Data Pelaksanaan Tugas Pengawas

DATA PELAKSANAAN TUGAS PENGAWAS
Supervisi
Menilai Kinerja
Membimbing
Melatih
Mengevaluasi
Presentasi
Pengembangan

Manajerial
Sekolah
Kepala Sekolah
Kepsek
Sekolah
......................
...........................

Akademik
Kepsek
Guru
Guru

Kepsek
..............
...............

Klinis
Guru
Pengawas
Pengawas
Guru
................
.................

Nama Pengawas

:

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NIP

:

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Topik

:

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Tempat Kegiatan

:

.................................................................

Hari/Tanggal

:

.................................................................

Semester/Tahun

:

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Bertemu dengan

:

.................................................................

:

.................................................................

:

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Materi Kegiatan

:

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Tujuan Kegiatan

.....................................................................................................................................

Indikator Kegerhasilan

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Permasalahan kegiatan supervisi

Komponen Analisis

Uraian

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Kondisi Nyata

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......................................................................................
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Kondisi Yang Sekolah
......................................................................................
Harapkan
......................................................................................
Permasalah

.......................................................................................

(Perbedaan antara kondisi ......................................................................................

nyata dan yang

......................................................................................

diharapkan)
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Refleksi Hasil Kegiatan

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Alternatif Solusi/
......................................................................................
Rekomendasi
......................................................................................
Mengetahui

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...................................

Pengawas Sekolah

........................................

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DATA PESERTA KEGIATAN SUPERVISI
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Nama Sekolah

:

..................................................................

Alamat

:

.................................................................

Hari/Tanggal

:

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Semester/Tahun

:

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Materi Kajian

:

.................................................................

No.

Nama

1.

Tanda Tangan



2.
3.




4.
5.



6.



7.



8.



Mengetahui

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Kepala Sekolah

Pengawas Sekolah

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