Reading Extension Activities Form
Document and reflect on your reading extension activities. Please complete all relevant sections.
Student Full Name
*
First Name
Last Name
Class/Grade
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Please Select
Grade 1
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Grade 5
Grade 6
Grade 7
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Date of Activity
*
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Book Title
*
Book Author
*
Type of Extension Activity
*
Book Report
Creative Writing (e.g., alternate ending, letter to character)
Art Project (e.g., drawing, poster, diorama)
Oral Presentation
Dramatic Performance (e.g., skit, monologue)
Research Project
Other
Brief Description of Your Activity
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Upload a File or Photo of Your Activity (optional)
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What did you enjoy or learn from this activity?
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How would you rate your engagement with this activity?
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Teacher Comments
Suggestions for Future Reading Activities
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