1. Numele şi prenumele
cursantului:____________________________________________________
2. Data: _________________________________________________________
3. Clasa: _________________________________________________________
4. Cadru didactic: _________________________________________________
5. Activităţile asistate:
_________________________________________________________
Lecţia: ____________________________________________________
Disciplina de studiu:
____________________________________________________
Subiectul:
____________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
(exemple: asistenţă, predare, sprijinirea cadrului didactic în procesul didactic, corectarea unor teste /
lucrări, aplicarea unor teste / lucrări, supravegherea clasei, organizarea unor activităţi)
______________________________________________________
______________________________________________________
______________________________________________________
Evaluator .......................................
(semnătura)