R6173 Form 3

PORTLAND PUBLIC SCHOOLS

Portland, Connecticut

HOMEBOUND-PROGRESS REPORT

Homebound Tutor:

Please be sure to fill in all the information below:

Subject: _______________________________________Classroom Teacher: __________________________________________

Tutoring performed at: _________________________________________Date: _________________________________________

Date Homebound Tutoring Ends: _______________________________________________________________________________

Student: _________________________________________Grade: ____________________________

Report covers the homebound instruction period from _______ to ________

Material Covered:

Progress Noted:

Tutor’s Name: __________________________________________________________________

Secondary -- To be completed bi-weekly for each subject tutored.

Elementary -- To be completed monthly.

Return to: (Designated Staff) ___________________________________________________________

School: ___________________________________________________________________________