Monthly Dorm Report-Brazil

Monthly Dorm Report
School Name *
Report for the Month of *
Student Name *
International Student Coordinator
Monthly Evaluation 1 = Needs to Improve, 2 = Satisfied, 3 = Acceptable, 4 = Very Satisfied

1. Student respects and abides by the dorm rules. *

	1	2	3	4

1 is Need to Improve, 4 is Very Satisfied

2. Overall, the student demonstrates healthy sleeping habits. *

	1	2	3	4

1 is Needs to Improve, 4 is Very Satisfied

3. Student demonstrates good personal hygiene. *

	1	2	3	4

1 is Needs to Improve, 4 is Very Satisfied

4. Student cleans his/her own room and bathroom. *

	1	2	3	4

1 is Needs to Improve, 4 is Very Satisfied

5. Student watches TV, news, or movies. *

	1	2	3	4

1 is Needs to Improve, 4 is Very Satisfied

6. Student goes to the grocery store, shopping mall, and/or the market. *

	1	2	3	4

1 is Needs to Improve, 4 is Very Satisfied

7. Student participates in organized dorm activities. *

	1	2	3	4

1 is Needs to Improve, 4 is Very Satisfied

8. Did the student arrange any travel this month? *

	1	2	3	4

1 is Needs to Improve, 4 is Very Satisfied

Did the student arrange any travel this month?

Yes No
9. Which subject(s) seems to be most improved this month? *
10. Subjects you think the student would be benefit from additional tutoring in? (Multiple choices) *

ENGLISH LAN/ELA/ESL ALG/ALGEBRA GEOMETRY AMERICAN GOV/POL AMERICAN HISTORY BIO/BIOLOGY CHEM/CHEMISTRY PHYSICS PE THEOLOGY Others
11. Does the student participate in extracurricular activities at school? *

Yes No
12. Which extracurricular activities is the student interested in? (Multiple choices) *

Art Community Service Language Leadership Media and Technology Music Religion Social Activity Speech and Political Sports and Recreation Study Club Others
Thank you so much for taking the time to answer all of these questions. Before you submit your answers, please don’t forget to upload 5 recent photos of our lovely student. The natural parents will definitely appreciate it.
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Please provide suggestions in the following areas:
1. Daily Life:
2. Language:
3. Academics:
4. Other:
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