Goal Setting Form
This form is to be used as a component of the 5 Pillar Exceptional Teaching Evaluation System. The teacher completes this form in the fall of the school year. Log into your google account and provide your e-mail address below to get started. Upon completion of the form, a copy will be sent to you, and you will be able to edit the form after it has been submitted if you need to revise your goals. You will also have the opportunity to reflect on your progress at the end of the goal cycle by returning to the form.
Email address *
Name *
Your answer
What school do you work at? *
SMART Goal #1
You will Complete 2 SMART goals and one Professional Growth goal. Your SMART goal needs to be Specific, Measurable, Achievable, Relevant, and Time-bound.

Specific – What specific area of student learning are you focusing on?
Measurable – How will you know progress is made and your goal is accomplished?
Achievable – Is it a realistic, stretch goal? What will you do to achieve the goal?
Relevant – Does your goal align with the mission of the school/department/grade level/district? How does it impact students?
Time-bound – What is the timeline for accomplishing your goal?

Your Professional Growth goal is based on a Performance Target or Pillar of your choice that you would like to focus on this year based on your Self-Reflection
Target Population (what group of students will this goal address?) *
Your answer
What baseline data will you use to measure the learning of your Target Population? (Baseline data can be a pre-assessment of some kind, data from last spring, or data you plan to collect) *
Your answer
Statement of Student SMART Goal/Targets Including Time Interval: (What are you trying to achieve? How will you measure progress toward the goal? Is this a B-HAG (Big, Hairy, Audacious Goal) stretch goal? *
Your answer
Content and Performance Standards taught, Assessments to be used, Strategies to be implemented to achieve the student learning goal. *
Your answer
Rational for Growth Target (What is your Why?) *
Your answer
Professional Learning/Support Requested: *
Your answer
Did you achieve your goal? Why or why not? What progress was made toward it? (to be completed after the goal cycle or at the end of the year)
Your answer
SMART Goal #2
You will Complete 2 SMART goals and one Professional Growth goal. Your SMART goal needs to be Specific, Measurable, Achievable, Relevant, and Time-bound.

Specific – What specific area of student learning are you focusing on?
Measurable – How will you know progress is made and your goal is accomplished?
Achievable – Is it a realistic, stretch goal? What will you do to achieve the goal?
Relevant – Does your goal align with the mission of the school/department/grade level/district? How does it impact students?
Time-bound – What is the timeline for accomplishing your goal?

Your Professional Growth goal is based on a Performance Target or Pillar of your choice that you would like to focus on this year based on your Self-Reflection
Target Population (what group of students will this goal address?) *
Your answer
What baseline data will you use to measure the learning of your Target Population? (Baseline data can be a pre-assessment of some kind, data from last spring, or data you plan to collect) *
Your answer
Statement of Student SMART Goal/Targets Including Time Interval: (What are you trying to achieve? How will you measure progress toward the goal? Is this a B-HAG (Big, Hairy, Audacious Goal) stretch goal? *
Your answer
Rational for Growth Target (What is your Why?) *
Your answer
Content and Performance Standards taught, Assessments to be used, Strategies to be implemented to achieve the student learning goal. *
Your answer
Professional Learning/Support Requested: *
Your answer
Did you achieve your goal? Why or why not? What progress was made toward it? (to be completed after the goal cycle or at the end of the year)
Your answer
Professional Growth Goal
What Pillar and Performance Target(s) would you like to focus on improving this year, and what kind of support would you like from your supervisor?
Which Pillar would you like to focus on? *
Which Performance Targets would you like feedback and support with?
Professional Learning/Support Requested *
Your answer
Are you interested in having a coach work with you to achieve your goals? *
A copy of your responses will be emailed to the address you provided.
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