PA SLO Template - Pennsylvania Department of Education
2430145-111442500Administrator’s Name __________________ School/Position ___________________ Date _________ComponentsAdministrator ResponsesStudent Learning Objective (SLO)State your measurable student academic SLO.FORMTEXT?????FORMTEXT????Data and EvidenceDescribe the data and evidence used to create and measure your SLO.FORMTEXT???????FORMTEXT?????Student PopulationIdentify the student population(s) selected for this SLO.FORMTEXT?????FORMTEXT?????Action Plan and TimeframeDescribe the action plan and timeframe in reference to implementation, analysis of data, and reporting for this SLO.FORMTEXT?????FORMTEXT?????Performance IndicatorsDescribe the expected results for students included in this SLO.FORMTEXT?????FORMTEXT?????Performance Level MeasuresDescribe the performance measures to be used to determine student progress.FORMTEXT?????FORMTEXT?????Principal ExpectationsDescribe what criteria will be used to determine the levels of Distinguished, Proficient, Needs Improvement, and Failing.FORMTEXT?????FORMTEXT?????Framework for LeadershipDescribe your leadership role in facilitating the attainment of this SLO by referencing appropriate components within the four Domains of the Framework for Leadership. FORMTEXT?????Administrator ReflectionTo be completed by the administrator being evaluated.FORMTEXT?????ActivitySupervising Administrator’s Comments / SignaturePrincipal/School Leader’s Comments / SignatureInitial ConferenceComments: FORMTEXT?????Signature: _____________________Date: _________Comments: FORMTEXT?????Signature: _____________________Date: _________SLO ApprovedSignature: _____________________Date: _________FORMTEXT?????Signature: _____________________Date: _________FORMTEXT?????Mid-Year Review Comments: FORMTEXT?????Signature: _____________________Date: _________Comments: FORMTEXT?????Signature: _____________________Date: _________End of Year Review Comments: FORMTEXT?????Signature: _____________________Date: _________Comments: FORMTEXT?????Signature: _____________________Date: _________Final Rating & Score (0 – 3)FORMTEXT????? 3 – Distinguished 2 – Proficient 1 – Needs Improvement 0 – Failing Criteria for each level will be agreed upon by both the supervising administrator and the principal/school leader during the initial conference. ................
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