Series 602.6.2.5P - Report of Data Collection for Consideration of Single Subject Acceleration

 

Student's name ______________________________  Date of birth ___________  C.A.________

                                                                                              yr/mth

School ______________________________  Grade_____ Subject area                                 

Name of parent(s)/guardian(s) ______________________________________________________

Address________________________________________________ Phone                                     

Achievement data:

Woodcock Johnson Achievement Scores (if needed):

MAP Scores:

Report Cards (for elementary students in subject being considered):

Data collection by:_____________________________________ Date:_________________

Individual Intellectual Ability Test – Must have been completed within two years. (The Slossen is not an approved measure.)

Name of test:

Results: 

Data collection completed by:____________________________ Date:_________________

Critical Questions:

A.  Has the student been single subject accelerated previously?       ❏ Yes   ❏ No

B.  Does the student want to be considered for single subject acceleration?     ❏ Yes   ❏ No

C.  Will a sibling be in the same subject if the student is single subject advanced?     ❏ Yes   ❏ No                                                                                     

Report by classroom subject teacher:

 

 

 

 

 

 

 

 

Teacher:______________________________________________ Date:_________________

Other report(s) by classroom teacher(s):

 

 

 

 

 

 

 

 

Teacher:______________________________________________ Date:_________________

 

c: case studies file 

Procedures/602.6.2.5P/9-22-08