CAS Reflection Form Cover Sheet

CAS Reflection Form Cover Sheet

Student Name:______

Name of Activity/Project:______

Number of hours and type of hours (C, A, or S):______

Summarize what you did in this activity and how you interacted with others in a 5-7-sentence paragraph.

In 2 pages, answer as many of the following questions as are applicable (some questions might not apply to every activity, but by the time you are done with ALL activities, you should have answered every question).

·  Explain what you hoped to accomplish through this activity.

·  How successful were you at achieving your goals? What difficulties did you encounter and how did you overcome them?

·  Why was this activity important to you?

·  What did you actually learn about yourself and others through this activity?

·  How did your perceptions of yourself or the world around you change as a result of this activity?

·  Did anyone help you to think about your learning during this activity? If so, who helped and how did they help?

·  Was this activity valuable to you or others? Explain.

·  What might you do differently next time to improve the outcome?

·  How can you apply what you have learned in other life situations?

A verification form should be completed by your Activity Supervisor and submitted with this reflection cover sheet.

If you are providing alternative verification (as specified in your activity proposal), please attach it to this sheet.

Attach your answers to the above questions and any other verification information to this sheet and return it to the CAS Supervisor by the appropriate deadline (15th of each month).

Student Signature:______Date:______

For BTHS office use:

_____Approved ______Not Approved Date:______

CAS Verification Form

Student Name:______

Name of Activity/Project:______

Approximate Number of Hours:______

To be completed by the Activity Supervisor:

Please evaluate the student in the following categories:

Punctuality and attendance

______

______

Effort and Commitment

______

______

Further Comments

______

______

The activity was (circle one):

Satisfactorily Completed Not Satisfactorily Completed

Activity Supervisor’s name:______

Activity Supervisor’s signature:______

Date:______