Office of Field Services
Licensure Program Concern Conference
Cleveland State University
Concern Conference
There are occasions when Cleveland State University College of Education faculty, school mentor teachers or
administrators, university supervisors, or other personnel may feel that a College of Education student has a
problem meeting the minimum expectations of a CSU student and/or a future teacher. When this occurs, there
are many ways to communicate this concern to a student: e.g., the faculty member might communicate orally or
in written comments on an assignment or on an evaluation form. Another way of communicating concern is
through a “Concern Conference” with the student. This is a formal procedure in which one of more faculty
members (or other personnel listed above) and the CSU student communicate with each other about a perceived
problem, collaboratively develop ways in which the problem can or should be addressed, and write these out in
a document. You will find a copy of a Concern
Conference form below.
A Concern Conference is a serious matter that if agreed upon stipulations are not met may result in a change of
mentor match (within the same or at a different school) or removal from the student’s licensure program. If the
Concern Conference results in a change of mentor match, any additional Concern Conferences may result in
dismissal from the licensure program. Only one change in mentor is allowed.
The College of Education has an Ombudsperson whose job is to assist students with academically related
problems that have not been resolved to the student’s satisfaction. The Ombudsperson is prepared to objectively
arbitrate issues that may develop at a Concern Conference, should that be necessary. The Ombudsperson may
be contacted by calling the Education Student Services Offices (ESSC) at 216.687.4625.
Office Of Field Services Objective Form Spring, 2015
Intern: ___________________________ CSU ID _____________
Disposition in
Question
Attendance

Punctuality

Completes
Work in a
Timely
Manner

Demonstrates
Organizational
Skills
Sample Objective
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
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
Observe all
Pertinent
Policies and
Procedures

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

Lesson
Planning
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

Intern will report to the field site each day as
scheduled. If the intern misses _____ days in the
field/seminar as of (date), he/she will be required to
meet with OFS who could at that time terminate the
remainder of this experience.
Intern will report to the field site each day scheduled
by (time). If the intern is tardy _____ more times to
the field/seminar as of (date), he/she will be
required to meet with OFS who at that time will
schedule make up days in the field or terminate the
experience.
Intern will submit completed lesson plans (with all
supplemental materials) to mentor teacher(s) on
_______ (Thursday/Friday) for the following week.
Intern will submit observation lesson plans to
supervisor at least 48 hours before the scheduled
observation.
Intern will complete (specific assignment) by (due date)
Intern will keep a binder with tabs to separate work
for field and seminar.
Intern will submit completed lessons, reflections,
artifacts, and other portfolio requirements only. No
more partial assignments will be accepted.
Attend all field experiences, classes and seminars
fully prepared to submit assignments due. (They are
on my computer, flash drive, I have them) will no longer
suffice. If you don’t have them, they will be marked
as missing.
Intern will not use cell phone while at the site or in
seminar.
Intern will not check personal email on school
computers.
Intern will cover tattoo while in the field.
Intern will not form inappropriate “friendships”
with students. Intern is to take on the role of the
professional.
Intern will follow CSU format when completing all
lesson plans for both the mentor teacher and the
supervisor.
Intern will revise lesson plans as needed.
Lesson plans must be legible
To Be Completed By:
On -going
On-going
Friday’s date
Date which is 48 hours before next
formal observation
Specific due date of the assignment
On-going
Specific due date(s) of the
assignment(s) in questions
Specific due date(s) of the
assignment(s) in questions
On-going
On-going
On-going
The dates will be specific to the due
dates of the lesson plans.
Create a “window of time” to allow
students to revise plans.
On-going
Office of Field Services Objective Form Spring, 2010
Intern: ___________________________ CSU ID _____________
Accepts and
Responds to
Feedback
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
Project an
Appropriate
Professional
Appearance in
Professional
Settings
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Intern uses suggestions from mentor teacher and
revises plans accordingly.
Intern completes and submits Follow-Up Form
after formal observations.
Intern uses supervisor suggestions to correct
Artifacts to receive a rating of Proficient or Above
Intern will not wear jeans in the field except on
special days like Spirit Days or Field Trip Days
Intern’s skirt will be at least fingertip length or
longer.
Intern will not allow undergarments of any kind to
show when in the field or at seminar.
Intern will not wear body piercings when in the
field.
Intern will cover tattoo when in the field.
Mentor teacher has addressed oral hygiene with the
intern and intern agrees to make a conscious effort
to be mindful of the situation.
Supervisor has discussed bodily odor with the
intern. Intern agrees to shower daily and wear clean
clothes to the field and to seminar.
Intern agrees to iron clothes so as not to have a
disheveled appearance when in the field.
Intern will not eat or drink in the classroom other
than for class parties or activities
Create a “window of time” to allow
students to revise plans.
Create a “window of time” to allow
students to complete Follow Up
Form.
Create a “window of time” to allow
students to revise and resubmit
Artifacts.
On-Going
Office of Field Services Conference Record
Intern: ___________________________
ID: ____________________
Date of Conference: _________________
Practicum Student Teacher
Undergraduate
Graduate
Licensure Program: _______________
Does intern have a FLAG Form on file in Student Services? Yes
No
Initiator of Conference:
 Supervisor: ____________________________________
 Intern: _______________________________________
 Other: ________________________________________
 Mentor(s): _________________________________________
 OFS Staff: __________________________________________
Area(s) of Concern:
Professional Relationships
 Intern-Supervisor and/or OFS Staff
 Intern-Mentor Teacher(s)
 Intern-Other: ____________________________________________________
Professional Responsibilities
 Meeting Field Obligations
 Low Assessment Scores
 Meeting Syllabus Requirements
Professional Competency
 Content Knowledge
 Intern-Peer(s)
 Intern-Students
 Lesson Planning
 Lesson Delivery
Classroom Management
Lack of initiative
 Attendance/Tardiness
Disposition(s) _______________________________________
 Skills: _____________________  Clinical Experience
 Oral/Written Expression
Brief Explanation of Problem:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Planning and Progress Chart
Objective
Objective
Met
Signatures:
OFS Staff: __________________________________
Intern: ________________________________________
Mentor Teacher: _____________________________
Supervisor: ____________________________________
Other: __________________________________________