Jefferson Elementary School Block J Award 2024-25
First Semester Application

Name: _________________________	Grade: ________	Room #: ________ General Rules:
1. Student must have completed the season or activity or be a member in good standing to check an activity. 2. Student must earn the correct number of points in each area to be eligible for this award.
3. Student’s teacher will verify this application form for accuracy prior to submission. 4. Where required, the advisor/coach’s initials must be present.
5. A student with a major conduct referral to the office requiring disciplinary action is not eligible for the Block J Award. 6. Excessive tardies/absences can disqualify.

Mind – Scholarship & Cocurricular: (Need 6 points per semester)
Principal’s Honor Qtr. 1 (2 points) Principal’s Honor Qtr. 2 (2 points) High Honor Roll Qtr. 1 (2 points) High Honor Roll Qtr. 2 (2 points) Honor Roll Qtr.1 (1 point) Honor Roll Qtr. 2 (1 point)
Math Diagnostic: Met Half of Stretch Growth (1 point) Reading Diagnostic: Met Half of Stretch Growth (1 point)
Essay Contest Qtr.1 or 2 (1 point)
STAR Reader Award (need ½ of total pts.to get point) (1 point)
G.A.T.E. Participation (1 point) ____________ Drama Production (1 point)



Body – Athletics/Fitness: (Need 4 points per semester for 5th/6th graders, 3 points per semester for 4th graders) Football (1 point) ____________
Girls Volleyball (1 point) ____________ Cross Country (1 point) ____________ Wrestling (1 point) ____________ Basketball (1 point) ____________
Pep and Cheer & Spirit (1 point) ____________ Effort & Citizenship- Outstanding in PE on Report Card Qtr. 1 (1 point)
Effort & Citizenship- Outstanding in PE on Report Card Qtr. 2 (1 point)
District Qualifier (1 point) ____________
Outside Sport (1 point) Must be a sport not offered at Jefferson ____________

Spirit – Student Leadership/Community Service: (Need 6 points per semester)
Run for Student Council Office (1 point) Student Council Officer (1 point)
Recorders/Band/Choir/Strings – Outstanding on Report Card Qtr. 1 (1 point)
 Recorders/Band/Choir/Strings – Outstanding on Report Card Qtr. 2 (1 point)
Community Serv./Involvement-4 hrs. per semester (attach verification form) (1 point)
Effort & Citizenship – All Outstanding - Qtr. 1 (1 point) Effort & Citizenship – All Outstanding - Qtr. 2 (1 point) Exemplary Attendance – 1 absence & 1 tardy- Qtr. 1 (1 point)
Exemplary Attendance – 1 absence & 1 tardy- Qtr. 2 (1 point)
Poster Contest Qtr. 1 or 2 (1 point)

Totals per semester Mind (6 points)
Body/Fitness (5th/6th – 4; 4th - 3)

Spirit (6)

# Points ________ ________
________

Student has met Block J standards Yes	No Due to teacher by January 24th, 2025

*Revised 7/1/24	Teacher’s Initials: ________