STUDENT ASSISTANCE PROGRAM
FOLLOW-UP OBSERVATION FORM

Please return this form as soon as possible in the attached envelope to 

Date

Student   Year

Staff Member   Subject   Hour

Please provide information so we may assess the student's progress.
Please assess student's performance within the last two (2) months (circle appropriate description).

ACADEMIC PERFORMANCE


Declined                                   No Change                                   Improved 

                                                                                                    Current Grade

CLASSROOM BEHAVIOR

Declined                                   No Change                                   Improved 
 
 

PROMPTNESS/ABSENCES


Declined                                   No Change                                   Improved 
 


APPEARANCE/PHYSICAL INDICATORS


Declined                                   No Change                                   Improved 
 
 

Comments:

 
 

Signature: _________________________________                    Date: _____________________
 


    Upon completion, please print and return to person who requested this form. (Please seal the envelope.)