Application for Re-Assessment

Name: _________________________________________Deadline: ______________________Period: _____

Assessment: ____________________________________Circle: ____ Computer Test or Paper Test_____

Directions: After completing your assessment corrections, please complete the items on this sheet and return to
Mrs. Greenwell for an opportunity to re-assess. Be sure it is thorough, a parent has signed at the bottom and
you follow through on your plan! Keep in mind there are deadlines!

1. On a scale of 1-10 (1 being worst, 10 being best),

rank your performance on the assessment.

2. Were the majority of your mistakes:

(1) Careless errors or (2) Lack of understanding the material?

3. In a paragraph, explain your mistakes. You may need assistance in this area if you marked (2) for #2.
Knowing your mistakes will assist in setting up the next part. See me during advisory if you need help.
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4. In a paragraph, explain what you will do to ensure better performance on the re-assessment. What is
your plan? How will you prevent making the same mistakes? Use this plan to study!
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Date Submitted First Score Re-Assessment Date Re-Assessment Score Recorded/Notes

(sign up on calendar, get a pass) (Mrs. Greenwells space)

approved re-submit
PARENT SIGNATURE/Comments:
 Correction Form
Directions: You may use this template to help you organize and understand your mistakes.
Circle C (correct) or I (incorrect) for each problem and make corrections in the space provided
for each incorrect problem.

Problem Correct/ Correction Notes

Incorrect
1
C I

2 C I

3 C I

4 C I

5 C I

6 C I

7 C I

8 C I

9 C I

10 C I
11 C I

12 C I

13 C I

14 C I

15 C I

16 C I

17 C I

18 C I

19 C I

20 C I

CR C I