To be submitted to the Building Principal. Please print.
Substitute’s name | ID # | |
School | Assignment | |
Classroom teacher’s name | Date of substitution |
Areas of concern with a brief explanation:
☐ Arrived late and/or left early | ||
☐ Inappropriate dress | ||
☐ Improper language | ||
☐ Lack of classroom control | ||
☐ Accurate records not kept | ||
☐ Failed to provide written feedback | ||
☐ Physical aggression against student | ||
☐ Received parental complaint | ||
☐ Did not follow lesson plans or routines | ||
☐ Classroom was left unorganized and messy |
| ☐ Other |
Reported by: ☐ Student ☐ Staff ☐ Both
In the future, please do not assign this substitute to:
☐ Classroom/Teacher’s name | ||
☐ Grade level | ||
☐ Building | ||
☐ In any capacity | ||
Reporter’s name (printed) | ||
Reporter’s signature Date