This is a half-page form designed for students requesting a chair placement challenge (two half-page forms per printed page to save paper).
There are blanks for the challenger's name, the challengee (person being challenged), and the music to be used for the chair placement challenge. There is a separate box for the director's use only, including the challenge day, challenge time, and outcome of the chair challenge for record keeping purposes.
I have students fill out the upper section of the challenge form using our classroom guidelines for chair challenges. These are then posted on the wall under a labeled day of the week (Monday through Friday) so that students are given a visual reminder of their challenge day. A completed copy is kept in a folder for my personal future reference.