This form will be used for incidental and composite observations

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Form
104-C
Concordia Parish
School Board
Concordia Parish School Board
Personnel Evaluation Program
NOTICE OF CHANGE OF EVALUATOR
EVALUATEE____________________ LOCATION _____________________
POSITION ______________________ DATE _____________________
This form is your official notification that your evaluator has changed effective
____________________________. Beginning with the effective date, your
evaluator is
(Date)
_____________________________
(Name)
________________________________
(Position)
Previously conducted observations or evaluations will continue to be valid and
will remain an official part of the Single Official File.
______________________________
Evaluatee’s Signature
______________________
Date
_______________________________
Evaluator”s Signature
_______________________
Date
*Signatures indicate that the Evaluate and Evaluator have discussed the Notice of Change of Evaluator form and
the Evaluatee has been given a copy of the form.
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