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Quarterly Technology S.A.M.R. Survey
Documentation of lessons that integrate technology use with students.
Teacher Name
Your answer
Date
MM
/
DD
/
YYYY
Did you collaborate with Sean for this lesson?
Did you collaborate with/co-teach this lesson with anyone else? If so, who?
Your answer
Choose one that best describes the collaboration
Purpose of Technology
Content Area
Location
Software Used
Your answer
Brief Description of Lesson (Write at least two sentences describing what students were expected to do)
Your answer
What level on the S.A.M.R. model does this lesson fall?
Reflection on how the lesson went: (Think about student reaction, student learning, and what worked well or didn't work well)
Your answer
Would you do this lesson again?
Is there anything you need assistance with to make this lesson more effective in the future?
Your answer
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