Fillable Self-Reflection Form The purpose of this form is

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Self-Reflection Form The purpose of this form is

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Self-Reflection Form
The purpose of this form is to prepare you to complete your Student Growth Plan. We would like you
to think about how the year is going so far for you. NOTE: The second quarter evaluations will NOT
include teacher comments for most students. Therefore, we ask you to reflect carefully on your own
performance in the following areas.
1. Do you complete all of your assignments?
Never Rarely Sometimes Almost Always Always
2. Do you seek help from your teachers during tutoring when you have questions, need
to make up assignments, feel confused or want to find out more about a particular topic?
Never Rarely Sometimes Almost Always Always
3. Are you attentive in class? Are you doing your best to follow along and to learn the
material as it is being discussed?
Never Rarely Sometimes Almost Always Always
4. Do you participate actively in class discussions? Do you look for ways to contribute to
the conversation and to show interest?
Never Rarely Sometimes Almost Always Always
5. Do you begin preparing for exams ahead of time by reviewing your notes each night?
Never Rarely Sometimes Almost Always Always
6. Do you try to find ways to help your classmates/other students at school in their
academic goals? Do you allow those around you to concentrate and participate in class?
Do you look for opportunities to help your peers better understand the curriculum?
Never Rarely Sometimes Almost Always Always
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7. Do you try your best to find something in each class that personally interests you?
Never Rarely Sometimes Almost Always Always
8. When you are absent, do you get notes, handouts and assignment information from
classmates or your teacher so that you don’t fall behind?
Never Rarely Sometimes Almost Always Always
Is there anything in your life outside of school (sports, changes in your family, chronic
illness, etc.) that is negatively impacting your performance at school? If so, do you have
a plan in place to deal with this or have you sought help from teachers and parents?
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How does your work first quarter compare with your work second quarter? Did you
improve? Did you fall behind? Was the quality of your work unchanged?
__________________________________________________________________________________
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Ideas for possible goals/thoughts/comments:
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Please keep this form in a safe place and use it as you complete your Student Growth Plan!
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Completed 22 October 2021

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