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 Media Specialists Templates


Collaborative Planning Facilitations Form | Instructional Templates | Materials Management Forms | Permission, Policy, and Volunteer Forms

Collaborative Planning Facilitations Form

Cooperative Planning Form

This cooperative planning form from Lovejoy High School Media Center may be customized to facilitate joint planning between media specialists and teachers. Form may be used to facilitate fulfillment of Georgia Department of Education's State Board Policy regarding the necessity for cooperative planning.

Evaluation of Collaborative Resource Based Teaching

This form can be used after students have used the resources in the media center for an activity, lesson, or unit. Teachers and/or media specialists can evaluate the effectiveness of the materials and equipment in terms of the quantity and quality of resources and the alignment to objectives. Form was compiled and submitted by Patricia Wall, media specialist at River Trail Middle School, Fulton County Schools.

Hot Topics - Media Request Form

Media specialists may distribute this surveys to elementary teachers in order to determine the nature of topics slated for curriculum study each month. With this knowledge, media materials may be selected to support classroom instruction.

Instructional Planning Checklist

Teachers may use this instructional planning checklist from Starr's Mill Media Center to communicate student needs for media center projects.

Media Pass: Why I'm Here Form (elementary)

Media Specialists may encourage elementary school teachers to send individual students to the media center with this accompanying form. Form is designed to keep students on task by communicating student needs for specific media center visits. Form includes practical information such as whether students are supposed to be working with computers or other students, or whether students will need the help of media staff.

Media Request Form

Media Specialists can use this template to keep track of media and materials loaned out to classroom teachers. Teachers can fill in this form when requesting materials (books, videos, reference materials, software, etc.) from the media center. They can request specific titles or can ask the media specialist to locate materials that are appropriate for a particular theme or content topic. The easy-to-use form contains checkboxes, drop-down menus, and fill-in fields. This form also includes a section in which the media specialist can enter the titles of materials loaned out to the classroom teachers. This is most appropriate for non-automated systems.

Public Library Alert Form

This Public Library Alert Form may be faxed to community libraries to alert media specialists of upcoming school events and student projects. Use the form to invite even greater communication and collaboration between school and community library systems.

Teacher/Media Specialist Planning Guide

Teachers and media specialists can use this form to facilitate collaborative planning of activities and units in which students will need to access the media center resources. Form was compiled and submitted by Patricia Wall, media specialist at River Trail Middle School, Fulton County Schools.

Topics of Study - Media Support Form

Media specialists may distribute these surveys to teachers in order to determine the nature of topics slated for curriculum study each month. With this knowledge, media materials may be selected to support classroom instruction.

Instructional Templates

Book Report Template- Fiction, Elementary

Students can use this form for writing book reports on works of fiction. Created in MS Word, the form has a chart format in which students can type or print in the boxes.

Multimedia Book Report Rubric

Multimedia Book Report Rubric for Fiction. Use with any multimedia book review. From MidLink magazine.

Story Map Template: Word

A story map can be used by students to sort out the facts of a story they have read or as a tool for writing a story.

Materials Management Forms

Ideas for Facilitating the Return of Overdue Materials

Sometimes verbal reminders, notes home and even overdue notices with listed fines/replacement costs are not enough to prompt students and parents to return overdue materials. Here are some additional ideas for getting materials back. 

Overdue Notice- Middle School/High

Letter to send home to parents reminding them of overdue books and materials their child had borrowed from the Media Center. Includes fields for listing titles and replacement costs.

Overdue Notice_ Elementary

Letter to send home to parents reminding them of overdue books and materials their child had borrowed from the Media Center. Includes fields for listing titles and replacement costs and gives suggestions to parents on helping their child find the books. 

Wanted Poster for Fugitive Books

Overdue notices not effective? Need a new idea for encouraging students to find and return missing books? Customize this "Wanted- Fugitive Books" poster.

Permission, Policy, and Volunteer Forms

Media Center Volunteer Form

Wanted: Media Center Volunteers! This form outlines the possible roles and duties of media center volunteers. The bottom portion can be filled in by interested parents or community members.

Media Center Volunteer Form- Elementary

Wanted: Media Center Volunteers! This form outlines the possible roles and duties of media center volunteers. The bottom portion can be filled in by interested parents or community members.

Photo/Video/Student-Authored Work Consent Form and Release -Basic

This form applies to students being photographed, video taped, audio taped and interviewed in connection with school activities and events. It also gives consent for the school to use works generated/authored by students. The document should be customized to reflect the local school’s information and then printed on school letterhead stationery. A section for a notary can be added to the form if desired.

Photo/Video/Student-Authored Work Consent Form and Release -Formal

This form applies to students being photographed, video taped, audio taped and interviewed in connection with school activities and events. It also gives consent for the school to use works generated/authored by students. The document should be customized to reflect the local school’s information and then printed on school letterhead stationery. A section for a notary can be added to the form if desired. ?