Student Responsibility Report Sheet

Today’s day and date:_____________________

Your name (please print)____________________________ Date_____________________

Your class block_________

Check all that apply to you.

____ I did not have materials in class today.

circle: book, pencil, paper, notebook, other__________________.

____ I did not have the assigned homework.

____ I did the homework, but did not have it in class.

____ I did not return assigned materials (i.e. progress report).

Excuses: Check all that apply to you.

____ I did not have appropriate materials at home.

____ I forgot.

____ I was too sick to do my homework.

____ I was absent and did not get the assignment from another student.

(Day and date absent:_______________).

Reason you did not get assignment from another student:

____ Other: Explain in detail:

Place this form in your class assignment box before you leave class today.