CLASSROOM AND STUDENT
CHARACTERISTICS
Teacher Candidate –
Date –
Mentor Teacher –
School –
University Coordinator –
Subject / Grade Level –
Lesson Title/Unit Title –
Number of Minutes Per Lesson –
Total Number of Students
Females
Males
Age Range Number of students
who have limited
English proficiency (LEP)
What modifications are made for LEP students?
1. Classroom rules and routines that affect the lesson.
2. Describe the range of abilities in the classroom.
3. Describe the range of socio-economic backgrounds of the students.
4. Describe the racial/ethnic composition of the classroom and how you make your teaching and
learning culturally responsive.
Accommodations for Learning Differences
How many special education and gifted/talented students in your classroom?
Special Education Category
Number of
Students
Accommodations/
IEP Objectives
How many 504 Students?
Accommodations made for 504 Students
Additional considerations about the students for whom you need to adapt teaching? (e.g. religious beliefs,
family situations, sexual orientation?)