Formative Semester__ Year___ Summative Semester__ Year___
Candidate Name: ____________________________ School’s Name: __N/A______________________ City or County: ____N/A__________
Grade Level: __________________ Class size or group size: _____Subject/Topic: ___________________________________________
Time (minutes) required for lesson: ______________ Date(s) _____________________
Georgia Performance Standards for this lesson:
Purpose and relevance of the lesson:
Prerequisite skills or knowledge required for mastery of this lesson:
Goals of lesson aligned with Georgia Performance Standards:
Objectives of lesson that support the lesson’s goals:
Materials/Equipment/ Technology Required:
Procedures for Instruction:
Introduction that links new lesson to previous learning/prior knowledge:
Format of the lesson:
Application or independent practice:
REFLECTION: Not applicable for this assessment.
NOTE: Special Education Candidates should add the following information:
Name of classroom teacher of record: ___________________________________
Indicate whether the lesson is for an individual, a small group, a large group, or a complete class.
Indicate the IEP goals that support this lesson. Indicate how these IEP goals are aligned with Georgia Performance Standards.
Adopted: 4/27/2011 jwb