School Grade Responsibility Form

Class Period:

Math Class:

Grade Last Semester:

Describe the reasons why you received your last semester grade:

Grade you would like to receive this semester:

Objectives to reach your grade goal (you must select 5):

Number of Unprepared this semester:

Number of Missing Homework :

Extra Credit completed this semester:

Using the information you selected above, fully explain your rationale for your actual grade at this point in the semester:

 1     2     3     4     5

Select Your Course 6th Grade Math Applications 7th Grade Math Applications 7th Grade Pre-Algebra 8th Grade Math Applications 8th Grade Pre-Algebra 8th Grade Algebra

Select Grade A+ A A- B+ B B- C+ C C- D F

A     B

Prepared with text, pencils, binder

Homework completed showing all work

Class notes written clearly and reviewed

Study fully for each test and/or quiz

Participate in class / ask questions

Seek extra help if needed

Complete optional extra credit assignments

Select Number of Unprepared 0 1-3 4-5 6-8 9-10 11 or more

Select Number of Missing Homework 0 1-3 4-5 6-8 9-10 11 or more

Select Extra Credit Completed 0 1 2 3 4