"Student Contract for Academic Improvement"

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Student Contract for Academic Improvement
Student Name________________________________
Class________________________________________
Teacher_____________________________________
Date________________________________________
Nature of Concern:
____Attendance
____Failed exam ____Missed exam ____Behavior
____Missing Homework
____Other:__________________
Current Course Grade: ______
Grade I would like to get: ______
Barriers to My Academic Success:
____Poor time management
____Poor grades on tests in spite of hours spent preparing
____Lack of preparation
____ Incomplete class notes
____Not asking questions when I don’t understand
____Poor attendance
____Personal Concerns
____Other:______________________
Course of Action:
Service
Resource
Date
Tutoring
After School Program
Daily check sheet
Through Migrant Services
Health Consultation School Nurse
Other
Dates by which I will implement the plan:__________________
I hereby agree to abide by the terms of this plan:
Student Signature:____________________________________
Date:________________
Migrant Signature:____________________________________
Date:_______________
Parent(s) Signature:___________________________________
Date:________________
Student Contract for Academic Improvement
Student Name________________________________
Class________________________________________
Teacher_____________________________________
Date________________________________________
Nature of Concern:
____Attendance
____Failed exam ____Missed exam ____Behavior
____Missing Homework
____Other:__________________
Current Course Grade: ______
Grade I would like to get: ______
Barriers to My Academic Success:
____Poor time management
____Poor grades on tests in spite of hours spent preparing
____Lack of preparation
____ Incomplete class notes
____Not asking questions when I don’t understand
____Poor attendance
____Personal Concerns
____Other:______________________
Course of Action:
Service
Resource
Date
Tutoring
After School Program
Daily check sheet
Through Migrant Services
Health Consultation School Nurse
Other
Dates by which I will implement the plan:__________________
I hereby agree to abide by the terms of this plan:
Student Signature:____________________________________
Date:________________
Migrant Signature:____________________________________
Date:_______________
Parent(s) Signature:___________________________________
Date:________________
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