD

IS3 Spring Workshop
Mrs. Steggall Becker Elementary Shadow
PBIS Set Visit

4/15/14
3/25/14
6/11/14
12/27/1
4
4/30/14
4/24/14
5/16/14
3/25/14

Bomb Threat PD II

12/27/1
4

IS3 Conference

11/20/1
4

Alternative Site Evacuation PD

4/30/14

IS3 Spring Workshop

4/24/14
6/11/14

EC 4 hrs

Co-taught Classes

11/20/1
4

IS3 Conference

ISSL #2 Instructional Leadership

Standard
2

2a

Instructional Leadership
(Condensed Criteria)

Provides leadership for

Assessing/Developing/Improving
Climate and Culture

E.C.
/Elem/Sec/Sp Ed
(Indicate Grade
Level)
Approximate
Hours

DESCRIPTION

Completion
Date

Sec 3 hrs

IS3 Spring Workshop

4/24/14

Sec 1 hr
Elm 4 hrs

2b

Systematically/Fairly
Recognizing/Celebrating Staff/Student
Accomplishment

Sec 1 hr
Sp. Ed 5 hrs
EC 3 hrs

2c

Encourages design of more effective

learning experiences for students

EC 2 hrs
Elm 4 hrs

PBIS Set Visit

IS3 Conference

3/25/14
11/20/13

Usher/Security at West High Graduation

5/28/2014

Co-taught Classes

6/11/14

PBIS Meetings
Mrs. Steggall Becker Elementary Shadow
Shadow Mr. Steve Thune of Irving

12/17/13
5/16/14
3/21/14

Sp. Ed 5 hrs
EC 3 hrs

Elementary
Co-taught Classes

6/11/14
11/20/14

IS3 Conference
2d

Monitors/Evaluates Effective
Curriculum/Instruction/Assessment

Sec 2 hrs
Sp. Ed 5 hrs

IS3 Spring Workshop

Co-taught Classes

4/24/14
6/11/14

2e

Evaluates Staff and Provides ongoing

coaching for improvement

Sec 3 hrs

IS3 Spring Workshop

4/24/14

2f

Ensures professional development

that enhances teaching/learning

Sec 2 hrs

Alternative Site Evacuation PD

4/30/14

Sec 2 hrs
Sec 2 hrs

2g

Uses research/theory to
develop/revise professional growth
plan

Sec 1 hrs
Sp. Ed 5 hrs
EC 1 hr

2h

Promotes collaboration with all

stakeholders

IS3 Spring Workshop

Led staff discussion on fire drill analysis
IS3 Spring Workshop
Co-taught Classes
IS3 Conference

4/24/14
10/2/13
4/24/14
6/11/14
11/20/14

Sec 2 hrs

Alternative Site Evacuation Drill

Cancelation

4/28/14

Sec 1 hr

Spring Tornado Drill

3/27/14

Elm 2 hrs

Safety Chair Meeting II

3/13/14

Sp. Ed 5 hrs

Co-taught Classes

6/11/14

Sec 5 hrs
EC 1 hr
2i

Accessible and approachable to all

stakeholders

Sec 2 hrs
Sec 2 hrs

Greet Students in the Morning

Incident Command Team
Alternative Site Evacuation PD

6/10/14
12/2/14
4/30/14
4/28/14

Sec 1 hr

Alternative Site Evacuation Drill

Cancelation

Sp. Ed 5 hrs

Spring Tornado

6/11/14

Sec 5 hrs

Co-taught Classes

6/10/15

EC 3 hrs

Greet Students in the Morning

3/27/14

9/13/13

Responsibilities as Safety Chairman

2j

Visible and engaged in the

community

Sec 4 hrs
Sec 1 hr

Sec 2 hrs

Administrator for Girls Soccer Game

Administrator at Spring Vocal Music
Concert

5/16/14
4/28/14

4/28/14

Sec 1 hr

Alternative Site Evacuation Drill

Cancelation

Sp. Ed 5 hrs

Spring Tornado Drill

6/11/14

Sec 5 hrs

Co-taught Classes

EC 2 hrs

3/27/14

6/10/14
9/13/13

Greet Students in the Morning

Responsibilities as Safety Chairman

2k

Articulates and reinforces desired

school culture, showing evidence

Sec 3 hrs

Administrative Dress Code Sweep

Sp. Ed 5 hrs

Co-taught Classes

EC 3 hrs

PBIS Meetings

4/29/14
6/11/14
12/17/13

ISSL #3 Organizational Leadership

Standar
d3

3a

Organizational Leadership
(Condensed Criteria)

Complies with state and federal

mandates and local board policies

E.C.
/Elem/Sec/Sp Ed
(Indicate Grade
Level)
Approximate
Hours

DESCRIPTION

Completi
on Date

Sec 2 hrs

Alternative Site Evacuation Drill

4/28/14

Sp. Ed 2 hrs
Sec 1 hr

Cancelation
Special Education Coordinator

3/4/14
12/2/14

Incident Command Team

3b
3c

Recruitment, selection, induction, and

retention of staff for quality instruction
Addresses current and potential issues
in a timely manner

Sec 3 hrs

Bomb Sweep Team

12/12/13

Sec 2 hrs

Usher/Security at West High Graduation

5/28/14

Sec 3 hrs

Assistant Administrator for Prom

5/3/14

Sec 2 hrs
Elm 1 hr

Alternative Site Evacuation Drill

Cancelation

4/28/14
1/9/14

District Safety Meeting

3d

Effectively/efficiently manages fiscal

and physical resources

Elm 2 hrs
Sec 5 hrs

Shadow Mr. Steve Thune of Irving

Elementary

3/21/14
9/13/13

Responsibilities as Safety Chairman

3e

Protects instructional time

Sec 2 hrs
Sp. Ed 1 hr
Sec 3 hrs

3f

Uses effective communication

w/internal and external audiences
about school operations

Sec 1 hr
Sp. Ed 1 hr
Sec 3 hrs

Alternative Site Evacuation PD

Special Education Coordinator
Rekey West High Plan
Principals Meeting
Special Education Coordinator
Alternative Site Agreement

4/30/14
3/4/14
1/3/14

3/31/14
3/4/14
12/5/13

Standar
d4

4a

4b

ISSL #4 Collaborative Leadership

Collaborative Leadership
E.C.
DESCRIPTION
(Condensed Criteria)
/Elem/Sec/Sp Ed
(Indicate Grade
Level)
Approximate
Hours
Engages families and community, and
Elm 4 hrs
Shadow Mr. Steve Thune of Irving
promotes shared responsibility for
Elementary
Sec 5 hrs
student learning and education
Greet Students in the Morning
Sec 1
Athletic Eligibility Dispute
Promotes/supports structure for
family/community involvement

Sec 1 hr
EC 8 hrs
Sp. Ed 5 hrs
Sec 5 hrs

Completi
on Date

3/21/14
6/10/14
8/28/13

Administrator at Spring Vocal Music

Concert

4/28/2014

Shadow Mr. Steve Thune of Irving

Elementary

3/4/14

3/21/14

6/10/14

Special Education Coordinator

Greet Students in the Morning
4c

Facilitates connections of
students/families to health/social
services that support a focus on
learning

Elm 4 hrs
Sp. Ed 1 hrs
Elm 1 hr

Shadow Mr. Steve Thune of Irving

Elementary
Special Education Coordinator

3/21/14
3/4/14
1/9/14

District Safety Meeting

4d

Collaboratively establishes a culture

that welcomes and honors families

Elm 4 hrs

Shadow Mr. Steve Thune of Irving

Elementary

3/21/14

and community and seeks ways to

engage them in student learning

EC 3 hrs

PBIS Meetings

12/17/13

ISSL #5 Ethical Leadership

Standar
d5

5a

Ethical Leadership
(Condensed Criteria)

Demonstrates ethical and

professional behavior

E.C.
/Elem/Sec/Sp Ed
(Indicate Grade
Level)
Approximate
Hours
Sec 2 hrs
Sec 5 hrs
Sec 5 hrs

DESCRIPTION

Completio
n Date

Assistant Administrator for Prom

5/3/14

UI Football Camp
GreetStudentsintheMorning

6/10/14

Demonstrates values, beliefs, and

attitudes that will inspire others to
higher levels of performance

Sec 5 hrs

5c

Fosters and maintains caring,

professional relationships with staff

Sec 5 hrs

Greet Students in the Morning

6/10/14

5d

Demonstrates appreciation for and

sensitivity to diversity in the school
community

Sec 1 hrs

Usher/Security at West High Graduation

5/28/14

5b

Sec 5 hrs

ELM 4 hrs
Sp. Ed 1 hr

UI Football Camp

3/29/14

GreetStudentsintheMorning

Shadow Mr. Steve Thune of Irving

Elementary

3/29/14
6/10/14

3/21/14
3/4/14

Special Education Coordinator

5e

Demonstrates respect for divergent

opinions

Sec 2 hrs
Sec 1 hr

Usher/Security at West High Graduation

Ledstaffdiscussiononfiredrillanalysis

5/28/14
10/2/13

ISSL #6 Political Leadership

Standar
d6

6a

Political Leadership
(Condensed Criteria)

Collaborates with service

providers/decision-makers to
improve teaching and learning

E.C.
/Elem/Sec/Sp Ed
(Indicate Grade
Level)
Approximate
Hours
Sec 1 hr
Elm 2 hrs

DESCRIPTION

Completi
on Date

MTSS Proposal

4/15/14

Sp. Ed 1 hr

Shadow Mr. Steve Thune of Irving

Elementary

Elm 2 hrs

Special Education Coordinator

Sec 2 hrs

Bomb Threat Team

3/21/14
3/4/11
11/14/13
12/5/13

Alternative Site Agreement

6b

Advocates for the welfare of all

Sp. Ed 1 hr

Special Education Coordinator

3/4/11

members of the learning community

Athletic Eligibility Dispute

Sec 1 hr

6c

Designs and implements appropriate

strategies to reach desired goals

Elm 2 hrs
Sp. Ed 1 hr

8/28/13
Shadow Mr. Steve Thune of Irving
Elementary
Special Education Coordinator

Program-Required Internship Experiences

Program-Required
Experience

Location (school,
agency, business, &
contact people)

Description

Completion Date

Full-Day Principal
Shadowing

Dunkerton High School

Shadow Justin Urbanek

3/5/2014

Irving Elementary

Shadow Steve Thune

3/18/14

Non-profit/Social
Service Experience

Carver Academy

Community Service w/ East

High Football Team

7/24/14

3/21/14
3/4/14

Business Internship
Experience

Waterloo Police Department

Shadow 3rd Shift police

officer

12/20/13