INTERNATIONAL BACCALAUREATE

CAS ACTIVITY EVALUATION FORM

Student Name:________________________________________________________________
Name of Activity:______________________________________________________________
Name of Organization:_________________________________________________________
Date(s) of Activity:_______________________ Approximate # of Hours: _________________
Length of Activity (weeks / days):_________________________________________________
This Activity is (check all that apply): Creative: _______ Action:_______ Service:________

DESCRIPTION OF ACTIVITY / REFLECTION:

Indicate which of the LEARNING OUTCOMES you feel are achieved with this activity:
__________ (1) Increased my awareness of my own strengths and areas of growth.
__________ (2) Undertaken new challenges.
__________ (3) Planned and initiated activities.
__________ (4) Worked collaboratively with others.
__________ (5) Shown perseverance and commitment in this activity
__________ (6) Engaged with issues of global importance.
__________ (7) Considered the ethical implications of my actions.
__________ (8) Developed new skills.
__________________________________________
Students Signature

_______________________
Date

INTERNATIONAL BACCALAUREATE
CAS ACTIVITY EVALUATION FORM

Student Name:________________________________________________________________
Name of Activity:______________________________________________________________
Name of Organization:_________________________________________________________
Date(s) of Activity:_______________________ Approximate # of Hours: _________________
Length of Activity (weeks / days):_________________________________________________
This Activity is (check all that apply): Creative: _______ Action:_______ Service:________

DESCRIPTION OF ACTIVITY / REFLECTION:

Indicate which of the LEARNING OUTCOMES you feel are achieved with this activity:
__________ (1) Increased my awareness of my own strengths and areas of growth.
__________ (2) Undertaken new challenges.
__________ (3) Planned and initiated activities.
__________ (4) Worked collaboratively with others.
__________ (5) Shown perseverance and commitment in this activity
__________ (6) Engaged with issues of global importance.
__________ (7) Considered the ethical implications of my actions.
__________ (8) Developed new skills.
__________________________________________
Students Signature

_______________________
Date

INTERNATIONAL BACCALAUREATE
CAS ACTIVITY EVALUATION FORM

Student Name:________________________________________________________________
Name of Activity:______________________________________________________________
Name of Organization:_________________________________________________________
Date(s) of Activity:_______________________ Approximate # of Hours: _________________
Length of Activity (weeks / days):_________________________________________________
This Activity is (check all that apply): Creative: _______ Action:_______ Service:________

DESCRIPTION OF ACTIVITY / REFLECTION:

Indicate which of the LEARNING OUTCOMES you feel are achieved with this activity:
__________ (1) Increased my awareness of my own strengths and areas of growth.
__________ (2) Undertaken new challenges.
__________ (3) Planned and initiated activities.
__________ (4) Worked collaboratively with others.
__________ (5) Shown perseverance and commitment in this activity
__________ (6) Engaged with issues of global importance.
__________ (7) Considered the ethical implications of my actions.
__________ (8) Developed new skills.
__________________________________________
Students Signature

_______________________
Date

INTERNATIONAL BACCALAUREATE
CAS ACTIVITY EVALUATION FORM

Student Name:________________________________________________________________
Name of Activity:______________________________________________________________
Name of Organization:_________________________________________________________
Date(s) of Activity:_______________________ Approximate # of Hours: _________________
Length of Activity (weeks / days):_________________________________________________
This Activity is (check all that apply): Creative: _______ Action:_______ Service:________

DESCRIPTION OF ACTIVITY / REFLECTION:

Indicate which of the LEARNING OUTCOMES you feel are achieved with this activity:
__________ (1) Increased my awareness of my own strengths and areas of growth.
__________ (2) Undertaken new challenges.
__________ (3) Planned and initiated activities.
__________ (4) Worked collaboratively with others.
__________ (5) Shown perseverance and commitment in this activity
__________ (6) Engaged with issues of global importance.
__________ (7) Considered the ethical implications of my actions.
__________ (8) Developed new skills.
__________________________________________
Students Signature

_______________________
Date

INTERNATIONAL BACCALAUREATE
CAS ACTIVITY EVALUATION FORM

Student Name:________________________________________________________________
Name of Activity:______________________________________________________________
Name of Organization:_________________________________________________________
Date(s) of Activity:_______________________ Approximate # of Hours: _________________
Length of Activity (weeks / days):_________________________________________________
This Activity is (check all that apply): Creative: _______ Action:_______ Service:________

DESCRIPTION OF ACTIVITY / REFLECTION:

Indicate which of the LEARNING OUTCOMES you feel are achieved with this activity:
__________ (1) Increased my awareness of my own strengths and areas of growth.
__________ (2) Undertaken new challenges.
__________ (3) Planned and initiated activities.
__________ (4) Worked collaboratively with others.
__________ (5) Shown perseverance and commitment in this activity
__________ (6) Engaged with issues of global importance.
__________ (7) Considered the ethical implications of my actions.
__________ (8) Developed new skills.
__________________________________________
Students Signature

_______________________
Date

INTERNATIONAL BACCALAUREATE
CAS ACTIVITY EVALUATION FORM

Student Name:________________________________________________________________
Name of Activity:______________________________________________________________
Name of Organization:_________________________________________________________
Date(s) of Activity:_______________________ Approximate # of Hours: _________________
Length of Activity (weeks / days):_________________________________________________
This Activity is (check all that apply): Creative: _______ Action:_______ Service:________

DESCRIPTION OF ACTIVITY / REFLECTION:

Indicate which of the LEARNING OUTCOMES you feel are achieved with this activity:
__________ (1) Increased my awareness of my own strengths and areas of growth.
__________ (2) Undertaken new challenges.
__________ (3) Planned and initiated activities.
__________ (4) Worked collaboratively with others.
__________ (5) Shown perseverance and commitment in this activity
__________ (6) Engaged with issues of global importance.
__________ (7) Considered the ethical implications of my actions.
__________ (8) Developed new skills.
__________________________________________
Students Signature

_______________________
Date

INTERNATIONAL BACCALAUREATE
CAS ACTIVITY EVALUATION FORM

Student Name:________________________________________________________________
Name of Activity:______________________________________________________________
Name of Organization:_________________________________________________________
Date(s) of Activity:_______________________ Approximate # of Hours: _________________
Length of Activity (weeks / days):_________________________________________________
This Activity is (check all that apply): Creative: _______ Action:_______ Service:________

DESCRIPTION OF ACTIVITY / REFLECTION:

Indicate which of the LEARNING OUTCOMES you feel are achieved with this activity:
__________ (1) Increased my awareness of my own strengths and areas of growth.
__________ (2) Undertaken new challenges.
__________ (3) Planned and initiated activities.
__________ (4) Worked collaboratively with others.
__________ (5) Shown perseverance and commitment in this activity
__________ (6) Engaged with issues of global importance.
__________ (7) Considered the ethical implications of my actions.
__________ (8) Developed new skills.
__________________________________________
Students Signature

_______________________
Date

INTERNATIONAL BACCALAUREATE
CAS ACTIVITY EVALUATION FORM

Student Name:________________________________________________________________
Name of Activity:______________________________________________________________
Name of Organization:_________________________________________________________
Date(s) of Activity:_______________________ Approximate # of Hours: _________________
Length of Activity (weeks / days):_________________________________________________
This Activity is (check all that apply): Creative: _______ Action:_______ Service:________

DESCRIPTION OF ACTIVITY / REFLECTION:

Indicate which of the LEARNING OUTCOMES you feel are achieved with this activity:
__________ (1) Increased my awareness of my own strengths and areas of growth.
__________ (2) Undertaken new challenges.
__________ (3) Planned and initiated activities.
__________ (4) Worked collaboratively with others.
__________ (5) Shown perseverance and commitment in this activity
__________ (6) Engaged with issues of global importance.
__________ (7) Considered the ethical implications of my actions.
__________ (8) Developed new skills.
__________________________________________
Students Signature

_______________________
Date

INTERNATIONAL BACCALAUREATE
CAS ACTIVITY EVALUATION FORM

Student Name:________________________________________________________________
Name of Activity:______________________________________________________________
Name of Organization:_________________________________________________________
Date(s) of Activity:_______________________ Approximate # of Hours: _________________
Length of Activity (weeks / days):_________________________________________________
This Activity is (check all that apply): Creative: _______ Action:_______ Service:________

DESCRIPTION OF ACTIVITY / REFLECTION:

Indicate which of the LEARNING OUTCOMES you feel are achieved with this activity:
__________ (1) Increased my awareness of my own strengths and areas of growth.
__________ (2) Undertaken new challenges.
__________ (3) Planned and initiated activities.
__________ (4) Worked collaboratively with others.
__________ (5) Shown perseverance and commitment in this activity
__________ (6) Engaged with issues of global importance.
__________ (7) Considered the ethical implications of my actions.
__________ (8) Developed new skills.
__________________________________________
Students Signature

_______________________
Date

INTERNATIONAL BACCALAUREATE
CAS ACTIVITY EVALUATION FORM

Student Name:________________________________________________________________
Name of Activity:______________________________________________________________
Name of Organization:_________________________________________________________
Date(s) of Activity:_______________________ Approximate # of Hours: _________________
Length of Activity (weeks / days):_________________________________________________
This Activity is (check all that apply): Creative: _______ Action:_______ Service:________

DESCRIPTION OF ACTIVITY / REFLECTION:

Indicate which of the LEARNING OUTCOMES you feel are achieved with this activity:
__________ (1) Increased my awareness of my own strengths and areas of growth.
__________ (2) Undertaken new challenges.
__________ (3) Planned and initiated activities.
__________ (4) Worked collaboratively with others.
__________ (5) Shown perseverance and commitment in this activity
__________ (6) Engaged with issues of global importance.
__________ (7) Considered the ethical implications of my actions.
__________ (8) Developed new skills.
__________________________________________
Students Signature

_______________________
Date

INTERNATIONAL BACCALAUREATE
CAS ACTIVITY EVALUATION FORM

Student Name:________________________________________________________________
Name of Activity:______________________________________________________________
Name of Organization:_________________________________________________________
Date(s) of Activity:_______________________ Approximate # of Hours: _________________
Length of Activity (weeks / days):_________________________________________________
This Activity is (check all that apply): Creative: _______ Action:_______ Service:________

DESCRIPTION OF ACTIVITY / REFLECTION:

Indicate which of the LEARNING OUTCOMES you feel are achieved with this activity:
__________ (1) Increased my awareness of my own strengths and areas of growth.
__________ (2) Undertaken new challenges.
__________ (3) Planned and initiated activities.
__________ (4) Worked collaboratively with others.
__________ (5) Shown perseverance and commitment in this activity
__________ (6) Engaged with issues of global importance.
__________ (7) Considered the ethical implications of my actions.
__________ (8) Developed new skills.
__________________________________________
Students Signature

_______________________
Date