S.L. Lewis Media Collaboration/Use Form
Date of Lesson
MM
/
DD
/
YYYY
Start Time:
Time
:
End Time
Time
:
Teacher
Your answer
Grade
Your answer
# of Students
Your answer
Subject
Your answer
Unit of Study
Your answer
Common Core Standard
Your answer
Brief explanation of the element/skill to be mastered:
Your answer
METI Role: How would you like for me to support the lesson?
Ex. Writing skills, research skills, none-just using space, etc.
Your answer
If not collaborating with the METI, what resources will your class utilize during your use of the media center?
Technology Integration
How will technology be integrated into this lesson?
Your answer
Collaboration Conference
(For Media Staff Only)
Your answer
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