Sample Assessment Forms for Students


School Report Card
Original: 1930

To Parents:
We give two separate reports. The first indicates the progress made by the pupil in the formation of the essential traits of good character and attitude of mind that make for good citizenship. Upon these depend the future of democracy and the stability of government. In this training we recognize that the school shares responsibility with the home. The second report indicates the progress in the regular grades. Superintendent, Los Angeles Unified School District


1. Obedience: Willingness to follow directions; respect for law and order.

2. Dependableness: Honesty, keeping of promises, promptness, loyalty, willingness to cooperate, self-control.

3. Courtesy: Courtesy to associates and to teachers, respect for rights of others; fair play; cheerfulness.

4. Cleanliness: Of person, clothes, behavior, speech.

5. Thrift: Respect for property, care of books, furniture and building, care of own property, consideration for the property of others, recognition of the value of time.

Conduct Grade for Report Card

(S= satisfactory; N= needs improvement)

___ Trustworthiness
___ Respectful
___ Responsible
___ Caring

____ Completes homework ____ Uses appropriate language
____ Attends classes regularly ____ Uses appropriate voice tone
____ Follows directions ____ Offers to help others
____ Follows through on commitments ____ Uses good manners


____ Caring
____ Turns in assignments

____ Offers friendship
____ Brings materials to class

____ Shows empathy
____ Does quality work

____ Comforts others
____ Does classroom chores

____ Shares resources

Planning and Assessment

Student Name:__________________________________________

Describe strategies you will use to demonstrate each of the following:

I will strive to be:


Hard working:


Rate yourself today on each: (1=poor; 6=excellent) Include strategies for improvement.
___ Respectful
___Hard working

Parent rating: Comments
____Hard working

The Week in Review

Student Name:_______________________ Date:__________

1. What was the high point of the week?

2. Whom did you get to know better?

3. What was the major thing you learned about yourself this week?

4. Did you institute any major changes in your life this week?

5. How could this week have been better?

6. Over what did you procrastinate this week?

7. Identify three decisions or choices you made this week. What were the results of these choices?



8. Did you make any plans this week for a future event?

9. What unfinished business do you have left?

Book Order Form

Return to Home Page

Return to Books