Name: ________________________

Teacher:

Criteria
4
Attendance /
Promptness

Level Of
Engagement In
Class

Student is late to
Student is always
class once
prompt and
every week and
regularly attends
regularly attends
classes.
classes.

Student is late to
class more than
once every week
and regularly
attends classes.

Student is late
to class daily
and/or has poor
attendance of
classes.

____

Student
proactively
contributes to
class by offering
ideas and asking
questions more
than once per
class.

Student rarely
contributes to
class by offering
ideas and asking
questions.

Student never
contributes to
class by
offering ideas
and asking
questions.

____

Student listens
when others talk,
both in groups
and in class.
Listening Skills
Student
incorporates or
builds off of the
ideas of others.

Behavior

Preparation

Points

Student
proactively
contributes to
class by offering
ideas and asking
questions once
per class.

Student does
not listen when
Student does not
Student listens
others talk, both
listen when others
when others talk,
in groups and in
talk, both in
both in groups
class. Student
groups and in
often interrupts
and in class.
class.
when others
speak.

____

Student almost
never displays
disruptive
behavior during
class.

Student rarely
displays
disruptive
behavior during
class.

Student
occasionally
displays
disruptive
behavior during
class.

Student almost
always displays
disruptive
behavior during
class.

____

Student is always
prepared for class
with assignments
and required
class materials.

Student is
usually
prepared for
class with
assignments and
required class
materials.

Student is rarely
prepared for class
with assignments
and required
class materials.

Student is
almost never
prepared for
class with
assignments
and required
class materials.

____

Total---->
Teacher Comments:

____

1) Attendance Evidence:
______________________________________________________________________________
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2) Engagement Evidence:
______________________________________________________________________________
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______________________________________________________________________________
______________________________________________________________________________
3) Listening Skills Evidence:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
4) Behavior Evidence:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
5) Preparation:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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