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Field Monitor Classroom Observation Form

Please complete a classroom observation form for each class visit conducted by the legislator you are accompanying.

  1. Your name:
  2. Legislator’s name:
  3. Teacher’s name:
  4. School visited:
  5. Date of visit:
  6. Number of students present in class at time of legislator’s visit:
  7. Others present:
  8. Grade level of majority of students in class visited by legislator:
  1. Time legislator spent:
  2. Lecturing: minutes
  3. Eliciting and answering students’ questions: minutes
  4. Asking questions and listening to students’ answers: minutes
  5. Leading a discussion among students:minutes
  6. Other (please describe below):minutes
  1. Duration of visit: minutes

Lessons

  1. To what extent did the legislator attempt to teach the following lessons:
  2. Legislation simulation – conducted a simulated committee hearing:

Not at allSomeA lot

  1. Solved a class problem – class debated and negotiated an agreement to resolve a problem:

Not at allSomeA lot

  1. A day in the life of a legislator – shared a page from their calendar:

Not at allSomeA lot

  1. The perfect chocolate chip cookie – class debated and arrived at a compromise:

Not at allSomeA lot

  1. Other (please describe on additional sheet of paper):

Not at allSomeA lot

Use of Materials

  1. Did the teacher show the Your Ideas Count video to the class?* Yes No
  2. Did the legislator show the Your Ideas Count video to the class? Yes No
  3. Did the teacher distribute the Your Ideas Count booklet to the class?*Yes No
  4. Did the legislator distribute the Your Ideas Count booklet to the class?Yes No

* Please obtain this information from the teacher.

  1. How would you rate students’ level of attention during the legislator’s visit?

Very attentive
(Virtually all students appeared to be paying attention throughout the visit)

Attentive
(A large majority of students appeared to be paying attention throughout the visit)

Somewhat inattentive
(Some students were inattentive, e.g., talking, reading, playing at various times)

Very inattentive
(Many students were inattentive throughout the visit)

  1. How would you rate students’ participation during the legislator’s visit?

High level of participation
(Many students, 50 percent or more, participated in discussions or asked questions)

Moderate level of participation
(Some students, 25 to 49 percent, participated in discussions or asked questions)

Low level of participation
(Few or no students, fewer than 25 percent, participated in discussions or asked questions)

Please use additional paper, as needed, to provide information on the following:

  1. Legislator’s main points:
  1. Students’ questions: