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Mr. Saad - Retake Form
This is the digital version of the form that needs to be filled out before a student can complete a retake of a summative/formal assessment such as a quiz or test.
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Student's Full Name
Your answer
Grade Level (A/B)
Your answer
Test/Quiz Name
Your answer
Original Test Score
Your answer
Student Reflection
I think I did not pass this test because I . . . .
Your answer
On this test I did not understand…
Your answer
To be successful on my next test I will (3 steps you will take)…
Examples plan steps to retaking a test: o
Schedule a study session with teacher o
Make corrections to my test o
Seek help from other students o
Schedule the retake o
Retake the test
Your answer
Parent Approval Notice
I understand my child has not shown mastery of the class content and needs to retake the quiz/test. I know that Mr. Saad is available for help and retakes Mondays through Thursdays after school 3:45-5:00 or during lunch by appointment.
Dear Parent/Guardian, if you agree with the statement above please type your name and today's date in the space below
Your answer
Additional comments to teacher?
Leave blank if not applicable.
Your answer
Schedule the Retake
This is merely a request. Teacher reserves the right to deny the request due to other commitments.
Choose a day for the retake
Mr. Saad is available most days Monday - Thursday (3:45 - 5:00 pm).
MM
/
DD
Time of Day for Retake
After School (3:45- 5:00 pm)
During Lunch
* If you plan to do your retake during lunch: during what period would you take the retake?
Period 4
Period 5
Period 6
Period 7
Period 8
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