Today's Date: Your Name: Street Address Address (cont.) City State/Province Zip/Postal Code Work Phone Home Phone E-mail
Avoids reading out loud? Never reads for pleasure? Makes grades which are not indicative of his/her abilities? Procrastinates and lacks motivation in performing school work? Avoids writing thank you notes or other correspondence? Relies on a calculator to do simple math computations? Fails to carry out oral or written directions? Fails to complete assignments? Scores lower on standardized tests than his/her actual abilities as reflected in school grades? Fails to set academic goals and lacks aspiration towards being successful?
