Katy ISD Observation Procedures and Guidelines
University Student and ACP Application / Request
Process for Approval to Observe in Katy ISD
1. Review the Katy ISD Observation Procedures and Guidelines form.
2. Complete and send the following documentation to Jacque Dritsas via email (JacqueRDritsas@katyisd.org), mail
or fax (281-644-1825) to Jacque’s attention:
a. KISD Observation Procedures and Guidelines form;
b. Observation Hour Request Form;
c. Observation General Information Sheet;
d. Consent to Perform Criminal History Background Check ;
e. Letter or syllabus for course requirements related to classroom observation.
**** All of the above forms/documents must be completed and sent as requested before approval will be granted.
PLEASE NOTE:
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Fall Observations begin after the 2nd week in September and end the last week of November
Fall Observation Applications / Requests will not be considered after the second week of November
Spring Observations begin after the 3rd week in January and end the last week of March
Spring Observation Applications / Requests will not be considered after the second week of March
KISD will not approve more than 10 hours per semester
Observation Guidelines
1. It will typically take a minimum of 10 business days to process your request to complete observation hours.
2. All cell phone use for any purpose during observations is prohibited.
3. Professional dress is required for all observers. Admittance to campus may be denied if attire is deemed
inappropriate by an administrator.
4. Provide the campus with your driver’s license to run through the RAPTOR for a background check.
5. You must bring the Observation Request Form with you to each campus after approved by HR.
6. Remember that all information concerning students is confidential.
7. You can only observe on the campuses provided to you by the Human Resource contact person. You are not to make
requests for other campuses.
8. You may not observe in your child’s classroom.
9. Respect the campus making the decisions of which classrooms and teachers you will be assigned to observe.
10. The campus administrator has the authority to deny or discontinue requests for observation hours.
11. Approved observation time frames are by semester and do not extend into another semester.
12. Be respectful of the campus’ ultimate purpose, educating the students that attend the campus and serving the needs
of those families. Assisting with observations is not a focus to their main goal. Please be courteous to the campus
assisting you.
13. Be mindful that it is in your best interest to observe in multiple districts to provide you with a better spectrum of
experiences.
My signature indicates that I have read the procedures and instructions for Katy ISD observations. I understand and will
comply with these guidelines. I understand that it is not a requirement of Katy ISD to allow me to observe on any campus. I
will provide all the requested documentation and information before I am given any further direction on the process of
observing on the campuses. I will respect the confidentiality of the students, teachers, and campus during my time of
observation.
_________________________________________
Signature
___________________________
Date
Observation Hour Request Form
Name: _________________________________________
Date: _________________________
Certification Area: _______________________________
Phone: ____________________________ Personal Email: ________________________________________
Name of University: ______________________________________________________
Observation Request (limit of 10 hours per semester):
I am required to observe
hours in the classroom.
I am requesting to complete
hours of observations in Katy ISD.
I am requesting to observe the following hours at each of the below grade levels:
Elementary (Prek-5)
Junior High (6-8)
High School (9-12)
DO NOT WRITE BELOW THIS LINE
This section will be completed by a representative from the KISD Human Resources Department.
You are approved to observe at:
Elementary (Prek-5) for
Contact
___________
Junior High (6-8)
Contact
___________
High School (9-12)
Contact
___________
___________________________________________________
Signature of Human Resource Designee
hours.
at
for
.
hours.
at
for
at
.
hours.
.
______________________________________
Date
Observation General Information Sheet
Last Name
First Name
Middle Name
1. Will you abide by the safety rules of the district while observing on
campus?
____ yes ____ no
2. Will you protect the confidentiality of the students, teachers, and campus
while observing in Katy?
____ yes ____ no
3. Have you filed an application with Katy ISD?
____ yes ____ no
4. Have you worked for Katy ISD in any capacity?
What capacity?_________________________________________________
____ yes ____ no
______________________
5. Do you have any relatives working for Katy ISD?
____ yes ____ no
Locations: ________________________________________________________ _____________________
6. Do you have children attending Katy ISD schools?
____ yes ____ no
Locations: __________________________________________________________________________
7. Have you been convicted of a felony or any crime involving *moral turpitude?
____ yes ____ no
8. Have you been convicted of a felony or any crime?
____ yes ____ no
9. Has any court ever deferred proceedings without entering a finding of guilty, and
placed you on probation (including deferred adjudication)?
____ yes ____ no
10. Has any court ever placed you on probation for any offense?
____ yes ____ no
If you answered “yes” to any of questions 7-11, then please explain and include the year of the offense/event.
*Moral turpitude is defined as an act of baseness, vileness or depravity in the private and social duties which a person owes another
member of society or society in general and which are contrary to the accepted rules of right and duty between persons. Crimes involving
moral turpitude include, but are not limited to theft, attempted theft, murder, rape, swindling, and indecency with a minor.
Signature
Date
Katy Independent School District
Consent to Perform Criminal History Background Check
For Katy ISD Student Observers
NOTE: Any misrepresentation or omission of the information requested on this form will have an adverse
impact upon your application.
Last Name
First Name
Middle Name (per birth certificate)
Last Name: (per birth certificate) and any other last names you have used)
Social Security Number
Sex
Race
Male
___ ___ ___ - ___ ___ - ___ ___ ___ ___
Date of Birth (MM/DD/YY)
Female
Current Address
City
State
Zip Code
PLEASE COMPLETE THE INFORMATION REQUESTED BELOW FOR ALL LOCATIONS
OF RESIDENCE SINCE THE DATE OF YOUR 18TH BIRTHDAY. YOU MUST BE SPECIFIC ABOUT DATES.
City/Town
County/Parrish
State
Year From
Year To
(Please use a separate sheet, if necessary, to provide complete information.)
I herby certify that all information provided in this authorization is true, correct, and complete. I understand that if
any information is found to be incorrect or incomplete; it may be grounds for cancellation of my observation request
at the discretion of Katy ISD.
Signature
Date
Please return this form to:
Katy ISD Human Resources / P.O. Box 159 / Katy, TX 77492
(or include as an attachment with other documents)
HUMAN RESOURCES OFFICE USE ONLY
WINOCULAR:
Cert
Admin
Par/Tec
Sub
Other (Aux)
RESULTS:
FI/OS ____________ Archive ____________ Nat’l ____________
You must include
Letter or syllabus
for
course requirements
related to
classroom observation