This is an assessment score card for EngageNY's 6th Grade Math Mid-Module Assessment 3. There are three columns that teachers may fill out (test question number, standard(s), and notes and attach to the assessment. Teachers may use this as communication to parents, for student portfolios or assist in recording report card grades.
The third page has the Common Core State Standards listed, each with a definition according the CCSS website.
This document is in PDF format.