Teacher S Signature:Date

Name: / School Year:
Grade Level: / Assignment:
Name of Evaluator: / Building:
Date of Goal Setting Conference:
Professional Growth Goal 1:Performance Standard
1. Performance Growth Goal:(Indicate Performance Standard(s) addressed in this goal.)
Performance Standard #1: Preparation for Instruction
Performance Standard #2: Use of Data to Inform Instruction
Performance Standard #3: Delivers Quality Instruction
Performance Standard #4: Interventions to Meet Diverse Needs
Performance Standard #5: Classroom Environment
Performance Standard #6: Leadership
Performance Standard #7: Professionalism
2. State the goal. (Use SMART format – Specific, Measurable, Attainable, Relevant, Time Bound.)
3. Describe data sources consulted and a summary analysis of the data that indicate the
needfor the goal.
4. Plan of action. (Outline what you will do, including the timeline(s).)
5. Evaluation of the goal. (How will success be measured?)

Teacher’s Signature:Date:

Evaluator’s Signature:Date:

Name: / School Year:
Grade Level: / Assignment:
Name of Evaluator: / Building:
Date of Goal Setting Conference:
Professional Growth Goal 2: Student Achievement
CRS 22-9-106(1)(V)(e) “One of the standards for measuring teacher performance shall be directly related to classroom instruction and shall include multiple measures of student performance.”
1. State the goal. (Use SMART format – Specific, Measurable, Attainable, Relevant, Time Bound.)
2. Describe data sources consulted and a summary analysis of the data that indicate the
need for the goal.
3. Plan of action. (Outline what you will do, including the timeline(s).)
4. Evaluation of the goal. (How will success be measured?)

Teacher’s Signature:Date:

Evaluator’s Signature:Date:

Name: / School Year:
Grade Level: / Assignment:
Name of Evaluator: / Building:
Date of Goal Setting Conference:
Professional Growth Goal 3: Student Achievement
(Required for non-E&R teachers or optional for E&R teachers)
CRS 22-9-106(1)(V)(e) “One of the standards for measuring teacher performance shall be directly related to classroom instruction and shall include multiple measures of student performance.”
1. State the goal. (Use SMART format – Specific, Measurable, Attainable, Relevant, Time Bound.)
2. Describe data sources consulted and a summary analysis of the data that indicate the
need for the goal.
3. Plan of action. (Outline what you will do, including the timeline(s).)
4. Evaluation of the goal. (How will success be measured?)

Teacher’s Signature:Date:

Evaluator’s Signature:Date:

Name: / School Year:
Grade Level: / Assignment:
Name of Evaluator: / Building:
Date of Goal Setting Conference:
Professional Growth Goal 4: Student Achievement
(Required for non-E&R teachers)
CRS 22-9-106(1)(V)(e) “One of the standards for measuring teacher performance shall be directly related to classroom instruction and shall include multiple measures of student performance.”
1. State the goal. (Use SMART format – Specific, Measurable, Attainable, Relevant, Time Bound.)
2. Describe data sources consulted and a summary analysis of the data that indicate the
need for the goal.
3. Plan of action. (Outline what you will do, including the timeline(s).)
4. Evaluation of the goal. (How will success be measured?)

Teacher’s Signature:Date:

Evaluator’s Signature:Date: