5:220-E1 Sub Complaint Form

Professional Personnel

Unsatisfactory Performance Report for Substitute Teachers

To be submitted to the Building Principal.


Substitute’s Name:      ___________________________________

Substitute’s ID            _______________

School:  _____________________      Assignment:  ______________________

Classroom teacher’s name:  ________________________________

Date of substitution:  ___________________

Areas of concern with a brief explanation:

_____ Arrived late and/or left early

_____  Inappropriate dress Improper language

_____  Lack of classroom control

_____  Accurate records not kept

_____  Failed to provide written feedback

_____  Physical aggression against student

_____  Received parental complaint

_____  Did not follow lesson plans or routines

_____  Other

Reported by:           _____Student           _____Staff           _____Both

Principal Signature: _________________________________________


To Be Completed By Assistant Superintendent for Human Resources

_____  I have addressed concerns with Substitute – No further action required

Based on my findings, please do not assign this substitute to:

_____  Classroom/Teacher’s name

_____  Grade level

_____  Building

_____  In any capacity


Assistant Superintendent for HR:  _________________________________

Date:  ________________

Date Amended:   4/22/2015