Assignment Concern Survey

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* 1. What is your name?

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* 2. What period and class are you in?

per 3 English 3 GHP

per 6 AP Lang

Per 7 AP Lang

Per 8 English 3 GHP

Per 3 English 3 GHP

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* 3. What is the name of the assignment about which you are concerned?

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* 4. Was this assignment turned in late (after the time at which Smith originally collected it)?

No, I turned it in with everyone else in my class during the period it was collected.

Yes, I was absent the day it was collected.

Yes, I was absent the day it was assigned.

Yes, I turned it in for late, partial credit.

Other (please specify)

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* 5. Is your concern about the location of the assignment (i.e. you think it is "missing") or is the concern about the grade the assignment earned?

I believe the assignment is missing.

I have a concern about the grade.

Other (please specify)

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* 6. If you believe that you have turned in your paper on time with your class, then check off all of the following actions that you have taken.

Checked the Wall on "No Name Papers"

Re-checked my notebook.

Re-checked my locker

I have done none of the above and will have to do so immediately.

Other (please specify)

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* 7. Did you email your assignment or share it with Smith on a Google Doc?
A. If you emailed it to me, then write the email address from which you sent it below.
B. If you shared it with me on a Google Doc, then chances are I did not get the assignment because of access issues. Unless the directions of the assignment specifically said to share the Doc with me, then you need to print out the assignment and give it to me. If the directions of the assignment told you to share the doc with me, then make sure that you shared it to the correct gmail address. I will not be able to access any Docs sent to my @parklandsd.org account.
Tell me what I need to know in the space below.

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* 8. If your concern is about the grade itself and not about the location, then please check all of the following that apply:

I believe that there might be a data entry mistake (usually this is the case when grades are exceedingly low given past performance--for example, Smith only enters "5" instead of "55.").

I have read over the assignment rubric and comments, and I would like to schedule a conference to discuss the assignment.

The class has not yet received back the assignment, and I would like to schedule a time to look at and discuss my graded assignment.

I do not have a grade yet or I have a zero.

Other (please specify)

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* 9. If you would like to schedule a time to meet, then please let me know when is best for you. Smith teaches periods 3, 6, 7, 8, and 9 and will not be able to conference during those times. She is available to meet during your study halls or lunch (you may not meet with her during the instructional time of another class without written permission from that class's teacher) periods 1, 2, 4 and after school. If the issue is quick, then we may be able to take care of it at the end of class, but with 30 or more students in each class, this is not always timely.

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* 10. If the previous questions have not yet fully represented your concern, then please use the space below to fully communicate the situation to Smith.