North Meck IB Diploma Program
CAS Recording & Reporting Form
Name: _______________________________________________________________________________________
Name of Activity/Event/Project:__________________________________________________________
Date the activity began and ended: _______________________________________________________
Total # of hours: ______________ (You must attach a log of dates and times for ongoing projects)
Directions: Please place a check (√) by each of the learning outcomes you achieved during this activity. Not all learning outcomes will be achieved for each activity, but all outcomes will be achieved over time.
_____ Outcome 1: Increase their awareness of their strengths and areas for growth
They are able to see themselves as individuals with various skills and abilities, some more developed than others, and understand that they can make choices about how they wish to move forward.
_____ Outcome 2: Undertaken new challenges
A new challenge may be an unfamiliar activity, or an extension to an existing one.
_____ Outcome 3: Planned and initiated activities
Planning and initiation will often be in collaboration with others. It can be shown in activities that are part of larger projects, for example ongoing school activities in the local community, as well as in small student-led activities.
_____ Outcome 4: Worked collaboratively with others
Collaboration can be shown in many activities, such as team sports, playing music in a band, or helping in a kindergarten.
_____ Outcome 5: Shown perseverance and commitment on their activities
At a minimum, this implies attending regularly and accepting a share of the responsibility for dealing with problems that arise in the course of activities.
_____ Outcome 6: Engaged with issues of global importance
Students may be involved in international projects but there are many global issues that can be acted upon locally or nationally (for example, environmental concerns, caring for the elderly).
_____ Outcome 7: Considered the ethical implications of your actions
Ethical decisions arise in almost any CAS activity (for example, on the sports field, in musical composition, in relationships with others involved in service activities).
_____ Outcome 8: Developed new skills
As with new challenges, new skills may by shown in activities that the students has not previously undertaken, or in increased expertise in an established area.
Student Signature:__________________________________________________________________________
TO BE COMPLETED BY THE ACTIVITY SUPERVISOR (an adult not related to the student)
Comments on student’s performance:
Activity Leader’s signature:___________________________________________________Date:______________________
Activity Leader’s name:___________________________________________________________________________________
Agency/Organization:_____________________________________________________________________________________
Contact phone number/e-mail:__________________________________________________________________________
Tips for Reflection:
*Turning in this form does NOT replace your reflection piece; it is simply to help you document & record your progress.
ü Understand the difference between an activity & a project; an activity is a one-time event, like helping out with Race for the Cure whereas a project is ongoing for several months/years where you have dedicated many hours on a regular basis; projects evolve over time such as creating, practicing, and performing a dance or participating in a club throughout the year.
ü Your reflection should be ongoing, thorough, and meaningful and should delve into many aspects of your activity or project. Keeping an electronic journal or a place where you can make entries throughout the duration of the project would be wise.
ü In your reflection, first, explain what you did, who you worked with, and your duties/actions during that time you worked with the particular person/group/agency.
ü Explain which outcomes were accomplished during your project/activity & how the project or activities impacted you personally, but as well as those you worked with.
ü Explain whether creativity, action, and/or service was involved during this experience.
ü Incorporate elements of TOK within your reflection; what ways of knowing did you experience? Were there any ethical considerations you encountered?
Reflection Format I’ve Chosen for This Activity or Project:
____ Written reflection (typed or handwritten)
____ On-going journal
____ Video
____ Oral (you must submit notes and signature(s) of all participants)
_____ Other: ___________________________________________________________________________________________________
Completing Activities/Projects:
Ø Projects/activities are only complete when this form and accompanying reflection has been filed in your CAS folder, located in H7.
Ø We encourage you to file monthly. All CAS hours must be fully documented by May 1st. The minimum amount of hours is 150!