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The University of Tennessee at Chattanooga

FINAL MENTOR EVALUATION FORM
Directions
Candidates: Accreditation requirements demand that you show proficiency in EACH of the ELCC standards
below. Please list, after each standard, the field experience in which you engaged that allowed you to demonstrate
competency in that standard. You may list more than one activity for any one standard but are not required to do so;
if one demonstrated your competency, that is all you need. You may use the same activity for more than one standard
element.
Then save the form (save as NAME MentorEvalFinalYEAR and
forward this form, with you additions, to your mentor
Mentors: Please respond to the indicators shaded in gray below. Additional indicators and comments may be added.
Scores of 3 and 4 would be expected.
NO =
1=
2=
3=
4=
5=

Not Observed
Less than aspiring / not proficient
Aspiring (a candidate new to a principal licensure graduate program would be expected to perform at this
level) / not proficient
Between aspiring and beginning (this would be the minimal expectation for a beginning assistant principal)
/ minimally proficient
Beginning (a beginning assistant principal would be expected to perform at this level) / proficient
Above beginning / above proficient
The TN Administrator evaluation rubric should be used as a guide to this scoring and can be aligned with the
field experience categories A-G below.

Candidates NAME: Nikki Russell

ELCC1: Candidateshave the knowledge and ability to promote the success of all students by
facilitating the development, articulation, implementation, and stewardship of a school or district vision of
learning supported by the school community.
Field Experience Category (TILS) A: An effective instructional leader implements a systematic, coherent
approach to bring about the continuous growth in the academic achievement of all students.
NO 1
2
3
4
5
1.1 Develop a school vision for learning:
x
CANDIDATE: Worked closely with other coworkers on the
SIP.
MENTOR please evaluate in the boxes to the right
1.2 Articulate a school vision for learning
x
CANDIDATE: Worked closely with other coworkers on the
SIP. School vision was briefly reviewed at the beginning of the
plan.
MENTOR: Please evaluate in the boxes to the right
1.3 Implement a school vision for learning
x
CANDIDATE: Worked with other coworkers on the SIP. Chair
of Family and Community Involvement Committee.
MENTOR: Please evaluate in the boxes to the right
1.4 Steward a school vision for learning
x
CANDIDATE: Worked with other coworkers on the SIP. Chair

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of Family and Community Involvement Committee.

MENTOR: Please evaluate in the boxes to the right
1.5 Promote community involvement in school vision for learning
x
CANDIDATE: Chair of committee, planned school wide event,
held fund raisers, Math Night, Science Night, Reading Night.
MENTOR: Please evaluate in the boxes to the right
Additional:
Comments:
ELCC 2: Candidateshave the knowledge and ability to promote the success of all students by promoting
a positive school culture, providing an effective instructional program, applying best practice to student
learning, and designing comprehensive professional growth plans for staff. The intern demonstrates
understanding of pedagogy and implementation of instructional program.
Field Experience Category B: An effective instructional leader creates a school culture and climate based
on high expectations conducive to the success of all students.
Field Experience Category C: An effective instructional leader facilitates instructional practices that are
based on assessment data and continually improve student learning.
Field Experience Category D: An effective instructional leader improves student learning by developing
and sustaining high quality professional development.
NO 1
2.1 Promote a positive school culture
CANDIDATE: Chair of Family and Community Involvement
All School-Committee, Faculty Rep for PTA .
MENTOR: Please evaluate in the boxes to the right
2.2 Provide an effective instructional program
CANDIDATE: Chair of Family and Community Involvement
All School-Committee, Faculty Rep for PTA .
MENTOR: Please evaluate in the boxes to the right
2.3 Apply best practices to student learning
CANDIDATE: Chair of Family and Community Involvement
All School-Committee, Faculty Rep for PTA .
MENTOR: Please evaluate in the boxes to the right
2.4 Design comprehensive professional growth plans
CANDIDATE: Chair of Family and Community Involvement
All School-Committee, Faculty Rep for PTA .
MENTOR: Please evaluate in the boxes to the right
Additional:
Comments:

5
x

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ELCC 3: Candidateshave the knowledge and ability to promote the success of all students by managing
the organization, operations, and resources in a way that
promotes a safe, efficient, and effective learning environment.
Field Experience Category B: An effective instructional leader creates a school culture and climate based
on high expectations conducive to the success of all students. and
Field Experience Category E: An effective instructional leader facilitates learning and teaching through
the effective use of resources
NO 1
2
3
4
5
3.1 Manage the organization
x
CANDIDATE: Chair of Family and Community Involvement
All School-Committee, Faculty Rep for PTA, observe a
teacher, etc.
MENTOR: Please evaluate in the boxes to the right
3.2 Manage the operations
x
CANDIDATE: Chair of Family and Community Involvement
All School-Committee, Faculty Rep for PTA, observe a
teacher, Math Night, Science Night, Reading Night, etc.
MENTOR: Please evaluate in the boxes to the right
3.3 Manages resources
CANDIDATE: Chair of Family and Community Involvement
All School-Committee, Faculty Rep for PTA, observe a
teacher, Math Night, Science Night, Reading Night, etc.
MENTOR: Please evaluate in the boxes to the right

Additional:
Comments:
ELCC 4: Candidateshave the knowledge and ability to promote the success of all students by
collaborating with families and other community members, responding to diverse community interests and
needs, and mobilizing community resources
Field Experience Category A: An effective instructional leader implements a systematic, coherent
approach to bring about the continuous growth in the academic achievement of all students.
Field Experience Category E: An effective instructional leader facilitates learning and teaching through
the effective use of resources
Field Experience Category G: An effective instructional leader responds to and influences the larger
personal, political, social, economic legal and cultural context in the classroom, school and local
community while addressing diverse student needs to ensure the success of all students.
NO 1
2
3
4
5
4.1 Collaborate with families and other community members
x
CANDIDATE: Chair of Family and Community Involvement
All School-Committee, Faculty Rep for PTA, observe a
teacher, Math Night, Science Night, Reading Night, Fall
Festival, Spring Carnival, student incentive program, etc.
MENTOR: Please evaluate in the boxes to the right

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4.2 Respond to community interests and needs

CANDIDATE: Chair of Family and Community Involvement
All School-Committee, Faculty Rep for PTA, observe a
teacher, Math Night, Science Night, Reading Night, Fall
Festival, Spring Carnival, student incentive program, etc.
MENTOR: Please evaluate in the boxes to the right
4.3 Mobilize community resources
CANDIDATE: Chair of Family and Community Involvement
All School-Committee, Faculty Rep for PTA, observe a
teacher, Math Night, Science Night, Reading Night, Fall
Festival, Spring Carnival, student incentive program, etc.

MENTOR: Please evaluate in the boxes to the right

Additional:
Comments:
ELCC 5: Candidateshave the knowledge and ability to promote the success of all students by acting
with integrity, fairly, and in an ethical manner.
Field Experience Category F: An effective instructional leader facilitates continuous improvement in
student achievement through processes that meet the highest ethical standards and promote advocacy,
including political advocacy where appropriate.
NO 1
2
3
4
5.1 Acts with integrity
CANDIDATE: Prepare and conduct parent/student support
sessions, Chair of Family and Community Involvement All
School-Committee, Faculty Rep for PTA, Math Night, Science
Night, Reading Night, Fall Festival, Spring Carnival, student
incentive program, etc.
MENTOR: Please evaluate in the boxes to the right
5.2 Acts fairly
CANDIDATE: Prepare and conduct parent/student support
sessions, Chair of Family and Community Involvement All
School-Committee, Faculty Rep for PTA, Math Night, Science
Night, Reading Night, Fall Festival, Spring Carnival, student
incentive program, etc.
MENTOR: Please evaluate in the boxes to the right
5.3 Acts ethically
CANDIDATE: Prepare and conduct parent/student support
sessions, Chair of Family and Community Involvement All
School-Committee, Faculty Rep for PTA, Math Night, Science
Night, Reading Night, Fall Festival, Spring Carnival, student
incentive program, etc.
MENTOR: Please evaluate in the boxes to the right
Additional:
Comments:
ELCC 6: Candidateshave the knowledge and ability to promote the success of all students by
understanding, responding to, and influencing the larger political, social, economic, legal, and cultural
context.

5
x

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Field Experience Category F: An effective instructional leader facilitates continuous improvement in

student achievement through processes that meet the highest ethical standards and promote advocacy,
including political advocacy where appropriate.
Field Experience Category G: an effective instructional leader responds to and influences the larger
personal, political, social, economic legal and cultural context in the classroom, school and local
community while addressing diverse student needs to ensure the success of all students.
NO 1
2
3
4
5
6.1 Understands the larger educational context
x
CANDIDATE: student incentive committee member, Family
and Community Involvement Committee Chair, etc.
MENTOR: Please evaluate in the boxes to the right
6.2 Responds to the larger educational context
x
CANDIDATE: student incentive committee member, Family
and Community Involvement Committee Chair, etc.
MENTOR: Please evaluate in the boxes to the right
6.3 Influences the larger educational context
x
CANDIDATE: student incentive committee member, Family
and Community Involvement Committee Chair, etc.
MENTOR: Please evaluate in the boxes to the right
Additional:
Comments:
1Other:
School Leadership Professional Fitness Standards: Mentors:
please comment on each standard (not the individual bullets,
unless you want to!)
Standard 1: Personal and Academic Integrity: A student in the
School Leadership is expected to:
Provide complete and accurate information in the
application process.
Refrain from acts involving dishonesty, cheating, fraud,
deceit or misrepresentation.
Refrain from any act of plagiarism, which includes any
misrepresentation of academic ownership, including (but not
limited to) falsifying citations, presenting anothers work as
ones own, or using data without permission.
Represent all data accurately and without
misrepresentation.
Standard 2: Professionalism: A student in the School Leadership
program is expected to:
Uphold the legal standards of his/her profession.
Demonstrate appropriate self-control (such as anger
control, impulse control, response to feedback) in interpersonal
relationships with faculty, peers, and other associates.
Respect the fundamental rights, dignity, and worth of all
Standard 3: Confidentiality: A student in the School Leadership
program is expected to:
Respect the rights of other students with respect to privacy

NO 1

5
x

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and confidentiality.
Maintain confidentiality regarding class discussion topics.
Maintain the anonymity of subjects.
Follow all stipulations of the IRB regarding research
Mentor Signature/Title/School: Greg Wilkey/Assistant Principal/East Side Elementary School
Date: April 8, 2015
THANK YOU!
Additional Comments (optional). These may be in reference to the candidate or the program in general.
(use back of page or type here.)
PLEASE discuss this form with the candidate and have the candidate return it to his/her professor.
If you do not wish to return it with the candidate, please put in a sealed envelope and give to the
candidate,
or email it to barry-kamrath@utc.edu or Fax him at 423-425-5443