Name:
Appraiser:
Campus:
Appraisal Year:
Date Submitted:
Assignment/Grade:
PROFESSIONAL DEVELOPMENT AND SUPPORT
TEACHER SELF-REPORT FORM
Contributions to the Improvement of Academic Performance of All Students on Campus
The following are general rules for use of the Teacher Self-Report (TSR):
1) Based upon the nature of the teaching assignment, TEKS/State Assessment objectives may vary in content and
level of difficultly.
2) Context for the objectives include (1) teaching field, (2) assignment and/or (3) varying characteristics of the
teacher’s students.
3) Depending upon the classroom context, objectives may be identified for:
a. A subset of the TEKS/State Assessment objectives.
b. A subset of classes assigned to the teacher.
c. A subset of the teacher’s students.
4) The TSR requires the least amount of writing necessary to communicate the point or make the example (limited
to one-half page per item).
Section I*
The data requested in Section I must be presented to the principal within the first three weeks after the
orientation. The teacher may elect to revise this section prior to the annual summative conference.
1. Which academic skills (TEKS/State Assessment objectives) do you directly teach or reinforce in your classes?
READING
Reporting
Category
Grades/Subjects
where TEKS/State
Assessment
objectives are tested
1
3
1
4,5,6,7,8
2
3,4,5,6,7,8
3
3,4,5,6,7,8
TEKS/State Assessment
Check
all that
apply
The student will demonstrate an ability to understand a variety of written texts across
reading genres.
The student will demonstrate an ability to understand and analyze a variety of written
texts across reading genres.
The student will demonstrate an ability to understand and analyze literary texts.
The student will demonstrate an ability to understand and analyze a variety of written
texts across reading genres.
WRITING
Reporting
Category
Grades/Subjects
where TEKS/State
Assessment
objectives are tested
1
4
1
7
2
3
4,7
4,7
TEKS/State Assessment
The student will demonstrate an ability to compose a variety of written texts with a
clear, central idea; coherent organization; sufficient development; and effective use of
language and conventions.
The student will demonstrate an ability to compose a variety of written texts with a
clear, controlling idea; coherent organization; sufficient development; and effective
use of language and conventions.
The student will demonstrate an ability to revise a variety of texts
The student will demonstrate an ability to edit a variety of texts.
Check
all that
apply
ELA
Reporting
Category
Grades/Subjects
where TEKS/State
Assessment
objectives are tested
1
Eng I, Eng II, Eng III
2
Eng I, Eng II, Eng III
3
Eng I, Eng II, Eng III
4
Eng I
4
Eng II, Eng III
5
6
Eng I, Eng II, Eng III
Eng I, Eng II, Eng III
TEKS/State Assessment
Check
all that
apply
The student will demonstrate an ability to understand and analyze a variety of written
texts across reading genres.
The student will demonstrate an ability to understand and analyze literary texts.
The student will demonstrate an ability to understand and analyze a variety of written
texts across reading genres.
The student will demonstrate an ability to compose a variety of written texts with a
clear, controlling idea; coherent organization; sufficient development; and effective
use of language and conventions.
The student will demonstrate an ability to compose a variety of written texts with a
clear, controlling thesis; coherent organization; sufficient development; and effective
use of language and conventions.
The student will demonstrate an ability to revise a variety of texts
The student will demonstrate an ability to edit a variety of texts.
MATHEMATICS
Reporting
Category
Grades/Subjects
where TEKS/State
Assessment
objectives are tested
1
3,4,5,6,7,8
2
3,4,5,6,7,8
3
3,4,5,6,7,8
4
3,4,5,6,7,8
5
3,4,5,6,7,8
1
Alg I
2
Alg I
3
4
Alg I
Alg I
5
Alg I
1
Geometry
2
Geometry
3
Geometry
4
Geometry
5
Geometry
1
Alg II
2
Alg II
3
Alg II
TEKS/State Assessment
The student will demonstrate an understanding of numbers, operations, and
quantitative reasoning.
The student will demonstrate an understanding of patterns, relationships, and
algebraic reasoning.
The student will demonstrate an understanding of geometry and spatial reasoning.
The student will demonstrate an understanding of the concepts and uses of
measurement.
The student will demonstrate an understanding of probability and statistics.
The student will describe functional relationships in a variety of ways.
The student will demonstrate an understanding of the properties and attributes of
functions.
The student will demonstrate an understanding of linear functions.
The student will formulate and use linear equations and inequalities.
The student will demonstrate an understanding of quadratic and other nonlinear
functions.
The student will demonstrate an understanding of geometric structure.
The student will demonstrate an understanding of geometric patterns and
representations.
The student will demonstrate an understanding of dimensionality and the geometry of
location.
The student will demonstrate an understanding of congruence and the geometry of
size.
The student will demonstrate an understanding of similarity and the geometry of
shape.
The student will demonstrate an understanding of the foundational properties and
attributes of functions.
The student will demonstrate an understanding of the use of representational tools to
solve problems.
The student will demonstrate an understanding of the properties of quadratic
Check
all that
apply
4
Alg II
5
Alg II
6
Alg II
7
Alg II
functions.
The student will demonstrate an understanding of the connections between algebraic
and geometric representations of quadratic functions and relations.
The student will demonstrate an understanding of the properties of square root
functions.
The student will demonstrate an understanding of the properties of rational functions.
The student will demonstrate an understanding of the properties of exponential and
logarithmic functions.
SCIENCE
Reporting
Category
Grades/Subjects
where TEKS/State
Assessment
objectives are tested
1
5, 8
2
5, 8
3
5, 8
4
5, 8
1
Biology
2
Biology
3
Biology
4
Biology
5
Biology
1
Chemistry
2
Chemistry
3
Chemistry
4
Chemistry
5
Chemistry
1
Physics
2
Physics
3
4
Physics
Physics
TEKS/State Assessment
The student will demonstrate an understanding of the properties of matter and energy
and their interactions.
The student will demonstrate an understanding of force, motion and energy and their
relationships.
The student will demonstrate an understanding of components, cycles, patterns and
natural events of Earth and space systems.
The student will demonstrate an understanding of the structures and functions of
living organisms and their interdependence on each other and on their environment.
The student will demonstrate an understanding of biomolecules as building blocks of
cells, and that cells are the basic unit of structure and function of living things.
The student will demonstrate an understanding of the mechanisms of genetics.
The student will demonstrate an understanding of the theory of biological evolution
and the hierarchical classification of organisms.
The student will demonstrate an understanding of metabolic processes, energy
conversions, and interactions and functions of systems in organisms.
The student will demonstrate an understanding of the interdependence and
interactions that occur within an environmental system and their significance.
The student will demonstrate an understanding of the properties of matter and the
periodic table.
The student will demonstrate an understanding of atomic theory and nuclear
chemistry.
The student will demonstrate an understanding of how atoms form bonds and can
qualify the changes that occur during chemical reactions.
The student will demonstrate an understanding of the conditions that influence the
behavior of gases and the energy changes that occur in chemical reactions.
The student will demonstrate an understanding of solutions and can apply the factors
that influence the behavior of solutions.
The student will demonstrate an understanding of the relationship of force and
motion in one and two dimensions.
The student will demonstrate an understanding of gravitational, electrical, magnetic,
and nuclear forces.
The student will demonstrate an understanding of momentum and energy.
The student will demonstrate an understanding of waves and quantum phenomena.
Check
all that
apply
SOCIAL STUDIES
Reporting
Category
Grades/Subjects
where TEKS/State
Assessment
objectives are tested
1
8
2
8
3
8
4
8
1
World Geography
2
World Geography
3
World Geography
4
World Geography
1
World History
2
World History
3
World History
4
World History
5
World History
1
2
US History
US History
3
US History
4
US History
TEKS/State Assessment
Check
all that
apply
The student will demonstrate an understanding of issues and events in U.S. history.
The student will demonstrate an understanding of geographic and cultural influences
on historical issues and events.
The student will demonstrate an understanding of the role of government and the
civic process on historical issues and events.
The student will demonstrate an understanding of economic and technological
influences on historical issues and events.
The student will demonstrate an understanding of the ways geography influences
history, political systems, political activity and civic processes.
The student will demonstrate an understanding of Earth’s physical and human
patterns, characteristics and processes that affect people, places and environments.
The student will demonstrate an understanding of the patterns, characteristics and
processes of cultures.
The student will demonstrate an understanding of how resources, economic activities,
economic systems, and issues are related to economic and technological development.
The student will demonstrate an understanding of issues and events in world history
from 8000 BC to AD 1750.
The student will demonstrate an understanding of issues and events in world history
from 1750 to the present.
The student will demonstrate an understanding of geographic and cultural influences
on world history.
The student will demonstrate an understanding of civics and the historical
development of government.
The student will demonstrate an understanding of economic and technological
influences on world history.
The student will demonstrate an understanding of issues and events in U.S. history.
The student will demonstrate an understanding of geographic and cultural influences
on U.S. history.
The student will demonstrate an understanding of the role of government and the
civic process in U.S. history.
The student will demonstrate an understanding of economic and technological
influences on U.S. history.
OTHER OBJECTIVES
With the approval of the principal, certain high school teachers may substitute other standardized measures and related
objectives which are addressed in the AEIS system. This may include SAT/ACT, AP, TASP, and end-of-course
examinations. Specify below.
2. What processes do you use to assess the needs of your students with regard to academic skills (TEKS/State
Assessment objectives)?
Description
Disaggregated TEKS/State Assessment data
Curriculum-correlated assessment materials
Teacher-designed assessment process/materials
Diagnostic observations
Other standardized test results
Cumulative classroom performance data
Other (describe)
Check
all that
apply
PROFESSIONAL DEVELOPMENT AND SUPPORT
TEACHER SELF-REPORT FORM
Contributions to the Improvement of Academic Performance of All Students on Campus
Section II*
The data requested in Section II and III must be provided to the principal at least two weeks before the annual
summative conference. Limit all responses to one-half page per response.
3. Describe a specific instructional adjustment (e.g., materials, sequencing, etc.) which you have made based on
the needs assessment of your students.
4. Describe the approaches you have used to monitor classroom performance and to provide feedback to students
regarding their progress in academic skills (TEKS/State Assessment objectives).
5. Describe how you assisted your students who were experiencing serious attendance problems.
6. Describe your approach in working with students who were failing or in danger of failing.
Section III*
7. List or describe, in the space provided below, your professional development activities for the past year related
to campus/district goals, assigned subject/content, needs of students, or prior appraisal performance in the
following areas: in-service, team planning, mentoring, collaboration with colleagues, self-study, video
coursework or distance learning, university-level coursework, professional conferences, and other nontraditional activities.
8. As a result of your professional development activities described above, what have you been able to use in your
classroom that has positively impacted the learning of students?
9. Be prepared to discuss three target areas for continued professional growth. In order to organize your thoughts,
you may wish to make notes below, but it is not required.
* Information primarily related to Domain VI