Keterangan :
Simpulan Pengamat
Lingkarilah jawaban berikut sesuai dengan kesimpulan bapak/ibu pengamat.
Keterlaksanaan Pembelajaran Tersebut:
1. = Tidak Baik
2. = Kurang Baik
3. = Baik
4. = Sangat Baik
Saran :
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Surabaya, ...................................
Pengamat,
(...................................................)
NIP.