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NAME OF STUDENT
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DATE OF ACTIVITY
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NAME/FOCUS OF ACTIVITY
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NUMBER OF CHILDREN
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AGE RANGE OF CHILDREN
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ORIGINATING IDEA BASED ON OBSERVATION:
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LEARNING ANTICIPATED
(MUST be completed, according to program model/approach)
(REFERENCES INCLUDED)
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DEVELOPMENTAL SIGNIFICANCE
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HIGH SCOPE KEY DEVELOPMENTAL INDICATOR (KDI)
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WHERE WILL THE ACTIVITY TAKE PLACE
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WHEN IN THE DAILY ROUTINE/SCHEDULE WILL THIS OCCUR
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MATERIALS: (Be Specific)
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BEGINNING
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MIDDLE
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END/TRANSITION
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