Directions: This form is to be used by the classroom teacher and after-school tutor to share information about an individual student's homework assignments and study habits. For each homework assignment, the teacher fills out the information in column one and gives the form to the tutor. After assisting the student, the tutor fills out the information in column two and returns the form to the teacher.
Today's Date:
Student's Name:
Teacher's Name:
Tutor's Name:
Completed by teacher.
Completed by tutor.
The homework for today is:
This student:
___ Completed the homework easily and independently.
___ Had difficulty understanding what was asked in the homework.
___ Had difficulty completing the homework.
___ Had difficulty focusing on the assignment.
Please pay special attention to:
This student required:
___ No help with the assignment.
___ A little help.
___ Occasional help.
___ A great deal of help.
___ See comments on back.
This homework should take _____ minutes to complete.
