Field-Based Internship Planning Worksheet

Name: Dain Leytem_________________ Cohort: Purple

Due: November 1st of 1st Semester in Program & as changes are made.
Student uploads plan to SMS upon approval from Faculty Field Supervisor.

ISSL #1 – Visionary Leadership

Standard Visionary Leadership/Experience Area E.C. /Elem/Sec/Sp Ed DESCRIPTION Estimated

(Condensed Criteria) (Indicate Grade Level) Completion Date
Approximate Hours
1a Uses data for Establishment of Achievement E.C. - 4 -Parent Teacher Conference Data Fall/Spring
Goals Elem. - 2 2017-18
Sec.- 8 -AP Task Force
Sp. Ed. - 8

1b Uses best practice in Program Improvement E.C. - 1 -Dan Butler culture survey Fall/Spring
Elem. - 6 -Student Council Mission Statement 2017-18
Sec.- 2 development
Sp. Ed. - 0 -Inclusion Data

1c Articulates/Promotes High Expectations for E.C. - 0 -Student input regarding school Spring 2018
Teaching/Learning Elem. - 0 announcements
Sec.- 1
Sp. Ed. - 0

1d Aligns educational programs w/ District Vision E.C. - 1 -Assist in organizing Freshman Fall 2017
and Goals Elem. - 0 Orientation to facilitate engagement
 Sec.- 10 with clubs/sports
Sp. Ed. - 0 -Summer Reading Program

1e Provides Leadership for Major Initiatives and E.C. - 5 -Organize Homecoming activities and Spring 2018
Change Efforts Elem. - 0 school-wide Blood Drive
Sec.- 0
Sp. Ed. - 0

1f Communicates effectively with various E.C. - 2 -Communicates details and logistics of Spring 2018
stakeholders on progress Elem. - 0 Homecoming, Blood Drive, Project
Sec.- 11 K.I.D.S with stakeholders
Sp. Ed. - 2

ISSL #2 – Instructional Leadership

Standard Instructional Leadership E.C. /Elem/Sec/Sp Ed DESCRIPTION Estimated

2 (Condensed Criteria) (Indicate Grade Level) Completion Date
Approximate Hours
2a Provides leadership for E.C. - 0 Lead Homecoming, Teacher Fall/Spring
Assessing/Developing/Improving Climate Elem. - 2 Appreciation, Ram Fam Week, 2017-18
and Culture Sec.- 7 Covers of Comfort, Blood Drive, and
Sp. Ed. - 4 Prom.

2b Systematically/Fairly E.C. - 0 Worked with Social Studies Fall/Spring

Recognizing/Celebrating Staff/Student Elem. -0 Department to create Student of 2017-18
Accomplishment Sec.- 1 the Month criteria
Sp. Ed. - 4
2c Encourages design of more effective E.C. - 1 -Talented and Gifted Program Fall 2019
learning experiences for students Elem. - 0 Study
Sec.- 14
Sp. Ed. - 7

2d Monitors/Evaluates Effective E.C. - 0 -Created a classroom visit log Fall/Spring

Curriculum/Instruction/Assessment Elem. - 0 2019
Sec.- 6
Sp. Ed. - 7

2e Evaluates Staff and Provides ongoing E.C. - 0 -Mock Evaluations Spring 2019
coaching for improvement Elem. - 2 -Coach new teacher (mentor
Sec.- 0 meetings)
Sp. Ed. - 2

2f Ensures professional development that E.C. - 0 -AP Breakfast Fall 2019

enhances teaching/learning Elem. - 0 -AP Task Force
Sec.- 0
Sp. Ed. - 2

2g Uses research/theory to develop/revise E.C. - 0 -ITPDP Data Fall 2019

professional growth plan Elem. - 4 -Talented and Gifted Book Study
Sec.- 0
Sp. Ed. - 0

2h Promotes collaboration with all E.C. - 0 -Calendar Meeting Spring 2018

stakeholders Elem. - 2 -AP Access Meetings
Sec.- 3 -Observations
Sp. Ed. - 0

2i Accessible and approachable to all E.C. - 0 -Chaperone school events Fall/Spring

stakeholders Elem. - 0 -Extracurricular supervision 2017-2018
Sec.- 5
Sp. Ed. - 0
 2j Visible and engaged in the community E.C. – 0 -Covers of Comfort initiative Fall/Spring
Elem. - 0 -Plan Prom 2017-18
Sec.- 8 -Organize Blood Drive
Sp. Ed. - 1

2k Articulates and reinforces desired school E.C. - 0 -School Climate survey Fall/Spring
culture, showing evidence Elem. - 4 -Ram Fam Week 2017-18
Sec.- 5 -Homecoming
Sp. Ed. - 0

ISSL #3 – Organizational Leadership

Standard Organizational Leadership E.C. /Elem/Sec/Sp Ed DESCRIPTION Estimated
3 (Condensed Criteria) (Indicate Grade Level) Completion Date
Approximate Hours
3a Complies with state and federal mandates E.C. - 0 -IEP/504 Planning Spring 2018
and local board policies Elem. - 0 -Share Table liaison with
Sec.- 2 AmeriCorps
Sp. Ed. - 4

3b Recruitment, selection, induction, and E.C. - 0 -Served on Interview Committees Spring 2018
retention of staff for quality instruction Elem. - 0 for Registrar, School Counselor, SNF
Sec.- 3
Sp. Ed. - 0
3c Addresses current and potential issues in a E.C. - 0 -Weekly STUCO Meeting Fall/Spring
timely manner Elem. - 0 -Task Force Tracker 2017-18
-Coaches Meeting (AD)
 Sec.- 10 -Administration Meeting Dance
Sp. Ed. - 0 Protocol
3d Effectively/efficiently manages fiscal and E.C. - 0 Fall 2018
physical resources Elem. - 0 -Budget Meetings
Sec.- 3
Sp. Ed. - 1

3e Protects instructional time E.C. - 0 -Scheduling Meetings with registrar Spring 2018
Elem. - 0 -Activity Programing
Sec.- 2
Sp. Ed. - 0

3f Uses effective communication w/internal E.C. – 0 -Remind Fall/Spring

and external audiences about school Elem. - 0 -Conferences 2018-18
operations Sec.- 8 -Phone, Email, Website
Sp. Ed. - 0 -Positive referrals home

ISSL #4 – Collaborative Leadership

Standard Collaborative Leadership E.C. /Elem/Sec/Sp Ed DESCRIPTION Estimated
4 (Condensed Criteria) (Indicate Grade Level) Completion Date
Approximate Hours
4a Engages families and community, and E.C. - 0 -Family Activity Night Spring 2018
promotes shared responsibility for student Elem. - 0 -Student Government collaboration
learning and education Sec.- 2 dance safety
Sp. Ed. - 3

4b Promotes/supports structure for E.C. – 0 -PT Conference data Spring/Fall

family/community involvement Elem. - 5 -Plan/organize team service trip 2018
Sec.- 0 -PTA Meetings
Sp. Ed. - 0
 4c Facilitates connections of students/families E.C. - 0 Project K.I.D.S imitative Spring 2018
to health/social services that support a Elem. - 0 -Fulton/Bryant Community Nights
focus on learning Sec.- 5 -Fulton Conferences
Sp. Ed. - 0 -Bryant BLT + Site Council Meetings

4d Collaboratively establishes a culture that E.C. - 0 Covers of Comfort initiative Spring 2018
welcomes and honors families and Elem. - 0 -Project K.I.D.S
community and seeks ways to engage them Sec.- 2 -Family Night
in student learning Sp. Ed. - 0 -Induction Ceremony

ISSL #5 – Ethical Leadership

Standard Ethical Leadership E.C. /Elem/Sec/Sp Ed DESCRIPTION Estimated

5 (Condensed Criteria) (Indicate Grade Level) Completion Date
Approximate Hours
5a Demonstrates ethical and professional E.C. - 0 -Student of the Month Fall/Spring
behavior Elem. - 0 -Observe 2018
Sec.- 6
Sp. Ed. - 0

5b Demonstrates values, beliefs, and E.C. - 1 -Talented and Gifted Advisor Group Spring 2018
attitudes that will inspire others to Elem. - 0 -Special Needs Student (inclusion)
higher levels of performance Sec.- 6 -AP Access Task Force
Sp. Ed. - 0

5c Fosters and maintains caring, E.C. - 0 -Excel Tracker Fall 2017

professional relationships with staff Elem. - 0 Spring 2018
Sec.- 1
Sp. Ed. - 0

5d Demonstrates appreciation for and E.C. - 0 -Inclusion of Special Needs student Spring 2018
sensitivity to diversity in the school Elem. - 0 -Equity and Relationship Discussion
community
 Sec.- 6
Sp. Ed. - 1

5e Demonstrates respect for divergent E.C. - 0 -RSVP program Spring 2018

opinions Elem. - 0 -Ram Fam Discussions
Sec.- 1
Sp. Ed. - 0

ISSL #6 – Political Leadership

Standard Political Leadership E.C. /Elem/Sec/Sp Ed DESCRIPTION Estimated

6 (Condensed Criteria) (Indicate Grade Level) Completion Date
Approximate Hours
6a Collaborates with service E.C. - 0 Communicating with State Fall/Spring
providers/decision-makers to improve Elem. - 0 Representatives (Letter) 2017-18
teaching and learning Sec.- 1
Sp. Ed. - 2

6b Advocates for the welfare of all members E.C. - 0 City Council, School Board and Fall/Spring
of the learning community Elem. - 1 political forums 2018-19
Sec.- 2
Sp. Ed. - 0

6c Designs and implements appropriate E.C. - 0 AP Access Data Collection Fall 2017
strategies to reach desired goals Elem. - 0 Dan Butler Discussions (culture)
Sec.- 4
Sp. Ed. - 0
 Program-Required Internship Experiences

Program-Required Experience Location (school, agency, Description Estimated Completion Date

business, & contact people)

Full-Day Principal Shadowing Dan Butler, Principal (Epworth Discussed importance of data March 2018
Elementary) collection and culture
throughout visit

Non-profit/Social Service Food Bank Resurrection Parish Volunteered time at a local March 2019
Experience parish food bank assisting with
collection and distribution of
food

Business Internship Experience John Deere, Dubuque Shadowed Materials Engineer July 2018
and discussed skills and
expectations employers expect
from graduates