Goal Tracking: Daniel Pounders: 2/23/2016

Dear Teachers:

Please fill out this Goal/Behavioral Tracking Survey on Daniel Pounders for 2/23/16.

Please remember you are evaluating him on today's behaviors. This should only take you approximately 5-10 minutes. If you are in a co-taught class, I only need one survey per class.

I created a box to comment on any behaviors (positive or negative) from today and over the last two weeks that need to be addressed.

Your participation in this survey is valuable to track behavioral trends. This data can be used to head off possible behavioral problems along with providing the opportunity to reward good behavior.

Thank you

Mrs. DuRant

Please rate the student listed above in the following areas for 2/23/2016. 1 being the lowest and 5 being the highest.

Prepared for Class

On Task Behavior

Appropriate Behavior

Peer Relationships

Adult Relationships

Participation

Appears to have on clean shirt and pants daily

Notebook/Classwork/Interactive Notebook is organized

Responded to authority figure appropriately and respectfully

Please explain how the student did or did not respond to authority figure in an appropriate and respectful manner (Refer to Question One, Last Row)

* BASED ON TODAY'S ACTIONS: Did he ASK to take out his reader to read after all his work was completed.

Yes

On average, how many prompts does the student need to put away his reader and complete or participate in class?

Any other positive or negative comments about TODAY'S behavior? (Please note out of character behavior was present)

Any other positive or negative comments about behavior from the LAST TWO WEEKS (Please note out of character behavior was present)

Do you wish to speak to me in person?

Yes

Name, Class, Period

Thank you for filling out this survey!