Student Observation Checklist
This checklist is used by teachers to conduct an individual assessment
of the student’s behavior and interaction inside the class.
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Title Page
Student Name Text answer
Grade Level Text answer
School Year (e.g S.Y 2018-2019) Text answer
2/7
Conducted on Date/time
Enter Date and Time:
/ /
: AM / PM
Observed by Text answer
3/7
Audit
Academic / Instructional Behaviors
Attentive to instructions and tasks Select one
[ ] Strength
[ ] Average
[ ] Weakness
Follows along with instruction/ task Select one
[ ] Strength
[ ] Average
[ ] Weakness
Constructively contributes to class Select one
[ ] Strength
[ ] Average
[ ] Weakness
Organized work and work habits Select one
[ ] Strength
[ ] Average
[ ] Weakness
Works carefully and neatly Select one
[ ] Strength
[ ] Average
[ ] Weakness
Completes tasks Select one
[ ] Strength
[ ] Average
4/7
[ ] Weakness
Work willingly and without frustration Select one
[ ] Strength
[ ] Average
[ ] Weakness
Social Behaviors
Friendly and respectful toward adults Select one
[ ] Strength
[ ] Average
[ ] Weakness
Friendly and respectful toward peers Select one
[ ] Strength
[ ] Average
[ ] Weakness
Interacts appropriately with peers in a social setting Select one
[ ] Strength
[ ] Average
[ ] Weakness
Interacts appropriately with peers in an academic setting Select one
[ ] Strength
[ ] Average
[ ] Weakness
Respects others' safety and personal space Select one
[ ] Strength
[ ] Average
5/7
[ ] Weakness
Engages with peers Select one
[ ] Strength
[ ] Average
[ ] Weakness
General Behavior and Conduct
Exceptional work ethic Select one
[ ] Strength
[ ] Average
[ ] Weakness
Excellent manners Select one
[ ] Strength
[ ] Average
[ ] Weakness
Positive role model Select one
[ ] Strength
[ ] Average
[ ] Weakness
Shows great concern for school Select one
[ ] Strength
[ ] Average
[ ] Weakness
Involved in school activities Select one
[ ] Strength
[ ] Average
6/7
[ ] Weakness
Completion
General Observations / Recommendations Text answer
Name & Signature of Teacher Signature
Date: / /
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