GOAL SETTING AND ACADEMIC SELF-EVALUATION FORM

Name: ___________________________

Class: ____________________________

Week: ____________________________

Project: ___________________________

MY GOAL(S) FOR THE WEEK ARE: Encouraging both weekly goals and daily self-evaluation is
great!

____________________________________________________________________________
____________________________________________________________________________
SELF-ASSESSMENT OF WORK & BEHAVIOR: Did you consider using a wider range?
Scoring Scale:

N/A = not applicable

0 = I did nothing
1 = I did very little, much more effort needed
2 = I made progress but my use of time could/should have been better
3= I worked the majority of the time and made quite a bit of progress
4 = 100% effort- I worked hard and made significant progress

Monday Tuesday Wednesday Thursday Friday

During work time, I accomplished the
following today:

Score for work time

Note taking
Studied for Quiz/Test
Homework Completed
Focus/Listening/No sidebar
conversations
Asked/Answered ?s
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