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* 1. Student ID #

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* 2. Subject Taught (If middle or high school):

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* 3. Please choose one answer for each question - Acceptable Level of Functioning Not Demonstrated Early in School Year- Improvement Warranted

  Did Not Need to Improve Significant Improvement Moderate Improvement Slight Improvement No Change Slight Decline Moderate Decline Significant Decline
Turning in his/her homework.
Completing homework to your satisfaction.
Participating in Class.
Volunteering (e.g., for extra credit or more responsibilities).
Attending class regularly.
Being attentive in class.
Behaving well in class.
Academic performance.
Coming to school motivated to learn.
Getting along well with other students.

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