Form 3
ARKANSAS CITY UNIFIED SCHOOL DISTRICT #470
PLAN OF ASSISTANCE
Teacher:________________________________________					Date:_______________________
Problem Area:
1.	Performance Objective(s):
2.	Actions to Meet Objective(s):
3.	Evaluation of the Improvements:
Any item marked "unsatisfactory" must be accompanied by a Plan of Assistance as developed by the evaluator and teacher.
	Date:
	Reviewed By:
			Evaluator
					Evaluatee's Signature