LEARNING STUDENTS REPORT

Student:	Date:
Subject:	Teacher:

Index: Y I N
Yes / In Progress / No

Learning Foundations:

1. Prepared for instruction 1.1. Arrives in class on time
	Y I N
1.2. Makes eye contact with teacher	Y I N
1.3. Stays seated and quiet	Y I N
1.4. Has homework ready to hand in	Y I N
1.5. Has pens or pencils ready	Y I N
1.6. Has appropriate materials out	Y I N
2. Completes homework and class work 2.1. Neatly writes or types work
	Y I N
2.2. Demonstrates best effort	Y I N
2.3. Completes work in a timely manner	Y I N
2.4. Returns work unwrinkled, whole, unstained	Y I N
3. Uses organizational strategies 3.1. Uses homework planner
	Y I N
3.2. Neatly places work for each subject into its folder	Y I N
3.3. Uses homework folder nightly	Y I N
3.4. Cleans out notebook weekly	Y I N
3.5. Keeps book bags out of traffic areas	Y I N
3.6. Puts name, date, and title on each assignment	Y I N
4. Maintains time on task 4.1. Focuses on given assignment
	Y I N
4.2. Uses speaker power* during discussion *Speaker Power: When a student asks for speaker power, (s)he raises her/his hand. When acknowledged, that student has the right to be listened to with respect and without interruption.	Y I N
4.3. Asks for teacher assistance in appropriate manner	Y I N
5. Works independently 5.1. Attempts to use learning strategies before asking for help
	Y I N
5.2. Works quietly without disturbing other workers	Y I N
5.3. Shows attempt to complete homework or writes at least 2 sentences explaining his/her problem	Y I N
6. Works cooperatively 6.1. Uses speaker power* (*see 4.2 above)
	Y I N
6.2. Respects opinions of others	Y I N
6.3. Demonstrates individual accountability	Y I N
6.4. Displays positive interdependence	Y I N
6.5. Addresses group members and teachers by appropriate name	Y I N
7. Invested in academic progress 7.1. Knows grade, reading, writing, and math levels
	Y I N
7.2. Knows and uses individual learning strategies	Y I N
7.3. Sets SMART goals with teacher (specific, measurable, attainable, realistic, and timely)	Y I N
7.4. Monitors his/her own progress toward goals	Y I N
7.5. Shows initiative in day-to-day work	Y I N
7.6. Learns and employs self-advocacy skills	Y I N
Comments:	Assessment: H=Honors P=Progressing U=Unsatisfactory