GEAR UP ACTIVITY REPORT

Name:
Week of:
School:
For each question below, circle the number to the right
that best fits your opinion on the importance of the issue.
Use the scale above to match your opinion.

Question

/

Scale of Importance

Not at all / Not very / No Opinion / Some-what / Extremely
The students comprehended this week’s math lesson plans. / 1 / 2 / 3 / 4 / 5
The students comprehended this week’s reading lesson plans. / 1 / 2 / 3 / 4 / 5
The literacy section was too short. / 1 / 2 / 3 / 4 / 5
The math section was too short. / 1 / 2 / 3 / 4 / 5
I added my own “twist” to the math section. / 1 / 2 / 3 / 4 / 5
I added my own “twist” to the literacy section. / 1 / 2 / 3 / 4 / 5
I allowed the student/students to work on homework. / 1 / 2 / 3 / 4 / 5
The math curriculum was difficult to understand. / 1 / 2 / 3 / 4 / 5
The literacy curriculum was difficult to understand. / 1 / 2 / 3 / 4 / 5
I thought the students enjoyed the “wrap up” activities. / 1 / 2 / 3 / 4 / 5
My students are making educational progress. / 1 / 2 / 3 / 4 / 5
The students gained information from the college talk. / 1 / 2 / 3 / 4 / 5

Please indicate the days and times you spent preparing for this week- ______

______

In the following week I would like help from my site supervisor in the following areas (circle all that apply):

A)Classroom Management

B)Teaching ideas

C)Staying on pace from one activity to another on time

D)Attendance procedures or help with other weekly forms.

Other:

______

______

Please mention any problems you had with your classroom or any other supply or facility needs you have:

______

______

Please list any special concerns you have for any individual students. Please also mention any achievements by any of your students that you believe merit special recognition by GEAR UP staff, your student’s school, or the community as a whole. For example, good grades in school, volunteer work, etc….

______

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List the student you would like to receive a commendation for his/her effort this week & the name of award for that student. (Please remember to spread your awards around to as many deserving students as possible; do not simply give the same award to the same student week after week.):

______

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Please list any special concerns you have for any individual students. Please also mention any achievements by any of your students that you believe merit special recognition by GEAR UP staff, your student’s school, or the community as a whole.

______

______

What issues would you like to see addressed in the next meeting?

______

______

Would you like a GEAR UP Coordinator to contact you this week to discuss any concern that you might have? Please list the Coordinator that you would like to have contact you. Unless this applies to a child’s safety your comments will be kept anonymous.

______

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