Sijunjung,………………….20…..
Supervisor
……………………………………
NIP :
Format 2:
INSTRUMEN SUPERVISI AKADEMIK UMUM
I. IDENTITAS
1. Nama Sekolah : SMAN 2 Sijunjung
2. Nama Guru :
3. NIP :
4. Mata Pelajaran :
5. Kelas / Semester :
6. Jumlah Siswa :
7. Hari/Tanggal/Jam ke :
8. Kompetensi Dasar : ……………………………………………………………………
…………………………………………………………………..
Rentang Penilaian
1. Tidak baik : 0 - 40
2. Kurang baik : 41 - 60
3. Cukup Baik : 61 - 80
4. Baik : 81 - 90
5. Sangat Baik : 91 - 100
III. PROGRAM EVALUASI
Kesan Umum
1) ..............................................................................................................................
2) ..............................................................................................................................
3) ..............................................................................................................................
4) ..............................................................................................................................
5) ..............................................................................................................................
6) ..............................................................................................................................
7) ..............................................................................................................................
8) ..............................................................................................................................
Saran
1) ..............................................................................................................................
2) ..............................................................................................................................
3) ..............................................................................................................................
4) ..............................................................................................................................
5) ..............................................................................................................................
6) .............................................................................................................................
7) .............................................................................................................................
8) .............................................................................................................................
Sijunjung, ...................20….
Kepala Sekolah Guru Mata Pelajaran Supervisor
No Pertanyaan Jawaban
Kesan umum:
Saran:
Sijunjung , ………….......20….
Supervisor,
.............................................
NIP.......................................
Format 4:
Hasil Observasi
Hasil penilaian
Komponen
No Aspek yang disupervisi
yang dianalisis 1 2 3 4 5
Rata-rata
Sijunjung, ……………20…..
Supervisor,
Rentang Penilaian
1. Tidak baik (0-40)
2. Kurang baik (41-54)
3. Cukup (55-74)
4. Baik (75-90)
..............................................
5. Sangat baik (91-100)
NIP........................................