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Series 602.8.2.1.1P - Instruction Log for a Student Unable to be in School

Adopted: September 1983
Revised: November 2006

 

TEACHER: Submit this completed form to your principal when instruction is completed.

Student’s Name: ________________________________________________________ Grade: ______________

 

Date

Hours of Direct

Instruction

 

Specific Instructional Activities and Outcomes

Where Instruction Occurred

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of Teacher                                                                                        Date                         

Distribution:     Original - student’s cumulative folder                      

Copy – Office of Student Records

procedures/602.8.2.1.1P/11-27-06