North Carolina School Executive Evaluation
Consolidated Assessment Form
School Executive Name:
School:
Position/Assignment:
Evaluator Name:
ID #
School Year:
Years in Position:
Evaluator Title:
INSTRUCTIONS: In preparation for your Summative Evaluation, you will need to collect artifacts from various data sources to be
used in a consolidated assessment of your school leadership. Minimum data sources are listed below with room for you to add
additional artifacts and data sources to complete your consolidated assessment of school leadership. For each artifact or data
source, answer the question, “What does the artifact or data source say about your school leadership?”
Data Source
Self-Assessment Form
Goal Setting Form
Student Feedback
Teacher/Staff
Feedback
Parent/Guardian and
Community Feedback
Student Achievement
Data
Teacher Working
Conditions Survey
School Improvement
Plan
Other:
Other:
Other:
What does the artifact or data source say about your school leadership?