Independent Reading Response Form




Title: ___________ Month:_____________

Author: ____________

Pages: ______________



  1. Who is the protagonist in the story?







  1. What is the setting of your story?






  1. What is the conflict in your story?






  1. Was the book difficult to read? Would you recommend it to a friend? Why? Why not?






* Once you have completed this form you may set up an appointment to review your book with Mr. Stelzner or Ms. Wilson