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Today's date
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Child's First Name Last Initial
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Child's grade level
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Child exhibits self-confidence. Please type (Strongly Agree, Agree, Disagree or Strongly Disagree)
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Child shows optimism/hopefulness. Please type (Strongly Agree, Agree, Disagree or Strongly Disagree)
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Child expresses feelings. Please type (Strongly Agree, Agree, Disagree or Strongly Disagree)
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Child is able to ask for help. Please type (Strongly Agree, Agree, Disagree or Strongly Disagree)
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Child has positive relationship with peers. Please type (Strongly Agree, Agree, Disagree or Strongly Disagree)
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Child is willing to help others Please type (Strongly Agree, Agree, Disagree or Strongly Disagree)
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Child shows academic effort/progress. Please type (Strongly Agree, Agree, Disagree or Strongly Disagree)
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Child has positive attitude about school. Please type (Strongly Agree, Agree, Disagree or Strongly Disagree)
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Please comment about changes in the child.
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