MATANUSKA-SUSITNA BOROUGH SCHOOL DISTRICT
Instruction Department
501 N. Gulkana
Palmer, Alaska 99645
phone (907) 746-9212 fax (907) 746-9292
www.matsuk12.us
Developing citizens for a global
society by inspiring students to
think, learn, achieve and care.
Matanuska-Susitna Borough School District
Parent Survey of Teacher Performance
The purpose of this form is to provide feedback to your child’s teacher to improve the quality of instruction.
All information should address the local teacher standards and be observable in the teacher’s workplace. If
this information is to be considered as input into the teacher’s evaluation, this form must be signed and
submitted by February 1st.
Teacher Name:
Date:
School:
Standard #1:
A TEACHER KNOWS HIS/HER SUBJECT AREA AND HOW TO TEACH IT.
Uses a wide variety of up to date learning materials to enhance and extend learning.
Yes
Sometimes
No
Not observed
Assigns appropriate schoolwork and homework.
Yes
Sometimes
Standard #2:
No
Not observed
A TEACHER CAN DESCRIBE HIS/HER PHILOSOPHY AND RATIONALE FOR CURRENT
TEACHING PRACTICE.
Communicates to me in an understandable way the purpose of curriculum and activities in the
classroom.
Yes
Sometimes
No
Not observed
Standard #3:
A TEACHER UNDERSTANDS HOW STUDENTS LEARN AND DEVELOP, AND APPLIES THAT
KNOWLEDGE BY MONITORING AND ASSESSING STUDENT LEARNING.
Sets high expectations and helps my child to reach them.
Yes
Sometimes
No
Provides continued feedback to let my child know how he/she is doing.
Yes
Sometimes
No
Standard #4:
Parent Survey/Teacher
Not observed
Not observed
A TEACHER TEACHES STUDENTS WITH RESPECT FOR THEIR INDIVIDUAL AND
CULTURAL CHARACTERISTICS.
Page J-5
Varies activities to meet the needs of all learners.
Yes
Sometimes
No
Not observed
Shows respect and concern for my child and his/her culture.
Yes
Sometimes
No
Not observed
Standard #5:
A TEACHER CREATES AND MAINTAINS A LEARNING ENVIRONMENT WHICH PROVIDES
MULTIPLE OPPORTUNITIES FOR STUDENTS TO BE ACTIVELY ENGAGED AND
CONTRIBUTING MEMBERS.
Classroom is conducive to learning.
Yes
Sometimes
No
Not observed
Provides multiple opportunities for students to be successful.
Yes
Sometimes
No
Not observed
Disciplines students in a fair and positive manner.
Yes
Sometimes
Not observed
Standard #6:
No
A TEACHER WORKS AS A PARTNER WITH PARENTS, FAMILIES AND COMMUNITY.
Works cooperatively with me to promote student learning.
Yes
Sometimes
No
Not observed
Communicates with me on a regular basis and in an understandable manner concerning my child.
Yes
Sometimes
No
Not observed
Makes me feel comfortable in contacting her/him.
Yes
Sometimes
No
Not observed
COMMENTS:
_____________________________ ________
Parent Signature*
Date
_____________________________ ________
Teacher Signature
Date
(Signature indicates receipt)
_____________________________ ________
Principal/Director Signature
Date
*You have the option to sign this form. Signed forms will be considered as input into this employee’s evaluation if received by
February 1. Unsigned forms will be for feedback purposes only and go directly to the employee. The principal shall maintain
signed forms for a minimum of two years, and they will not become a part of the official personnel file. After two years, the form(s)
may be removed from the building file at the teacher’s request.
Parent Survey/Teacher
Page J-6
It is the responsibility of the principal/director to meet with the teacher to discuss the comments and provide the teacher with an
opportunity to respond.
TEACHER COMMENTS: (Attach additional page if necessary)
Parent Survey/Teacher
Page J-7