Student Name: ________________________
Date: ________________________
Unit/Topic: ________________________

Step 1: Learning Goal

What skill or concept do I want to master?

Why is this goal important to me?

Step 2: Pre-Assessment

My current level (from quiz, IXL diagnostic, or teacher feedback):
☐ I need extra practice
☐ I am approaching mastery
☐ I have mastered this and want enrichment

Step 3: Action Plan

What activities will I do to achieve my goal?

• ☐ Practice problems from class or homework

• ☐ Use IXL or other online math tools

• ☐ Work on enrichment or challenge problems

• ☐ Collaborate with peers or ask the teacher for guidance

• ☐ Other: __________________________

Step 4: Resources Needed

What materials or support will I need to succeed?

Step 5: Timeline

When will I complete each step?

• Step 1: ________________________

• Step 2: ________________________

• Step 3: ________________________

Step 6: Reflection

What did I learn? What was challenging?

Next Steps / New Goal:

Teacher Signature: ________________________

Student Signature: ________________________

Student Name: ___________________________
Grade: ___________
Subject / Unit: ___________________________
Time Frame: ___________________________

1. Learning Goal

What do you want to learn or accomplish?

My learning goal is:
I will __________________________________________

2. Success Criteria

How will you know you have been successful?

I will know I have met my goal when I can:

• ☐ Clearly explain my learning using accurate information
  
  

• ☐ Use evidence or examples to support my ideas
  
  

• ☐ Organize my work in a clear and logical way
  
  

• ☐ Demonstrate effort, creativity, or deeper thinking
  
  

3. Learning Activities (Choose at least TWO)

What will you do to reach your goal?

☐ Conduct research using books or reliable online sources
☐ Create a presentation, report, or visual explanation
☐ Design a model, experiment, or investigation
☐ Create an infographic, diagram, or concept map
☐ Other: ___________________________________________

4. Resources and Supports

What tools or help will you use?

• ☐ Classroom materials
  
  

• ☐ Online resources
  
  

• ☐ Teacher conferences
  
  

• ☐ Peer collaboration
  
  

• ☐ Graphic organizers or planning tools
  
  

5. Timeline and Checkpoints

How will you manage your time?

• Research completed by: ___________________
  
  

• Draft or progress check-in by: ______________
  
  

• Final product due: ________________________
  
  

6. Evidence of Learning

How will you show what you learned?

I will demonstrate my learning by creating:

7. Reflection

Think about your learning process.

• What strategies helped you succeed?
  

  
  

• What challenges did you face and how did you overcome them?
  

  
  

• How did this goal stretch or challenge your thinking?
  

  
  

8. Agreement

By signing below, I agree to work toward my learning goal and take responsibility for my learning.

Student Signature: _______________________ Date: __________

Teacher Signature: _______________________ Date: __________

Student Name: ___________________________
Teacher: Dr. MeDrano
Class/Period: ___________________________
Date Range: ___________________________

1. Learning Goal (Student Generated):

What do you want to improve, explore, or master?

My Goal:

2. Rationale (WHY This Matters to Me):

Why is this goal important to your learning?

3. Learning Plan (Content & Process):

Content Focus (Skills/Concepts):
☐ Literary Analysis (Theme, Symbolism, etc.).
☐ Writing (Argument, Narrative, Informational).
☐ Research/Inquiry.
☐ Vocabulary/Language.
☐ Other: ___________________________

Process (How YOU Will Learn):
☐ Independent Reading/Research.
☐ Small group collaboration.
☐ Teacher Conference/Check ins.
☐ Digital tools (iPad, Slides, etc.).
☐ Creative exploration (Art, Media, Design).

4. Product Options (How YOU Will Show Learning):

Choose ONE or propose your own:

☐ Analytical Essay.
☐ Presentation (Slides/Video/Podcast).
☐ Creative Project (Visual, Model, Storyboard).
☐ Research Report.
☐ Teaching Lesson to Peers.
☐ Other (approved): ___________________________

5. Steps & Timeline (Goal Setting Plan):

Step

              What I Will Do

Due Date

1

__________________________

__________

2

__________________________

__________

3

__________________________

__________

4

__________________________

__________

6. Resources Needed:

☐ Books/Articles.
☐ Teacher support.
☐ Technology (iPad, Apps).
☐ Peer collaboration.
☐ Other: ___________________________

7. Work Expectations (Accountability):

I agree to:

• Stay on task and use time productively.

• Follow classroom procedures and expectations.

• Seek help appropriately (Peer - Teacher).

• Show consistent effort and independence.

Student Initials: ________

8. Checkpoints & Teacher Feedback:

Date

      Progress / Feedback

________

__________________________

________

__________________________

9. Self-Reflection (Complete at End):

What did I learn?

How well did I meet my goal?

What will I improve next time?

10. Teacher Evaluation:

☐ Exceeds Expectations
☐ Meets Expectations
☐ Approaching

Comments:

Signatures

Student: ___________________________
Teacher: ___________________________

Student Name: ________________________
Unit Topic: ________________________
Dates: ________________________

My Learning Goal

What do I want to learn in this unit?

What I Already Know (Pre-Assessment Reflection)

What do I already understand about this topic?

My Learning Choices (Choose 1–2)

I will complete:

☐ Science reading + notes
☐ Hands-on investigation/lab
☐ Video + reflection questions
☐ Teacher-guided small group
☐ Enrichment challenge task (advanced thinking)
☐ Independent research project

My Product (How I Will Show My Learning)

I will demonstrate my understanding by:

☐ Poster / model
☐ Lab report
☐ Presentation (Google Slides / oral)
☐ Short video explanation
☐ Written explanation
☐ Other: ________________________

Success Criteria

I will be successful when I can:

• Explain key science concepts clearly

• Use correct science vocabulary

• Support my ideas with evidence

• Complete my chosen task with effort and accuracy

Teacher Checkpoints

☐ Check 1
☐ Check 2
☐ Final Review

Teacher Feedback:

Reflection

What did I learn? What was challenging?

Name: ___________________________
Date: ___________________________

Subject: Reading / Math / Writing (circle one)

My Learning Goal (4th Grade Example)

I will improve my ability to identify the main idea and key details in nonfiction text.

Or

I will improve my multiplication fluency with 2-digit by 1-digit numbers.

Why this goal is important to me:

It will help me understand what I read better and do well on tests and class assignments.

Success Criteria (How I will know I met my goal)

• I can identify the main idea in a passage with at least 80% accuracy

• I can support my answer with at least 2 key details

• I can explain my thinking to my teacher or partner

Steps I will take to reach my goal:

1. I will use a graphic organizer to break down text or math problems

2. I will practice during independent work time for at least 10 minutes daily

3. I will ask questions during small group instruction when I am confused

Strategies I will use:

⬜ Graphic organizers
⬜ Partner reading or peer help
⬜ Teacher conferencing
⬜ Online practice (such as IXL or assigned website)
⬜ Manipulatives or visuals

Timeline

I will work on this goal for 2 weeks and check my progress every Friday.

Check-In Reflection (Weekly)

What progress have I made this week?

What is still challenging for me?

What will I do next to improve?

Final Reflection

Did I meet my goal? How do I know?

What did I learn about myself as a learner?

Personalized Learning Plan for Differentiated Instruction

Student Name: _________________________
Date: _________________________
Subject/Topic: _________________________
Completion Date: _________________________

1. Learning Goal (Content)

What concept, skill, or standard am I working on?

____________________________________________________________________________

What do I already know about this topic?

_______________________________________________________________________________

2. My Learning Plan (Process)

I agree to complete the following learning activities:

☐ Activity 1: ___________________________________

☐ Activity 2: ___________________________________

☐ Activity 3: ___________________________________

How will I complete my work?

☐ Independently

☐ With a partner

☐ Small group

☐ Teacher conference

☐ Other: ______________________________

3. Resources and Materials

Materials I will use:

☐ Textbook

☐ Articles/Reading Materials

☐ Technology/Digital Resources

☐ Other: ______________________________

4. Product Options (How I Will Show My Learning)

Choose one or more products:

☐ Written Response

☐ PowerPoint Presentation

☐ Poster/Infographic

☐ Research Project

☐ Other: ______________________________

5. Work Habits and Learning Responsibilities

I agree to:

☐ Stay on task during work time.

☐ Follow classroom expectations.

☐ Use materials responsibly.

☐ Ask for help when needed.

☐ Complete work by the agreed deadline.

☐ Demonstrate perseverance when tasks are challenging.

☐ Respect the learning environment and others.

☐ Monitor my own progress.

6. Success Criteria

I will know I have been successful when:

☐ I meet the learning target.

☐ I can explain what I learned.

☐ I demonstrate mastery of the skill or concept.

☐ My product meets the rubric requirements.

☐ I complete all agreed-upon tasks.

7. Progress Monitoring

Check-In Date ________________________________________________

Progress Notes___________________________________

Teacher Initials _________________________

8. Reflection

What did I learn?

What worked well for me?

What challenges did I overcome?

What would I do differently next time?

Agreement

I understand the expectations of this learning contract and agree to complete the work to the best of my ability.

Student Signature: _________________________

Teacher Signature: _________________________

Parent/Guardian Signature (Optional): _________________________

Purpose of This Learning Contract

This contract supports differentiation of content, process, and product by outlining individualized learning goals, materials, learning activities, and product choices. It encourages student ownership, independence, responsibility, and appropriate work habits while ensuring that instructional objectives and learning standards are met.