Teaching & Learning Center
Supervisor Visit Form

Intern Name:

Supervisor Name:

Class / Subject Observed:

Date Of Visit:


Spoke To Administration?

Yes   No

Name And Position:

Administration's Comments:


Spoke To Mentor?

Name Of Mentor:

Mentor's Comments:


Any Other Support Staff?

Name And Position:

Comments:


Areas Of Strength:

Immediate Areas To Address:

Follow-Up Plans: