/ Bremen HS District 228
Student Growth Model / 3

Type III Assessment: Student Learning Objective

Educator Information: / Planning Information:
Academic Year: / Course:
Teacher Name: / Grade Level:
School: / Choose an item. / Timeframe:
Timeline and Sign-Off:
Name of Observer:
Observer Sign-Off of initial SLO with date:
Electronic signature indicates this step is complete. / Date: / Click here to enter a date.
Due date of Final SLO: / Click here to enter a date.
Student Population and Growth Target
Identify the number of students in your class by subgroup (complete all three boxes to the right): / Number of General education students:
Click here to enter text. / Special education students:
Click here to enter text. / ELL/LEP students:
Click here to enter text.
Identify the sample size for the SLO process: (check which method will be used in the SLO process) / Whole class
☐ One target for all students
☐ Individual student targets / Whole class: Tiered
☐ Based on pre-assessment data
☐ By subgroup (Gen Ed, SpEd and ELL)
Learning Goal
State the learning goal using the SMART goal format. / (When) During the Click here to enter text. school year, (who) I will (what) Click here to enter text. as measured by Click here to enter text..
What enduring understanding (big idea) is supported by the learning goal? (Refer to UbD or AP Curriculum Framework, if needed) / The “big idea” supported by the learning goal is Click here to enter text.
Learning Standards
Give the standard(s) that is/are directly applicable to the learning goal (enduring understanding). Provide the exact text and not just the standard number.
Assessments and Scoring Procedures
Briefly describe the assessments that will measure student performance and how each assessment will be scored*.
Describe any assessment or scoring procedure that may require accommodations for individuals and/or groups of students, if necessary.
·  IEP and/or 504 accommodations
·  Adjustments made for ELL/LEP students

*Note: Any rubric used in the SLO process needs to be submitted to the observer. Criteria for scoring student work must be consistent through all assessments that will be used to measure growth.

Growth Expectations
Complete a data chart for your sample size (see examples in the resource guide) / Share the data table with your observer (attach your data table/Excel spreadsheet to this SLO upon completion).
What did you use to determine the baseline data and expected growth targets? (To be asked of the teacher by observer) / Electronic initials and date indicate that the teacher and observer have reviewed data determinations.
Teacher: / Observer: / Date: Click here to enter a date.
Midpoint Check-in
Complete the data chart with performance data for each student from the mid-point assessment. / Share the data table with your observer (attach your data table/Excel spreadsheet to this SLO upon completion).
Observer should review and discuss the data with the teacher using the conference questions provided in the guidebook.
Midpoint Check-in Sign-Off:
Electronic initials and date indicate that the teacher and observer have reviewed midpoint data. / Observer Initials: / Date: Click here to enter a date. / Teacher Initials: / Date: Click here to enter a date.
Description of changes made during the Midpoint Check-in: (to be completed by the observer)
Check appropriate box and document rationale for the change(s) / Rationale for changes:
☐ Under or overestimation of the student growth target
☐ Change in teacher assignment
☐ Significant change in student population or individual
☐ Student non-attendance issues
☐ Change in a student’s IEP or 504 plan
Outcomes
Complete the data chart with post-assessment data for each student. / Attach the final data table to the SLO for submission.
Explain how the actual number or percentage of students who achieved student growth targets translates into an appropriate teacher rating (to be completed by the observer). / Approximately Click here to enter text.% of students met their identified growth targets. Therefore, the appropriate teacher rating is Choose an item..
Type III Performance Rating
Unsatisfactory / Needs Improvement / Proficient / Excellent
☐ Less than 40% of students met the growth target(s). / ☐ 40% - 59% of students met the growth target(s). / ☐ 60% - 79% of students met the growth target(s). / ☐ 80% - 100% of students met the growth target(s).
Staff Signature: / Date:
The signature of the teacher indicates that he/she has had a conference with the observer, has read the report, and has knowledge of the contents. It does not indicate that the teacher agrees with this document.
Observer Signature: / Date:
SLO Data Table
Class:
Student Name
Last name, First name / IEP / ELL / Pre-Test Baseline / Growth Target
Choose an item. / Mid-Point Test / Post-Test / Outcome
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Insert more rows as needed.