1. Scheduled Date of re-test
Elementary Summative Mastery Ticket
This is a ticket to make a reattempt.
This form should be completed and given to your teacher on the day of the re-assessment.
Please choose at least TWO of these helpful ways to prepare for the re-test, and staple
ALL of your work to this paper.
I fixed or completed classroom work that received low scores.
I copied, reviewed, or rewrote notes from class..
I reread pages in my textbook and took notes, answered questions, or worked the problems.
I used an online resource to help prepare. (Website name :
Choose TWO of these items. I studied by:
making flashcards and reviewing with someone. Name:
studying with a partner. Name:
explaining the information, skill, or concept to an adult. Name:
having my parent or another adult re-explain the subject matter
playing an educational game approved by my teacher. Game name:
You should have completed at least FOUR items.
I understand that it is my responsibility to help myself prepare for the test.
Student signature Date:
I have monitored my child’s preparation for this retest and I feel that he/she is
prepared for the re-test.
Parent signature Date:
While we will always offer re-teaching opportunities, reassessment is limited to ONE per
subject every nine weeks. Reassessments do not rollover to the next nine weeks and WILL NOT be administered the last week of the grading period.
Student Name
Title of Summative
Score
Scheduled Date of re-test