Professional Education Faculty Member
Professional Development Plan for Direct Involvement in the Public Schools

Annual Review Self Assessment 
of
Five-Year Plan

FACULTY REVIEW DATES:  ____/___/___    ___/___/___    ___/___/___    ___/___/___


Faculty Member's Name (Please Print)_________________, _____________, _______
                                                                                       Last Name                      First Name             Mi

The primary purpose for the Professional Development Plan Self Assessment is to assist faculty members and department heads in annually reviewing the individual's five-year plan regarding public school involvement as per MO. STATUTE 168.400.3, RSMO. The evaluation tool will allow faculty and heads to identify strengths, weaknesses, and make appropriate change to support effective public school involvement. The secondary purpose for this assessment tool is to provide quantitative data for the Professional Education Unit (PEU). Quantitative evaluations will allow the PEU to characterize the current picture of faculty involvement as a whole unit.

Please use the 5-point Likert scale to report your overall evaluation of how well you are meeting your five-year goals:

 5=outstanding,     4=above average,     3=average,      2=below average,        1=poor

          1. I am participating in all of my identified public school         1   2   3   4   5

2. I am meeting or making progress toward the objectives      1   2   3   4   5
    I identified.

3. My plan is current and relevant to my work with the public  1   2   3   4   5
    schools.

4. I am following my proposed time line to effectively carry      1   2   3  4   5
    out my plan.

5. I have documented results of my involvement in the public   1  2   3   4   5
    schools relative to my five-year plan.

Faculty Member's Name (Please Print)

_____________________, _________________   _________________    ___/___/___
       Last Name                                First Name                             Signature                    Date Signed

Department Head (Please Print)

_____________________, _________________   _________________    ___/___/____
     Last Name                                  First Name                             Signature                    Date Signed

self-assess.doc/ApprovedByPEC:12/12/01