RETAKE REFLECTION FORM
Student Name: ___________________________
Period: ___________________
Test:___________________
I plan to retest on ____________________________________. Include date and time of retake. After confirming the teacher’s availability, write your name on the retake or prearranged help calendar.
Plan of Action (to be completed by the student): How will you review for you next opportunity to show proficiency?
I did not pass this test because I . . . . . . (Check all that apply)
o Should have studied more o Used my time poorly
o Did not listen o Should have done my homework
o Wasn’t prepared for class o Should have taken notes
o Should have come for extra help o Should have asked questions
o Did not follow instructions o Other: _______________________
I studied _______ hours for this test. This is how I studied …
____________________________________________________________________________________________________________________________________________________________
On this test, I did not understand . . . . .
____________________________________________________________________________________________________________________________________________________________
To be successful on future tests, I will do the following three things . . .
1) ________________________________________________________________________
2) ________________________________________________________________________
3) ________________________________________________________________________
RETAKE HIGHLIGHTS
o The Test Retake must be student initiated.
o This new grade replace the original test grade.
o Retake tests will NOT be the same test given as the original.
o All assignments and projects must be complete and turned in prior to retake. Students must show sufficient evidence of review and study to retake.
o All retake assessments must be completed by the end of the next unit. Multiple retakes may be taken if the student plans enough time to review and take each.
o The original graded test must be corrected before the student retakes.
o Any Academic Honesty violation is not eligible!
Student Signature: ________________________________ Date: ____________
Parent Signature: __________