Bloomington Public Schools Reflective Statement

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This form must be filled out during your last year before relicensure if you have taught in a classroom for 15 or more consecutive days in the immediate 5 years preceding renewal. The following licenses are exempt: social worker, counselor, speech and language pathologist, school psychologist, licensed school nurse, and school administrator.

File Folder Number *

First Name *

Last Name *

email address *

My professional accomplishments are: *

The following best practice techniques were used to support student learning - *

You must include examples of your work that supported english language learners.

Examples of work that I did with PLC members (collegial/collaborative work) - *

You must include an example of how your work supported english language learners.

One of the best activities I did with students- *

I participated in/attended the following for continued professional growth - *

You must include at least one example of work towards supporting english language learners

My next steps for professional growth are: *

Please type your name to verify these are true statements created by you, the license applicant.

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