M.S.A.D. 49 Teacher Certification (SSSC)
Teacher Action Plan (TAP)
Name: ___________________________________ Date of Certificate Exp:___________________
Building:__________________________________ Grade Level/Subject:_____________________
Support Team Mentor Request:________________ SS#:_________________________________
Please Check: Type of Certificate:______________________
one year plan___________
| Teacher Action Plan | Teacher Action Plan Completed Work |
|
Signature:_______________________ Date__________ Mentor's Signature:_______________________________ SSSC Approval of Plan___________________________ Denial of Plan:_____________________________ Reason for Denial:__________________________ ________________________________________ ________________________________________ |
Signature:_______________________ Date__________ Mentor's Signature:_______________________________ SSSC Approval of Plan___________________________ Denial of Plan:_____________________________ Reason for Denial:__________________________ ________________________________________ ________________________________________ |
This application must be typed.
Professional development portfolio and classroom observations by STM must be included for final approval.
revised 8/00