Reflections Worksheet
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Month
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Day
Year
Date Picker Icon
Full Name
First Name
Last Name
E-mail
Teacher who exited
Mr or Mrs
Last Name
Mentor Group Teacher
What subject were you removed from?
What happened in the class for you to be exited?
What were you thinking of at the time?
On a scale of 1-5, do you feel that you deserved to be exited from the class?
Please Select
1 - No it wasn't my fault
2
3
4
5 - Yes the teacher was correct
Who has been affected by what you have done and in what way?
When will you visit the teacher to be welcomed back into class?
What will you say to the teacher?
Submit
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