KHS B.L.A.S.T.

Accountability Form Please return this form to the file box in the mailroom by Thursday at 3:45 p.m.

Department:

Room: Student Signature (Received Pass)

Teacher: Student Signature (Arrived to Tutorials)

Date: Make-Up Tutorials

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Teacher participated in the following activities during B.L.A.S.T Tutoring Supervising Study Club Sponsor Teacher Signature Make Up Testing Monitoring Hallways Other Date