Series 602.6.2.5P - Report of Data Collection for Consideration of Single Subject Acceleration
Adopted: June 2007
Revised: October 2021
Student's name ______________________________ Date of birth ___________ C.A.________
yr/mth
School ______________________________ Grade_____ Subject area
Name of parent(s)/guardian(s) ______________________________________________________
Address________________________________________________ Phone
Achievement data:
MAP Scores:
Report Cards (for elementary students in subject being considered):
Data collection by:_____________________________________ Date:_________________
Cognitive Ability Test – Must have been completed within two years.
Name of test:
Date Administered:
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
D. Does the student currently have like-ability peers in their grade level in the
subject being considered for single subject acceleration? ❏ Yes ❏ No
Report by classroom subject teacher:
Teacher:______________________________________________ Date:_________________
District Placement Assessment Results:
Teacher:______________________________________________ Date:_________________
c: case studies file
Procedures/602.6.2.5P/10-01-21