1. All professionals must submit a Form INV1.

a. Steps 2 through 7 must be completed within the first six to eight weeks of school, as determined by each school principal.
b. Late hires will complete the process within four instructional weeks from their start date.
2. Complete the top section of the form.
3. Set goals for Domains 1-4: (Domain 1 information will be entered on page 1, Domain 2 on page 2, etc.)
a. Use the components in each of the four domains to reflect on your past planning and preparation, classroom environment,
instruction, and professional responsibilities. Consider past observation results. STAAR data, benchmark data, lesson/unit
plans, assessments/rubrics and any other materials you have in your self reflection.
b. Answer the questions in the first three blocks of each page.
c. A minimum of one goal must be set for each domain.
4. Complete the 'Action Plans' section for Domains 1-4:
a. Based on the goals you have set, determine what steps you will take to accomplish them.
b. Write these steps in the 'Action Plans' block of each page.
c. In the 'Evidence of Completion' field, describe the specific evidence you will use to demonstrate you have completed the
actions.
d. Enter the date the actions will be completed in the 'Completion Date' field.
5. Submit the form with completed Goals to your administrator/appraiser for review.
The administrator/appraiser will review your submission and discuss any modifications or clarifications, if necessary, at your goal
setting and action plan conference.
6. A conference will be scheduled and held by your administrator/appraiser.
Mentors and buddies can participate in the goal setting and action plan conference.
7. Bring the completed Form INV1 to all score card meetings.
8. At the summative conference you and the administrator/appraiser will discuss the completed form.
a. The professional and the administrator/appraiser must sign and date the completed form.
b. The administrator/appraiser will submit the form to be filed in the professionals campus file and save the electronic version.

Page 1 of 1

July, 2014

Name of Staff Member

Name of Appraiser

Brian J. Kennedy

Cheryl Fontenot

Date Reviewed

10/17/2014

Assignment

School Year

Instructional Technology Specialist

2014-2015

Campus

Jones Elementary

DOMAIN 1
PLANNING AND PREPARATION
CURRENT STRENGTHS
AREAS FOR FURTHER GROWTH
What areas of knowledge or specific skills do you currently consider
What areas of knowledge or specific skills would you like to
to be your strengths in this domain?
strengthen in this domain?
* 1d. Demonstrate knowledge of available resources, both within and
* 1c. Establishing goals for the technology program appropriate to the
outside of the district.
setting and staff served.
* I feel that I know the available resources on the campus and how we * I would like to develop a technology plan for our campus that lays
can utilize the technology in the classrooms.
out benchmarks for us to work towards each year so we can continue
* 1b. Demonstrating knowledge of the staff and technology needs of the to grow as a campus. I need to work on the campus technology plan
campus.
and make sure we have clear goals to work towards .
* I have reviewd the campus inventory document as well as discussed
with some of the teachers as to what technology they would like to have
on campus.
GOALS:
Based on your self-assessment of current strengths and areas for further growth, including administrative input, and school or district
initiatives, what goal(s) have you identified in this domain?
My goal this year is to creat a campus technology committee of tech enthusiasts. I would like ot get at least one teacher from each grade level
who is comfortable with helping their fellow grade level members with basic questions. This teacher would be apart of the technology committee
and will bring questions and concerns to me during our tech committee meetings. With the tech committee we will discuss how to best assist the
teachers during their lessons.

EVIDENCE OF COMPLETED
ACTIONS:

ACTION PLANS:

Describe specific actions you will take to achieve

your goals

Form a technology committee.

Once the technology committee is formed, we will meet and discuss
ideas and concerns on a bi weekly basis.

July, 2014

COMPLETION

DATE
Describe specific evidence you will use to
demonstrate you have completed the
I will keep
record of the tech committee sign in sheets Ongoing
actions
as well as the agendas.

Page 1 of 4

throughout the
year. By
January Tech
committee
should be
formed.

Form INV1

GOAL SETTING and ACTION PLAN

ALDINE INDEPENDENT SCHOOL DISTRICT
DOMAIN 2
CLASSROOM ENVIRONMENT
CURRENT STRENGTHS
What areas of knowledge or specific skills do you currently consider
to be your strengths in this domain?
* 2a. Creating an environment of respect and rapport.
I feel that I have created an environemnt of respect and rapport among
teachers as well as students. I believe that I am approachable for the staff
members. I think the students look forward to coming to computer class.
With getting them logged into their google accounts they seem really
excited to work collaboratively in and out of the classroom.

AREAS FOR FURTHER GROWTH

What areas of knowledge or specific skills would you like to
strengthen in this domain?
* 2b. Establishing a culture for learning and integrating technology. I
know tha tI need to get out into the classrooms to assist the teachers
with integrating technology into their classrooms. A few teachers have
already expressed their interest in utilizing technology in their
classrooms.

GOALS:
Based on your self-assessment of current strengths and areas for further growth, including administrative input, and school or district
initiatives, what goal(s) have you identified in this domain?
My goal is to make sure that each teacher in proficient using the technology in their classrooms as well as the technology available for temporary
check out.

EVIDENCE OF COMPLETED
ACTIONS:

ACTION PLANS:

Describe specific actions you will take to achieve

your goals

* Attend grade level PLC's to assist in the planning and integration of

technology in 3rd and 4th grades.
* Plan lessons with the teachers that utilize
the available technology. Teach lessons with the teachers to model the
use of technology.

July, 2014

Describe specific evidence you will use to

demonstrate you have completed the
* PLC Agendas
actions

COMPLETION
DATE

Ongoing
* Lesson samples
throughout the
* Sing in sheets or communicatoin to schedule school year.
model lessons.

Page 2 of 4

Form INV1

GOAL SETTING and ACTION PLAN

ALDINE INDEPENDENT SCHOOL DISTRICT
DOMAIN 3
INSTRUCTION
CURRENT STRENGTHS
AREAS FOR FURTHER GROWTH
What areas of knowledge or specific skills do you currently consider
What areas of knowledge or specific skills would you like to
to be your strengths in this domain?
strengthen in this domain?
* 3e. Demonstrating flexibility and responsiveniss.
* 3b. Implimenting training to integrate technology.
I feel that I have done a good job of prioritizing the issues that have come I need to get into the PLC's and planning time with the teachers so we
up thus far. I always scan my tech help resonses and prioritize them based can start developing lessons and materials to use during their dialy
on what I believe to be the most important. I have created training videos lessons.
to help some teachers that are having issues with certain issues such as
gradebook, mergin email accounts, creating shortcuts, etc. I will also
continue to offer trainings as certain issues arise. Teachers know the
process to request help fromme and the majority of the teachers use it.

GOALS:
Based on your self-assessment of current strengths and areas for further growth, including administrative input, and school or district
initiatives, what goal(s) have you identified in this domain?
My goal is to provide more support to the teachers for their daily lessons to increase thei students knowledge of their content area.

EVIDENCE OF COMPLETED
ACTIONS:

ACTION PLANS:

Describe specific actions you will take to achieve

your goals

Describe specific evidence you will use to

demonstrate you have completed the
Meet with teachers to find out where their students are and how we could Teachers
would use technology to assist with their Rti
actions

use technology to help bring their students to the next level. Also discuss and interventions.
where some of their students are excelling. Discuss ideas and activities
that would assist the teachers to remediate those skills.

July, 2014

Page 3 of 4

COMPLETION
DATE
Ongoing
throughout the
school year.

Form INV1

GOAL SETTING and ACTION PLAN

ALDINE INDEPENDENT SCHOOL DISTRICT

DOMAIN 4
PROFESSIONAL RESPONSIBILITIES
CURRENT STRENGTHS
AREAS FOR FURTHER GROWTH
What areas of knowledge or specific skills do you currently consider
What areas of knowledge or specific skills would you like to
to be your strengths in this domain?
strengthen in this domain?
* 4c. My strength in this domain is my communicating and collaborating
* 4b. I would like to strengthen my knowledge of submitting reports
within the school, as well as showing professionalism on and off campus. and budgets. This being my first year, this will be a completely new
I feel that I have task for me .
communicated with teachers and staff about how they could use
technology to assist them in their instruction.
* 4d. Participating in a professional
community.
TCCA 2014 shadowing Presenter
Chair- TCCA 2015 Presenter Chair * 4e. Engaging in professional
development
I have attended profesional
development and I will be continuing to attend staff developments that
will help me expand my knowledge of how to use technology in the
classrooms.

GOALS:
Based on your self-assessment of current strengths and areas for further growth, including administrative input, and school or district
initiatives, what goal(s) have you identified in this domain?
* My goal is to build an effective technology committee on campus.
* My goal is to get an accurate inventory of all of the technology that is on campus and make sure it is being used to its fullest potential.

ACTION PLANS:

Describe specific actions you will take to achieve

your goals

* I plan to work with my colleagues in order to obtain a better knowledge

of the reports and budgets that are neccessary.
* Update
technology inventory and make sure it is where it will be most effective.
* Meet
with Admin team to discuss how the technology committee should run so
they are on board with my goals.
* Set
guidelines for the technology committee and make sure teachers are on
board with them. Set up meeting dates so teachers know in advance.

EVIDENCE OF COMPLETED
ACTIONS:

COMPLETION

DATE
Describe specific evidence you will use to
have completed the
*At thedemonstrate
end of the you
year
we will have a system that will Ongoing
actions

keep track or what technology we have and where it is thoughtout the

located.
*At the school year.
end of the year, the technology committee has met
several times and found ways to assist teachers with
their technology needs.

of the reports and budgets that are neccessary.

* Update
technology inventory and make sure it is where it will be most effective.
* Meet
with Admin team to discuss how the technology committee should run so
they are on board with my goals.
* Set
guidelines for the technology committee and make sure teachers are on
board with them. Set up meeting dates so teachers know in advance.

keep track or what technology we have and where it is thoughtout the

located.
*At the school year.
end of the year, the technology committee has met
several times and found ways to assist teachers with
their technology needs.

Staff Member Signature | Date

July, 2014

Appraiser Signature | Date

Page 4 of 4

Form INV1