SAMPLE

XYZ Charter

719 Fourth Street

Anytown, TX

555/555-1234

Student Conference Record for Reading

Date: _________________________________

Student Name: _______________________________________________________________

What is the title of the book you are reading? ______________________________________

Who is the author? ___________________________________________________________

Have you read other books by the author? ___Yes ___No If so, which ones? ____________

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Why did you choose this book? (Use extra pages if needed) ___________________________

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Tell me something about the story so far. (Use extra pages if needed) ___________________

___________________________________________________________________________

___________________________________________________________________________

What would you like to do when you finish this book? (Options: Write a report, draw a poster, give an oral report to the class, write a letter to the author, etc.)

___________________________________________________________________________

Would you like to read another book by this same author? Why? ______________________

___________________________________________________________________________

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Teacher Comments: __________________________________________________________

___________________________________________________________________________

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