You may edit to suit your needs. I created this document to send home with our homework packets. I staple this form at the top of the homework packet. It allows me to know that parents have received the homework packet. It is another means of communication with parents. Knowing parents have received the student's homework means there are less "surprises" when grades go home. :-) I have also used the comment section for students to write their own goal for the following week.