Anecdotal record and behavioral observation checklist

1. Ubay National Science High School - Fatima, Ubay, Bohol 2014
Observations
and
Checklists
This section includes anecdotal observation forms and checklists
that can be used to evaluate student growth and development
through service learning. Checklists are done every grading period
to monitor student behavioral development.
Anecdotal Observation Record
This form is used to observe several students at the same time.
Predetermined observable behaviors are listed on the left side of
the form. The students' names are listed across the top of the
chart. The observer watches the targeted students and makes note
of their actions with regard to the predetermined behaviors. An
example is provided along with a blank form to allow teachers to
use their own selected behaviors.

2. Ubay National Science High School - Fatima, Ubay, Bohol 2014
Anecdotal Observation Record
(Incidents involving a particular student)
Name of Student/Year & Section:_____________________________________
Date and Time: _________________________________________________
Adviser: ______________________________________________________
Circumstance: __________________________________________________
Observations of events and behaviors:
Known or
Suspected
Setting Events
Antecedent Trigger
(what happened before
the trigger)
Behavior
(exactly what the
student did)
Consequences/
Responses
(how adults & peers
responded)
Comments/Summary:
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________

3. Ubay National Science High School - Fatima, Ubay, Bohol 2014
Service-learningChecklist
Student's Name:_________________________Grade & Section:____________
Adviser: _________________________ Date/Time:_____________________
Service Learning Activity:____________________Location:________________
Note: Please list the specific activities in which the student has been involved and the
skills that were practiced/learned:
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
Please update the student's performance below. Use the letter codes:
E=Excellent, VG=Very Good, S=Satisfactory, LS=Lessthan Satisfactory
Attendance/Punctuality: Rating of Student
Is consistentin attendance ______________
Reports to community site on time ______________
Attitude:
Accepts responsibility ______________
Is enthusiastic and interested ______________
Displays appropriate appearance and dress ______________
Is courteous and cooperative ______________
Displays emotional maturity ______________
Exercises good judgment ______________
Is sincere ______________
Relates well to a varietyofpeople ______________
Learning Process:
Shows initiative ______________
Assumes responsibilityfor own learning ______________
Asks appropriate questions ______________
Performances:
Begins work promptly ______________
Appreciates suggestions ______________
Completes assigned tasks ______________
Exhibits competence ______________
Progressively requires less supervision ______________
Is a dependable worker ______________
Follows directions carefully ______________
Other Areas Assessed:
__________________________________________________________________
__________________________________________________________________

4. Ubay National Science High School - Fatima, Ubay, Bohol 2014
Anecdotal Observation Record
(Performance inGroups During Service Learning)
Date and Time:_________________________________________________
Observer:_____________________________________________________
Site/Project/Service Learning Activity:_________________________________
Behavior _________ __________ __________ __________
Cooperation
Communication
with others
Motivation
Ability to work
Independently
Use of time
Ability to follow
Directions

5. Ubay National Science High School - Fatima, Ubay, Bohol 2014