Extracurricular Activity Success Assessment
Evaluate and record the success and outcomes of students participating in extracurricular educational activities.
Participant Full Name
*
First Name
Last Name
Activity Name
*
Date of Activity
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Role in Activity
*
Please Select
Participant
Team Leader
Organizer
Volunteer
Other
Type of Activity
*
Please Select
Sports
Arts & Culture
Science & Technology
Community Service
Academic Club
Other
Assessment of Key Competencies
*
Rows
Needs Improvement
Satisfactory
Good
Excellent
Leadership
1
2
3
4
Teamwork
5
6
7
8
Communication Skills
9
10
11
12
Initiative & Creativity
13
14
15
16
Responsibility
17
18
19
20
Problem Solving
21
22
23
24
Level of Engagement
*
1
2
3
4
5
Achievement of Activity Goals
*
Not Achieved
1
2
3
4
Fully Achieved
5
1 is Not Achieved, 5 is Fully Achieved
What were the participant's main strengths during the activity?
Areas for Improvement or Recommendations
Evaluator's Full Name
*
First Name
Last Name
Evaluator's Email Address
*
example@example.com
Submit Assessment
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