Independent Study In Physical Education - Activity Record

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SMMUSD Off-Campus Independent Study Physical Education Application Packet

STUDENT NAME

_____________________________

ID: ___________

HOUSE: _______

INDEPENDENT STUDY IN

PHYSICAL EDUCATION

ACTIVITY RECORD

REVISED August 2014

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - OFFICE USE ONLY- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Activity Record reviewed by

, 20

Grade Earned

PASS

FAIL (

)

due to the following reason(s)

Reviewer Signature

Date

Important Dates

Attendance and performance, and activity records must be submitted to the administrator in charge no later than 1 week

prior to the end of the semester for which you have been approved. Failure to complete and/or turn in on time will result in