Test Retake Notice Form With Reflection & Goal Setting

This 1-page Test Retake Form is designed for upper middle school and high school students who want to retake a test after a lower than expected result. To increase student self-reflection, diligence and advocacy, this form requires students to perform 4 major tasks before earning the right to retake an assessment:

1. Record their name, class, assessment title, and the grade they received
2. Reflect on their subject knowledge, study strategies, and readiness for the test
3. Describe the steps they will take to better understand the material or skills taught
4. Obtain parent and teacher signatures to assure that honest communication about their test result has occurred

Philosophy/How I Use This Product:

My original test retake policy was that any student who earned a score below 70% on a major test could retake an equivalent test to improve their grade. However, I became increasingly frustrated with students who took this policy for granted and came to the test retake session just as unprepared as they were for the first. I created this detailed form to help students understand that a test retake is something that must be earned through better self-reflection, better study strategies, and better self-advocacy if there were concepts they did not understand.

If a student would like to retake a test, they must first fill in the Test Retake Form in detail, which involves self-reflection and goal-setting. Secondly, the student must complete two review documents that I distribute to my students one week prior to the test (Unit Review, Sample Unit Test) that are optional the first time around. Thirdly, the student must get 3 signatures at the bottom of the Test Retake Form: their own, their parent(s), and their teacher to ensure that they have properly communicated their test result and plan of action with all parties.

Test Retake Form Sections:

Part 1 - Basic Information:

• Student information (name, class)
• Test information (title, earned grade)

Part 2 - Self-Reflection:

• Student rates themselves on a scale of 0 - 4 on the questions listed below:
  • I completed all of my class assignments for this unit.
  • I completed the Unit Review document in detail and checked it.
  • I completed the optional Sample Test in detail and checked it.
  • I used flash cards or Quizlets to study.
  • I had my parent(s) or others quiz me on unit topics.
  • I understood all of the unit topics before I took the test.
  • I asked for extra help about topics I didn’t fully understand.

Part 3 - Next Steps:

• Student describes the step(s) they will take to better understand course material.
• Student must check off that they have completed the following documents:
  • Original test (with corrections made)
  • Unit Review document (required)
  • Sample Test document (required)

Part 4 - Communication:

• Student is required to get 3 signatures in order to earn a retake:
  • Student signature (ensures retake form and all documents are complete)
  • Parent signature (ensures parent-student communication has occurred)
  • Teacher signature (ensures retake form and all documents have been received)

Downloadable in 2 Formats:

• I realize that most teachers utilize different policies and documents in their classrooms. As such, this product comes in a static PDF document and fully-editable Word document.
• Feel free to download the full PDF preview to see EXACTLY what you are getting. No surprises!

Part of a Line of Class Resource Products:

This product is part of my new Class Documents line of resources, which consists of materials that I use on a daily basis in my classroom to help students understand my expectations and to simplify frequent tasks such as communicating missed homework assignments to parents, reporting detentions, and providing late slips. Links to these documents are found below.

You Might Also Like These Class Documents Products:

BUNDLE - Class Documents

Form - Missing Homework Notice

Form - Detention Notice

Form - Test Retake

Form - Late Slip Cards

Form - Student Reflection

Form - Behavior Tracking Sheet (Daily and Weekly)

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Terms of Use:

Copyright © Douglas Enns. All rights reserved by author. This product is to be used by the original downloader only. Copying for more than one teacher, classroom, department, school, or school system is prohibited. This product may not be distributed or displayed digitally for public view. Failure to comply is a copyright infringement and a violation of the Digital Millennium Copyright Act (DMCA). Clipart and elements found in this document are copyrighted and cannot be extracted and used outside of this file without permission or license. Intended for classroom and personal use ONLY.