Instructional supervision Form 1
PRE-OBSERVATION INFORMATION
Teacher ________________________________________________ School ____________________________
District ________________________________________________ Division ____________________________
Grade/Year & Section _____________________________________ Subject ____________________________
School Year ________________ Semester __________________ Conference Date _____________________
Instructional Supervisor _______________________________________
Directions:
1. This form shall be answered by the Teacher prior to instructional support Visit.
2. The information will serve as guide for the pre-observation conference. Observer may ask additional job-
relevant data to provide a background for actual observation.
3. The filled up form shall be given back to the teacher to be placed in front of the teacher Observation Form
3A, B, C which will be used by the observer.
Pre- Observation information
1. When would you like to have instructional supervision and support?
Date and Time _________________________________
2. In which of your classes would you to be observed?
Class and the period to be observed: __________________________________________
3. What area or domain would you like to be observed? Please check.
_____ Diversity of Learners
_____ Content and Pedagogy
_____ Learning Environment
_____ School, Home, community Linkages
_____ Personal Growth and Professional Development
_____ Planning, Assessing and Reporting
_____ Others, specify
4. What specific teaching-learning parameters would you like to be focused? Please check.
_____ Motivation
_____ Teacher-Learners Interaction
_____ Questioning of the Lesson
_____ Testing
_____ Classroom management
_____ Time on Task
_____ Addressing multiple intelligence/learning styles
_____ Others, specify
5. What teaching method/strategy will you use?
6. How would you describe the class you will be teaching during the visit? Please provide information by
checking or filling up the required data.
a. Type of class:
( ) Monograde ( ) Class combination ( ) Multigrade
b. Size of class:
( ) Small class size Number of Learners _____________________________
( ) Big Class size Number of Learners _____________________________
c. Class Diversity:
( ) Homogeneous ( Describe ) _______________________________________________
( ) Heterogeneous ( Describe ) _______________________________________________
7. What three priority areas in your TSNA do you need the most support and assistance? Please enumerate
and specify.
a.
b.
c.
Submitted by: Noted by:
________________________________ ROIE M. UBAYUBAY, Ph.D.
Teacher Name & Signature School Head Name and Signature
Note: this space shall be used for needed information given during the pre-observation but are included above.