Student Name: ____________________
Teacher Name: ____________________
English Proficiency Level: ______________
Date/Meeting Time: ________________
Course/Grade Level: _________________
Current Course Grade: _______________
What are your short and long-term goals for this ML student?
Overall Goal(s)
What immediate skill(s)/need(s) does the ML need to improve ASAP?
More Practice Needed…
What habits or social skills does the ML need to focus on or improve?
Work Habits
What specific area(s) do you feel the student needs the most assistance?
Areas of Need
What does your student do well? Any strengths that benefit the ML?
Strengths/
Successes