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Name:   _ __________________________________________________                      
 
                                                            A ssignment   #   _ _____  
Teacher:   M iss   M adruga  
Course:   A VID   S eminar   P eriod   _ ____    
 
 
 
 
 
                                          S core:   _ ___________  
Date:   _ ________________________________  
ESAT   A VID   T UTORIAL   R EQUEST   F ORM   #   _ _____  
 
PROBLEM   S UBJECT:                                                                                     T EACHER:                                                                                                                   P ER:                       G RADE:  
Higher   L evel   Q uestion:  
 
 
 
 
 
 
Costa’s   L evel:   _ _____   S ource   f or   Q :       H W     /     C Ns     /       T est   o r   Q uiz     /     O ther         A ssignment   # /Date:   _ _________      
Know:   W hat   I   k now   a bout   t he   p roblem   i s…I   t ried   t o   a nswer   m y   q uestion   b y…  
 
 
 
 
 
 
What:   I   a m   c onfused   a bout…I   n eed   h elp   f iguring   o ut…I   w ant   t o   u nderstand…  
 
 
 
 
 
Learned:   C omplete   t he   R eflection   w ith   a   s tep-­‐by-­‐step   e xplanation   o f   y our   d iscovery:   T oday,   I   l earned…  
 
 
 
 
 
 
 
 
 
 
TRF   R ubric  
4   A dvanced  
3   P roficient  
2   B asic  
1   B elow   B asic  
Question   a nd   K WL   r eflects   a  
Question   a nd   K WL   r eflects   a  
Question   a nd   K WL   r eflects   a  
Question   a nd   K WL   r eflects   a  
multi-­‐Level   2 /3   p rompt   w ith   k ey  
single   L evel   2   o r   3   p rompt.  
Level   1   p rompt   w ith   C osta’s  
Level   1 /incomplete   q uestion  
details.   C osta’s   L evel   a nd   s ource  
Costa’s   L evel   a nd   s ource   o f   t he  
Level   i dentified.   T he   s ource   o f  
without   C osta’s   L evel   i dentified.  
of   t he   q uestion   a re   s pecifically  
question   a re   i dentified.   K WL   i s  
the   q uestion   i s   n ot   h onestly  
The   s ource   o f   t he   q uestion   i s   n ot  
identified.   K WL   i s   c lear   a nd  
clear   b ut   s hould   b e   m ore  
selected   a nd   t he   K WL   i s   n ot  
selected   a nd   t he   K WL   i s   n ot  
complete.  
descriptive.  
clear.  
complete.  
Reflection   i s   a t   l east   4   c omplete  
Reflection   i s   a t   l east   3  
Reflection   i s   e xplained   i n   2  
Reflection   i s   i ncomplete   a nd  
sentences   w ith   s pecific   a nd   a  
sentences   w ith   s pecific   d etails  
complete   s entences   a nd   g ives  
hardly   g ives   d etails   a bout   w hat  
detailed   l earning   d escription.  
about   w hat   w as   l earned.   I t  
some   d etail   a bout   w hat   w as  
was   l earned.   I t   i s   t oo   g eneral   a nd  
The   s tep-­‐by-­‐step   s olution   t o   t he  
explains   t he   s tep-­‐by-­‐step  
learned.   D oes   n ot   t horoughly  
does   n ot   e xplain   t he   a nswer   t o  
problem   h as   a   s pecific   e xample.  
process   i n   s olving   t he   p roblem.      
explain   t he   a nswer   t o   t he  
the   q uestion.  
Accountability   i s   a ccurately  
Accountability   i s   a ccurately  
question   a nd   i s   t oo   g eneral.  
Accountability   d oes   n ot  
reflected   a nd   c omplete   t o  
reflected   a nd   c omplete   t o   s how  
Accountability   w as   s tarted  
accurately   r eflect   t oday’s  
describe   a ll   m embers’  
most   m embers’   p articipation.  
accurately   b ut   d oes   n ot   r eflect  
participation   o r   i s   i ncomplete.  
participation.  
most   m embers’   p articipation.  

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