Printable Templates

Weekly Plans & Logs

Print-ready templates for weekly rhythm planning, daily learning logs, reading logs, project documentation, and annual hours tracking. Print individually or all at once.

Build Portfolio →

1 — Weekly Rhythm Plan

The Wellspring Academy — Weekly Plan

Week of: _________________________  ·  Child(ren): _________________________

PA Act 169 Contemporaneous Log
School Year: _______________
Monday
Morning (8–10am)
Late Morning (10–12pm)
Afternoon (12–2pm)
Late Afternoon (2–5pm)
Hours: ______
Tuesday
Morning (8–10am)
Late Morning (10–12pm)
Afternoon (12–2pm)
Late Afternoon (2–5pm)
Hours: ______
Wednesday
Morning (8–10am)
Late Morning (10–12pm)
Afternoon (12–2pm)
Late Afternoon (2–5pm)
Hours: ______
Thursday
Morning (8–10am)
Late Morning (10–12pm)
Afternoon (12–2pm)
Late Afternoon (2–5pm)
Hours: ______
Friday
Morning (8–10am)
Late Morning (10–12pm)
Afternoon (12–2pm)
Late Afternoon (2–5pm)
Hours: ______
Week's intention:
Total hours: _______   Cumulative: _______
Subjects touched:
☐ Eng  ☐ Math  ☐ Sci  ☐ Geo  ☐ Hist
☐ Civ  ☐ Hlth  ☐ PE  ☐ Mus  ☐ Art  ☐ Safety
Notes / what to remember:

2 — Daily Learning Log

Daily Learning Log

The Wellspring Academy · Newtown, PA · PA Act 169 Contemporaneous Record

Month: _______________ Year: _______
Date Child Learning Activity (what happened) PA Subject(s) Hours Approach
Monthly Total Hours
Supervisor signature: ___________________________   Date: ____________  ·  Portfolio kept at home  ·  Only evaluator certification submitted to district

3 — Reading Log

Reading Log

The Wellspring Academy · School Year: _______________ · Child: _________________________

PA Act 169 Evidence · English Subject
# Book Title Author Type Dates Response / Notes
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Types: Read Aloud (RA)  ·  Independent (I)  ·  Audio (A)  ·  Reference / Non-fiction (NF)

4 — Project Documentation Sheet

Project Documentation Sheet

The Wellspring Academy · PA Act 169 Work Sample / Portfolio Evidence

School Year: _______________
Project Name:
Child(ren):
Duration:
Started:    Completed:
PA Subjects covered:
Approach:  ☐ Unschooling   ☐ Waldorf   ☐ Montessori   ☐ Life Skills
Hours estimated:
Evidence items:
What the child did and learned (description of project):
Child's words — what they said about what they learned:
Work samples attached to this sheet (list items):
1.
2.
3.
4.
Supervisor: ___________________________
Date: _______________
This document is part of the portfolio kept at home per PA Act 169

5 — Annual Hours Tracker

Annual Hours Tracker

The Wellspring Academy · School Year: _______________ · Child: _______________

PA Act 169 Compliance Record
Grade level & goal (check one):
☐ Elementary (K–6): 900 hours OR 180 days     ☐ Secondary (7–12): 990 hours OR 180 days
Month Days Hours Subjects Covered (check all that apply) Cumulative Hours Cumulative Days
August☐Eng ☐Math ☐Sci ☐Geo ☐Hist ☐Civ ☐Hlth ☐PE ☐Mus ☐Art ☐Safety
September☐Eng ☐Math ☐Sci ☐Geo ☐Hist ☐Civ ☐Hlth ☐PE ☐Mus ☐Art ☐Safety
October☐Eng ☐Math ☐Sci ☐Geo ☐Hist ☐Civ ☐Hlth ☐PE ☐Mus ☐Art ☐Safety
November☐Eng ☐Math ☐Sci ☐Geo ☐Hist ☐Civ ☐Hlth ☐PE ☐Mus ☐Art ☐Safety
December☐Eng ☐Math ☐Sci ☐Geo ☐Hist ☐Civ ☐Hlth ☐PE ☐Mus ☐Art ☐Safety
January☐Eng ☐Math ☐Sci ☐Geo ☐Hist ☐Civ ☐Hlth ☐PE ☐Mus ☐Art ☐Safety
February☐Eng ☐Math ☐Sci ☐Geo ☐Hist ☐Civ ☐Hlth ☐PE ☐Mus ☐Art ☐Safety
March☐Eng ☐Math ☐Sci ☐Geo ☐Hist ☐Civ ☐Hlth ☐PE ☐Mus ☐Art ☐Safety
April☐Eng ☐Math ☐Sci ☐Geo ☐Hist ☐Civ ☐Hlth ☐PE ☐Mus ☐Art ☐Safety
May☐Eng ☐Math ☐Sci ☐Geo ☐Hist ☐Civ ☐Hlth ☐PE ☐Mus ☐Art ☐Safety
June☐Eng ☐Math ☐Sci ☐Geo ☐Hist ☐Civ ☐Hlth ☐PE ☐Mus ☐Art ☐Safety
TOTAL Goal: all 11 subjects documented across the year _____ / 900 or 990 _____ / 180
Supervisor certification: I certify this record accurately reflects the home education program under PA Act 169 (24 P.S. § 13-1327.1).
Signature: ___________________________   Date: _______________