Green Land

International School

Ecole Internationale
du Pré Vert

‫مدرســة الرض المخضـرة الدولية‬
CAS ACTIVITIES STUDENT’S SELF EVALUATION FORM
Student’s Name: …………………..
Activity Title: ………………..…….
Date:……………………….……..…
Location:…………………….…..…

Grade:……………
SY: /
Creativity, Action, and or service / Activity Code
Duration:…….. hr/s
Supervisor’s Name: ……………………….

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Short description of your activity:
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Why did you choose this activity? Did you find the experience worthwhile? Has it taught you
something?
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What/who helped you most in reflecting on what you were doing? How?
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IN PARTICULAR, HAS YOUR ACTIVITY HELPED THE FOLLOWING: (Circle the answer you choose)

Sense of responsibility
Compassion
Awareness of different cultures
Sense of service to the others and to the needs of the community
Initiative
Leadership
Willingness to accept advice
Competitiveness
Teamwork

No
No
No
No
No
No
No
No
No

A bit
A bit
A bit
A bit
A bit
A bit
A bit
A bit
A bit

A lot
A lot
A lot
A lot
A lot
A lot
A lot
A lot
A lot

N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A

What difficulties you have met?
* Time allocated for the activity
Not enough time
Too long

No
No

Partially
Partially

Yes
Yes

* Your Relationship with
Other students involved in the activity
The people you have been assisting
The institution you were working for
The supervisor of your activity

Bad
Bad
Bad
Bad

Good
Good
Good
Good

Excellent
Excellent
Excellent
Excellent

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CAS-Self Evaluation Form –CAS003/CSEF -DFC
Owner Title: CAS Coordinator
Date of Issue: Sep-05
Date of Use: 05/06

Green Land
International School

Ecole Internationale
du Pré Vert

‫مدرســة الرض المخضـرة الدولية‬
How much did you find this activity useful to
Not

Slightly

Exceptional

Why

Yourself
Your Community:
- School
- Family
- Neighbors
- Country
- World

How would you improve your performance next time you repeat this activity?
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Personal Comments:
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Student’s name:………………………………
Signature: ………………………….…..…….
Date: …………………………………….……

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CAS-Self Evaluation Form –CAS003/CSEF -DFC
Owner Title: CAS Coordinator
Date of Issue: Sep-05
Date of Use: 05/06