Responsibility LogStudent: _______________________________ Week of: _________________

Student learning and success are a priority in my classroom. In order to foster an environment where students feel safe, take responsibility for their learning, and feel a sense of personal pride, we will use a responsibility model. Students are expected to reflect upon their choices in hopes of becoming better decision makers.

The following chart shows your child’s progress in making good behavioral choices this week. Please discuss his/her actions and how they can be improved or maintained.

Date Behavior Choice Student Initials

Student Reflection

Directions: Discuss your behavior choices this week with your parents. Write a detailed description of how you can improve poor choices and maintain positive choices. Then, sign this form at the bottom and return in your Data Folder.

Positive Choices:

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Choices that need improvement:

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Student Signature: ____________________________________ Date: ________________

Parent Signature: _____________________________________ Date: ________________