LEARNING TASK 13

LEARNI
Accomplishing My Exit and Evaluation

Forms
Performance Task 1
Some Cooperating Schools will require a narrative report manually or in digital

form. This might be different from the learning Portfolio that your College Professor may
require or it may be the same with the few or added components. Make sure that you
compile all the needed forms, documents and other artifacts to ensure that you have the
proper documentation of your Teaching Internship.
The format and components of the Narrative Report may vary. This depends on
the template that your Cooperating school will require.
This is a sample format.

I. Preliminary Pages
 Title Page
 Acknowledgment
 Dedication
 Table of Contents
II. Brief History

 Vision, Mission, Goals of the School
 List of Administrative and Faculty
 School Facilities
III. Narrative Experiences (These may be done by weeks or as required).

 Introduction
 Observation and Activities
 Actual Teaching Activities
 Auxiliary Services and Other School Activities
IV. Evaluation of Experiences

 Insights Gained from all the Phase of Teaching
 Problems Encountered in Teaching Internship
 Suggestions, Reactions and Recommendations
V. References
VI. Appendices
VII. Curriculum Vitae
VIII. Certificate of Completion
Note: Other parts may be added or deleted by your College Supervisor and Cooperating
Teacher
Performance Task 2
Accomplish your exit clearance form and paste it here.
Performance Task 3
Accomplish The Teaching Internship Evaluation form and detach this page and
submit to your College Supervisor.
Teaching Internship Evaluation Form

(For Practice Teacher’s Use)
A. Respondent’s Profile
Instructions: Kindly supply the data asked and mark the appropriate information
on the blank provided for. Your answers will be highly appreciated.
Name ____________________________________________________________
SURNAME GIVEN NAME MAIDEN NAME
Name/ Address of Cooperating School ________________________________

Type of the School: Private Sectarian __ Private Non-Sectarian__ Public ___
Other please specify: ________________
Grade /Level / Taught
Pre-School High School
Elementary Special Education
Others, please specify

Subjects Taught
________ Filipino
________ English
________ Science
________ Math
________ Social Studies
________ All Subjects in Pre-elem
________ Other (pls. specify)
Number of Hours Rendered
________ 100-150 hours
________ 151-200 hours
________ 201-250 hours
________ 251- 300 hours
________ over 301 hours
B. Practicum Experiences
Instructions: The purpose of this evaluation is to gain given feedback regarding
the quality of your teaching internship. The concerns noted will initiate corrective
action to improve the quality of the learning experiences. Your honest answers to
this questionnaire will be highly appreciated. Please rate the items using the given
scale.
5- Excellent 4- Very Good 3- Good 2-Fair 1- Needs Improvement

5 4 3 2 1
Orientation Activities Excellent Very Good Fair Needs
Good Improveme
nt
1 Orientation of the Practice Teacher by the
practicum supervisor on Practice Teaching
2 Orientation of the Practice Teacher with the
Cooperating Principal
3 Orientation of the Practice Teacher by the
Cooperating Teacher
4 Familiarization of the Practice Teacher in the
School Facilities/ Equipment
5 Orientation on the School Rules and Policies
6 Required Practicum Student Form
7 Practicum Experiences of the Practice
Teachers
8 Consultation time with Cooperating Teachers
9 Assistance in Writing Lesson Plans
10 Providing feedbacks on the practice teacher’s
competencies
11 Meeting with the Cooperating Teachers on
schedule basis
12 Giving instructions on classroom routines
13 Providing assistance in making instructional
materials
14 Giving instructions in checking papers and
other assigned tasks
Rapport with the School Community
15 Rapport with School Administrators
16 Rapport with Cooperating Teachers
17 Rapport with students/pupils
18 Rapport with parents
Practicum Site
19 Accessibility of the Practicum Site /
Cooperating School
20 Safety and security of the Practicum Site /
Cooperating School
Rapport with the School Community
21 Quality of Auxiliary Services Rendered
Activities of the Student
22 Preparation of daily lessons
23 Participation in school activities in the
practicum site
24 Preparation of Instructional Materials
25 Conducting of Demonstration Lessons
26 Assistance in Classroom Routines
27 Structuring of Bulletin Boards
28 Preparation of Seatwork
29 Preparation of Quizzes
30 Preparation of other required activities
31 Others (pls. specify)
Suggestions/ Recommendations
Problems Encountered
WRITING MY REFLECTION
How did I feel after rendering ____ (number of hours) in my cooperating school?
CHECKING FOR MASTERY

Choose the letter of the correct answer.
1. Why do we need to do an exit clearance?

A. For compliance
B. For record purposes
C. For a graceful exit
D. For accountability purposes
2. What is the most important use of narrative report?

A. To keep for future use
B. For systematic assessment
C. To document the stay of practice teachers
D. To account for all the teaching experiences
3. How do you account for your teaching experiences?

A. Collaborate with your peers
B. Consult your College Supervisors
C. Interview your Cooperating Teacher
D. Record all your narrative experiences
4. Why is there a need to evaluate Teaching Internship?

A. To enrich the curriculum
B. To change school operations
C. To improve the delivery of Teaching Internship
D. To promote better relations among the school community
5. What value is instilled by accomplishing exit forms?

A. Accountability
B. Honesty
C. Responsibility
D. Trustworthiness
Thank you, Lord.

Fighting Future Teachers!

LEARNING TASK 13

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LEARNI

Accomplishing My Exit and Evaluation

Some Cooperating Schools will require a narrative report manually or in digital

This is a sample format.

II. Brief History

III. Narrative Experiences (These may be done by weeks or as required).

IV. Evaluation of Experiences

Teaching Internship Evaluation Form

Name/ Address of Cooperating School ________________________________

Pre-School High School

Elementary Special Education

Others, please specify

5- Excellent 4- Very Good 3- Good 2-Fair 1- Needs Improvement

CHECKING FOR MASTERY

1. Why do we need to do an exit clearance?

2. What is the most important use of narrative report?

3. How do you account for your teaching experiences?

4. Why is there a need to evaluate Teaching Internship?

5. What value is instilled by accomplishing exit forms?

Thank you, Lord.

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