Our school is using "Leaders of their Own Learning" by Ron Berger for its professional development program. One concept the author promotes is student self evaluation. While I've always used rubrics as a self-evaluation tool, I've never had a student holistically evaluate themselves in terms of their overall performance in a course.
I decided to pilot this method with my 10th grade World Literature students in preparation for parent-teacher conferences. Students don't typically attend parent-teacher conferences, and I'm hoping it will allow their voices to be heard. In addition, it allows them to reflect (and practice their writing!)
This process take significant class time to be successful. I will have to analyze the costs and benefits of adding "something else" into the mix. I probably won't have those answers until the second set of parent-teacher conferences in March when I have students complete the process again.
Feel free to create your own based on my sample. Some of it is specific to my course, but much of it could be used or tweaked for any high school program.