Student :_________________   Teacher:____________


Class:____________________   Date:______________


I. Current Student Achievement:


1.     Has student turned in all homework from the last week:


Yes[  ]                    No[  ]


If no, what assignments are missing?



2.     List the studentís test/quiz scores during the last week: 



3.     What is the studentís overall current grade? _________



II.                Future Student Achievement:


1.  Will there be any tests during the next week?  Yes [  ]    No [  ]


              If yes, when and covering what?


2.  Are there any major projects, papers, etc.  due in the near future?


              Yes [  ]                   No [  ]


              If yes, what is the nature of the project:_____________

                                                     Due date:_________________


III.             Miscellaneous:


1.  Are there any behavior problems?  Yes [  ]   No [  ]


              If yes, please describe:


2.  Do we need to meet?  Yes [  ]   No [  ]