For students to complete when they are missing a homework assignment. Can be adapted to your classroom or for class work/group work/etc.
Some teachers keep these in a binder, some will require a parent signature, some even turn this into a carbon copy form. Depending on your consequences this may or may not be helpful. I usually have a 3 strikes rule, each quarter if a student has 3 or more they get a detention or have to stay after school with me. I usually always give an additional assignment unless the work load was too much to begin with or they did not have technology at home to complete the homework- it just depends on the situation.
The idea is from Harry Wong.