DPA og Term 1

NAME: ___Bishr____________________________ HR: _____
Month:
September
List all physical activities participated in during the day.
Remember that students need to participate in a minimum of 30 minutes per day. Each activity must last at least 10 minutes.

Example: Dance class (70 min), walked at lunch (20 min), Soccer practice (80 min) Total
Minutes

Ex:
170 min
Week # 1
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

Week # 2
(Please Circle)

Met/ Not Met
___________
(HRT initials) M
T P.E. 75
W
Th P.E. 75
F

Week # 3
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

Week # 4
(Please Circle)

Met/ Not Met
___________
(HRT initials) M
T P.E. 75
W
Th P.E. 75
F

Week # 5
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

The student has MET/ NOT MET the DPA requirements for the above month.

HR Teacher Signature: _____________________________
NAME: ___Bishr____________________________ HR: _____
Month:
October
List all physical activities participated in during the day.
Remember that students need to participate in a minimum of 30 minutes per day. Each activity must last at least 10 minutes.

Example: Dance class (70 min), walked at lunch (20 min), Soccer practice (80 min) Total
Minutes

Ex:
170 min
Week # 1
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

Week # 2
(Please Circle)

Met/ Not Met
___________
(HRT initials) M
T P.E. 75
W
Th P.E. 75
F

Week # 3
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

Week # 4
(Please Circle)

Met/ Not Met
___________
(HRT initials) M
T P.E. 75
W
Th P.E. 75
F

Week # 5
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

The student has MET/ NOT MET the DPA requirements for the above month.

HR Teacher Signature: _____________________________
NAME: ___Bishr____________________________ HR: _____
Month:
November List all physical activities participated in during the day.
Remember that students need to participate in a minimum of 30 minutes per day. Each activity must last at least 10 minutes.

Example: Dance class (70 min), walked at lunch (20 min), Soccer practice (80 min) Total
Minutes

Ex:
170 min
Week # 1
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

Week # 2
(Please Circle)

Met/ Not Met
___________
(HRT initials) M
T P.E. 75
W
Th P.E. 75
F

Week # 3
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

Week # 4
(Please Circle)

Met/ Not Met
___________
(HRT initials) M
T P.E. 75
W
Th P.E. 75
F

Week # 5
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

The student has MET/ NOT MET the DPA requirements for the above month.

HR Teacher Signature: _____________________________
NAME: ___Bishr____________________________ HR: _____
Month:
December
List all physical activities participated in during the day.
Remember that students need to participate in a minimum of 30 minutes per day. Each activity must last at least 10 minutes.

Example: Dance class (70 min), walked at lunch (20 min), Soccer practice (80 min) Total
Minutes

Ex:
170 min
Week # 1
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

Week # 2
(Please Circle)

Met/ Not Met
___________
(HRT initials) M
T P.E. 75
W
Th P.E. 75
F

Week # 3
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

Week # 4
(Please Circle)

Met/ Not Met
___________
(HRT initials) M
T P.E. 75
W
Th P.E. 75
F

Week # 5
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

The student has MET/ NOT MET the DPA requirements for the above month.

HR Teacher Signature: _____________________________
NAME: ___Bishr____________________________ HR: _____
Month:
January
List all physical activities participated in during the day.
Remember that students need to participate in a minimum of 30 minutes per day. Each activity must last at least 10 minutes.

Example: Dance class (70 min), walked at lunch (20 min), Soccer practice (80 min) Total
Minutes

Ex:
170 min
Week # 1
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

Week # 2
(Please Circle)

Met/ Not Met
___________
(HRT initials) M
T P.E. 75
W
Th P.E. 75
F

Week # 3
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

Week # 4
(Please Circle)

Met/ Not Met
___________
(HRT initials) M
T P.E. 75
W
Th P.E. 75
F

Week # 5
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

The student has MET/ NOT MET the DPA requirements for the above month.

HR Teacher Signature: _____________________________
NAME: ___Bishr____________________________ HR: _____
Month:
February
List all physical activities participated in during the day.
Remember that students need to participate in a minimum of 30 minutes per day. Each activity must last at least 10 minutes.

Example: Dance class (70 min), walked at lunch (20 min), Soccer practice (80 min) Total
Minutes

Ex:
170 min
Week # 1
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

Week # 2
(Please Circle)

Met/ Not Met
___________
(HRT initials) M
T P.E. 75
W
Th P.E. 75
F

Week # 3
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

Week # 4
(Please Circle)

Met/ Not Met
___________
(HRT initials) M
T P.E. 75
W
Th P.E. 75
F

Week # 5
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

The student has MET/ NOT MET the DPA requirements for the above month.

HR Teacher Signature: _____________________________
NAME: ___Bishr____________________________ HR: _____
Month:
March
List all physical activities participated in during the day.
Remember that students need to participate in a minimum of 30 minutes per day. Each activity must last at least 10 minutes.

Example: Dance class (70 min), walked at lunch (20 min), Soccer practice (80 min) Total
Minutes

Ex:
170 min
Week # 1
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

Week # 2
(Please Circle)

Met/ Not Met
___________
(HRT initials) M
T P.E. 75
W
Th P.E. 75
F

Week # 3
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

Week # 4
(Please Circle)

Met/ Not Met
___________
(HRT initials) M
T P.E. 75
W
Th P.E. 75
F

Week # 5
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

The student has MET/ NOT MET the DPA requirements for the above month.

HR Teacher Signature: _____________________________
NAME: ___Bishr____________________________ HR: _____
Month:
April
List all physical activities participated in during the day.
Remember that students need to participate in a minimum of 30 minutes per day. Each activity must last at least 10 minutes.

Example: Dance class (70 min), walked at lunch (20 min), Soccer practice (80 min) Total
Minutes

Ex:
170 min
Week # 1
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

Week # 2
(Please Circle)

Met/ Not Met
___________
(HRT initials) M
T P.E. 75
W
Th P.E. 75
F

Week # 3
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

Week # 4
(Please Circle)

Met/ Not Met
___________
(HRT initials) M
T P.E. 75
W
Th P.E. 75
F

Week # 5
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

The student has MET/ NOT MET the DPA requirements for the above month.

HR Teacher Signature: _____________________________
NAME: ___Bishr____________________________ HR: _____
Month:
May
List all physical activities participated in during the day.
Remember that students need to participate in a minimum of 30 minutes per day. Each activity must last at least 10 minutes.

Example: Dance class (70 min), walked at lunch (20 min), Soccer practice (80 min) Total
Minutes

Ex:
170 min
Week # 1
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

Week # 2
(Please Circle)

Met/ Not Met
___________
(HRT initials) M
T P.E. 75
W
Th P.E. 75
F

Week # 3
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

Week # 4
(Please Circle)

Met/ Not Met
___________
(HRT initials) M
T P.E. 75
W
Th P.E. 75
F

Week # 5
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

The student has MET/ NOT MET the DPA requirements for the above month.

HR Teacher Signature: _____________________________
NAME: ___Bishr____________________________ HR: _____
Month:
June
List all physical activities participated in during the day.
Remember that students need to participate in a minimum of 30 minutes per day. Each activity must last at least 10 minutes.

Example: Dance class (70 min), walked at lunch (20 min), Soccer practice (80 min) Total
Minutes

Ex:
170 min
Week # 1
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

Week # 2
(Please Circle)

Met/ Not Met
___________
(HRT initials) M
T P.E. 75
W
Th P.E. 75
F

Week # 3
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

Week # 4
(Please Circle)

Met/ Not Met
___________
(HRT initials) M
T P.E. 75
W
Th P.E. 75
F

Week # 5
(Please Circle)

Met/ Not Met
___________
(HRT initials) M P.E. 75
T
W P.E. 75
Th
F P.E. 75

The student has MET/ NOT MET the DPA requirements for the above month.

HR Teacher Signature: _____________________________

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