Induction Reporting Form 2015-2016 Participants: s e : i: Name of Induction Teacher: | __Jalisa McKevie [Name of Administrator: | Donna Barrick [Name of Mentor: | |___ Angelia Cargitt Mentor’s Mailing Address & Social Security Number: _ z 5 Street: = — : P | | Code: les Mentors wil ive a $225 stipend for each teacher mentored, mailed to the address above. The mentors social security number is required. If concerned abeut privacy, add the SSN only to the copy being mailed to the district. Final Induction Ratings: (Circle one) Professional Practice: _(/ Exemplary/Proficient/Needs Improvement /Unsatisfactory | Exemplaty /Proficient/Needs Improvement /Unsatisfactory c 7B cemplary/Proficient/Needs Improvement/Unsatisfactory iFi : 7Wet Met/Incomplete | (Optional) Comments The teacher has developed a positive rapport with her students, | : egg: | She is cognizant of the needs in her classroom. She encourages her |Tegarding these ratings: | Students and their accomplishments. Signatures: Evaluators: By signing below, | verify that (1) the Induction program for this teacher was properly implemented, (2) | was a full participant in the process, and (3) | am in agreement with the above ratings. Administrator’s Signature: Amun Y. Suir, | verify that | have received these ratings. My signature at | agree with these results. “Induction Teacher's Ch 1 7 iam ignature: Meso | Mentor’s Signature: Teacher: By signing below, | | does not necessarily imply th ‘Mail this form with original signatures to the SCPCSD: 3710 Landmark Drive, Suite 201, Columbia, SC 29204