Pre-IB CAS Form

CAS: Activity Self-evaluation Form

Submit To: Lindsay Loftin CAS Coordinator

Name:_____________________________

Name of Activity/Project:______________________ Number of Hours:_____

1) Summarize what you did in this activity and how you interacted with others.

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

2) What did you learn about yourself and others through this activity? What

abilities, attitudes, and values have you developed through this activity?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

3) How did this activity benefit others?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

4) How can you apply what you have learned in other life situations?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Student’s Signature__________________________ Date: ___________________

Robert E. Lee High School IB Prep Program

June 2006 – April 2008

The activity leader should complete and mail this completed form to Lindsay Loftin at Robert E. Lee High School.

Thank you so much for working with students at Robert E. Lee High School. We value your opinion, so please answer the questions below. If you should have any immediate problems or concerns please, email me at Lindsay.Loftin@tylerisd.org. You may also leave me a voice message on my school phone by calling 903-262-2761.

1) Name of the organization that the student volunteered or participated in.

_____________________________________________________________________

2) Dates and times of service.

_____________________________________________________________________

3) Punctuality and attendance.

_____________________________________________________________________

4) Effort and commitment.

_____________________________________________________________________

5) Student supervisor’s name.

_____________________________________________________________________

6) Student supervisor’s phone number and email address.

_____________________________________________________________________

Student supervisor’s signature__________________________ Date:_____________

Following completion of student service, please mail this sheet directly to:

Lindsay Loftin 411 ESE Loop 323 Tyler, Texas 75701