Technology Integration Verification Form 

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 Riverview School District ‐ 2015‐2016 School Year Technology Integration Verification Form ‐ as per Section 8.2.4 of the REA CBA ‐ *Completed Form Due to Your Supervisor by June 1st 2016* Name: Location: Annual PILOT Survey Taken Tiers of Technology Integration Rubric Level(s): * *
*
*(see below - can choose more than one level)
Your Technology Integration Goal(s): Your Plan to Accomplish Technology Integration Goal(s): By Sept. 30th ‐ Supervisor’s Pre‐Approval Signature ____________________________ Date _____________ ******************************************************************************** By June 1st ‐ Summary of Your Technology Integration Goal(s) Progress: ******************************************************************************** I hereby affirm that the information contained on this page is true and accurate to the best of my ability. Employee's Signature ________________________________________ Date _____________ Supervisor's Signature ________________________________________ Date _____________ Summary of Process In the fall: 1.
2.
3.
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Take a short self‐assessment of current “Technology Integration” skills with the online PILOT survey. (Instructions on taking the PILOT Survey). Use the 3 level “Tiers of Technology Integration” rubric as a guide to create at least one Technology Integration Goal for the year (you can have more than 1). Complete this Technology Integration Verification Form documenting your work. Submit said form to your Supervisor by September 30th for pre‐approval. Please keep a paper or electronic copy of the form to complete in the spring and for your records. In the spring: 1. Complete this Technology Integration Verification Form and submit to your Supervisor by June 1st. 2. The Supervisor will then turn in your completed form to Payroll. 3. Pay will be dispersed in the June pay check. Tiers of Technology Integration Checklist
*To Help Guide Your Tech Integration Goal Planning*
Observable
Indicators
Tier 1: Teacher Productivity
Tier 2: Instructional Practices and Evaluation
Tier 3: Student Use of Technology to Meet Common Core
Standards and State Technology Standards
This tier focuses on the teacher using
technology to get their job done.
This tier involves teacher instructional planning,
preparation and informed decision making.
This tier focuses on student engagement in using technology in
individual and collaborative learning activities.
(See the WA State Educational Technology Standards)
Teachers:
Teachers:

Communicate effectively with
parents and staff using electronic
systems (email, shared servers)

Use electronic assessment systems for
goal setting and progress monitoring
(MAP, Smarter Balance, AimsWeb)

Produce, store, and retrieve
learning materials

Use Homeroom data repository to make
informed decisions on student growth

Find and use web based
teaching resources

Use Homeroom Evaluation tool to progress
through the teacher evaluation process
Use Skyward student information
system to track and grade
student progress

Communicate information to
parents and students via
up-to-date blogs or websites
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
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Teachers enable students to:

o Innovate: Demonstrate creative thinking, construct
knowledge and develop innovative products and processes
using technology.
o Communicate: Communicate information and ideas
effectively to multiple audiences using a variety of media
and formats.
Use classroom the presentation stations and
ActivBoard to create lessons, assess
students, and share electronic resources
o Collaborate: Use digital media and environments to
communicate and work collaboratively to support individual
learning and contribute to the learning of others.
Create electronic templates, guides,
checklists, rubrics and other planning
documents to support technology integrated
projects
Organize electronic resources for student
access and use (weblinks, image libraries,
video content, database information)
Use technology within all content areas to collaborate,
communicate, generate innovative ideas, investigate and solve
problems.
o Investigate and Think Critically: Research, manage and
evaluate information and solve problems using digital tools
and resources.

Demonstrate a clear understanding of technology systems and
operations and practice safe, legal and ethical behavior.
o Select and Use Applications: Use productivity tools and
common applications effectively and constructively
o Operate Systems: Understand technology systems and
use hardware and networks to support learning.
o Practice Safety: Practice safe, legal and ethical behavior
in the use of information and technology.
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