This free form is for teachers to keep a record of students who have less than satisfactory grades or conduct in their class. This is a word document, so you may type on it. Then print it out. You may also duplicate it according to the number of class periods and grading periods you have.
I use this in my class. I type the information (grade, student's name, etc.). Then, I get the students to sign and the date the form. When the student returns the form, I open up my binder and record the date that it was returned.