EFTA01709788

EFTA01709788 EFTA01709789 Warn Address Date of Birth Immunization Certification: Yes 0 No 0 Special Immunization Programs A NARRATIVE NOTE IS REQUIRED FOR REFERRAL AND OUTCOME ENTRIES STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES CUMULATIVE SCHOOL HEALTH RECORD (This form Is not intended for physician's use) Race Sex • S Father's Name Mother's Name Special Health Problems - See Narrative. Place of Bin Birth Recorded; Yes 0 No 0 Screening and Assessment ' Grades K-3 K 1 2 3 Screening Date Referral Outcome . c E" 4. .9 us 2 0 0CO Referral Outcome Screening Date I; a) Ce g 8S 0 Screening Date 1, 8 a> CC Outcome Vision ...s" -,7 fa /O Hearing I. .0 Height, Weight & Graphing /196 Nutrition Dental Health Mental Health Communicable Disease Records Review Physical Assessment Other Other Screening and Assessment Grades 4-8 If 4 5 6 7 8 [Screening Date 13 ::15 0 it Outcome Screening Date -0 8 .3) ec Outcome Screening Date Referral Outcome Screening Date Referral Outcome Screening Date PReferral Outcome /ision (J-115.7)r I I SICIR P -tearing -it- 43ieight, Weight &Gra•hin. 14 - W • lutrition rental Health 'lent& Health communicable Disease lecords Review hysical Assessment coliosis 'ther ther 1S-H Form 3041. MAY 80 (Replaces nravinlio tadifinne ....a • ant nn EFTA01709790 FLORIDA Verification of Receipt 1111 Fr II I (NOTE: This Is not the application for the scholarship.) • I verify that I have received and read the initial eligibility requirements 44 of the Florida Bright Futures S r the year 2004. Name or SCHOLARSHIP PROGRAM Signature Date Please return to your high school guidance counselor EFTA01709791 THE SCHOOL DISTRICT OF 1997-1998 END-OF-YEAR REPORT IIIIIIIIINME."....., ,•••• Elementary School school In a continuing effort to keep you informed, this report card insert is being provided to notify you of your child's progress toward meeting the school district's desired levels of performance in reading, writing, and mathematics. Your child's end-of-year performance level in reading, writing, and mathematics is identified below. READING WRITING (COMPOSITION) MATHEMATICS EKAt or above grade level L1 At or above grade level ErAt or above grade level El Below grade level* El Below grade level* ❑ Below grade level* *If Below grade level has been indicated for reading, writing, and/or mathematics, you will be asked to participate in the development of a plan to improve your child's academic performance. This plan will be developed at the beginning of the 1998-1999 school year. EFTA01709792 SEX RACIAL/ETHNIC GROUP MVVhite, Not Hispanic O Black, Not Hispanic U Hispanic O American STUDENT NUMBER Indian/Natiye Alaskan Islander • Asian/Pacific ADDR , . . al) Verified by Birth Certificate: O Yes If Not, What Type Verification? • • NA THER RESPONSIBLE ADULT AT HOME: P G OA s .11:01•4:1•141•111116•111.1.10100•11101.61•11.-11.•• Name Street City /.._Q-4. . I ma - .4I Date First Entered This District g—q-1.,Withdrawal Date Withdrawal Date, Withdrawal Date fGrade: FLORIDA PERMANENT RECORD CARD CATEGOAY A - Education Records GRADES K-5 School Year: 19- 19.94 Grade Grade: Grri4 dr : School Year: 19 93 -19 4/,‘ School Year. 19 -19 (4 5 School Year: 19 I -19 School Year-19 - 9 .7 - Days Present: (4,(0 Days Absent: 4 Days Presem: i , 2- Days Abient .3 Days Present: 1113 Days Abukir. '1 Days Present. AR Days Absent: // Days Present: I'D I Days Absent: \-3 Subject Teacher Mark Subject • Mik Subject Teacher I ark Subject Teacher Mark Subject Teacher ark MATHEMATICS MATHEMATICS MATHEMATICS MATHEMATICS II MATHEMATICS 1,y READING READING 11 READING READING READING a LANGUAGE LANGUAGE LANGUAGE JANGUAGE C...- C...• LANGUAGE SPELLING HANDWRITING N, SPFU-ING SPELLING HANDWRITING SPELLING HANENVRITING ‘6-SPELLING HANDWRITING HANDWRITING STUDIES SOCIAL STUDIES SOCIAL STUDIES SOCIAL STUDIES 7:1 SOCIAL STUDIES % _ROCK! SCIENCE and _HEALTH SCIENCE and JiEALTH 6SCIENCE and HEALTH V SCIENCE and HEALTH 3 SCIENCE and • HEALTH 'FS BEHAVIOR CODE AVERAGE 3BEHAVIOR CODE AVERAGE ..3 . BEHAVIOR CODE AVERAGE. BEHAVIOR CODE AVERAGE 3 BEHAVIOR CODE AVERAGE 3 ind,cine: Promote IP) Retain (RI Summer sow, (S51 Indicate: Promote DPI Retain (R) Summer School (SS) p Indicate: Promote IP) Retain (R) Summer Shod as p Indicate: Promote (P) Retain (R) sworn., School MS) ? Indicate: Promote (P1 Retain (R) Summer School MS/ tp IP Grade: OS—Schoot (Grade: School: (Grade: School: (Grade: School: (Grade: School Year 19- C -19 G School Year 19_•19 School Year 19 -19— School Year 19_-19— • School Year 19 .19 Days Present /1 1 Days Absent: q Days Present: Days Absent: Days Present: Days Absent: Days Present: Days Absent: Days Present: Days Absent: Subject Teacher Mark Subject Teacher Mark Subject Teacher Mark Subject Teacher Mark Subject Teacher Mark MATHEMATICS MATHEMATICS MATHEMATICS MATHEMATICS MATHEMATICS READING 9) READING READING READING READING LANGUAGE c.l-LANGUAGE LANGUAGE LANGUAGE LANGUAGE SPELLING C.• SPFLI ING SPELT ING SPED ING SPELLING HANDWRITING d HANDWRITING HANDWRITING HANDWRMNG HANDWRITING SOCIAL STUDIES r, SOCIAL SH.IDIES SOCIAL STUDIES SOCIAL STUDIES SOCIAL STUDIES SCIENCE and HEALTH 0 ISikEiN CE and SCIENCE and HEALTH . SCIENCE and HEALTH SCIENCE and HEALTH BEHAVIOR CODE . AVERAGE s.. BEHAVIOR CODE AVERAGE BEHAVIOR CODE AVERAGE BEHAVIOR CODE AVERAGE BEHAVIOR CODE AVERAGE Indicate: Promote IP) Retain IR) Indicate: Promote (P) Retain (R) Indicate: Promote (P) Retain Mr Indicate: Promote (P) Retain (R) - Indicate: Promote (P) Retain (A) 01-93d0 EFTA01709793 FLORIDA CERTIFICATION OF IMMUNIZATION Legal Authority: FLORIDA STATUTES 232.032, s. 64D-3.011, F.A.0 and s. 65C-22.006, F.A.C. LAST NAME J PARENT OR GUARDIAN DirettionC • Enter all appropriate doses and dates below. • Sign and date appropriate certificate (A-I, A-2, R. or C) on reverse side of form. • If the child is pnw•nting for the 7th grade requirement only and has preciously filed a Certificate of Immunization (680A or 680A-I) with their current Florida school, fill in boxed areas below and complete Part .t-2 on the reverse side of this form. For additional information: See Immunization Guidelines for School and Child ('are Facilities for information and instructions on form completion and immunization requirements. Guidelines are updated annually and are mailable from the local county health department. FIRST MI DOB MO/DMYR Child's SS# (optional) SEA IF imMt UATION ID# VACCINE. DTaP/DTP 2 DT3 Td' Polies HIB` MMR (Combined)' (Separate)' Hepatitis B' The state immunization ID# is an identifier supplied by the state immunization registry (optional). 2 DTP 5 doses required. If the fourth primary dose is administered on or after the fourth birthday a fifth dose is not required. DTaP is an acceptable alternative for one or more doses of DTP. DT (pediatric) is acceptable if Pertussis vaccine is medically contraindicated. (Complete Part C for Pertussis contraindication.) 4 Td (Adult) Vaccine is recommended for children 7 years of age or older. s Polio 4 doses required. If the third dose is administered on or after the fourth birthday. a fourth dose is not required. IPV is an acceptable alternative for one or more doses of OPV. Polio vaccine is not required for children 18 years of age or older. 6 Hib is required for child care and preschool entry and attendance only. 7 1st dose valid if given on or after 1st birthday. Second dose (measles) valid if given at least I month after Ist dose. A second dose of measles (preferably MMR) is required for students in grades K-4 in the 1997-98 school year, and 7th grade entry and attendance effective with the 1997/98 school year. In each subsequent year thereafter, the next highest grades are included. Includes single measles vaccine (6), single mumps vaccine (H) or single rubella vaccine (I). 9 Hepatitis B vaccine series is required for seventh grade entry and attendance effective with the 1997-98 school year and kinder- garten entry and attendance effective with the 1998-99 school year. In each subsequent year thereafter, the next highest grades are included. EFTA01709794 LAST NAME FIRST Mi DOB (MO/DAIVR) Certificate of Immunization for K-12 ExcludIng7th Grade Requirements PART A-1 (Immunizations are complete for school entry and attendance grades kindergarten through 12 with the exception of the 7th grade requirement.) DOE Code I I have reviewed the records available, and to the best of my knowledge, the above named child has been adequately immunized against diphtheria, tetanus, penussis, polio, measles, mumps, rubella and hepatitis B (for kindergarten effective with the I998.199 school year) for school attendance as docurnemed on the reverse side of this form. Physician or Clinic Name: Physician or (Print or stamp) Authorized Signature. Address. Date. Certificate of Immunization Supplement for 7th Grade Requirement Part A-2 (immunizations are complete for students who enter or attend the 7th grade after the beginning of the 1997/98 school year. Each subsequent year thereafter, the next highest grade will be included in the requirement.) DOE Code 8 I have reviewed the records available, and to the best of my knowledge, the above named child has received the following immunizations required for entry and attendance in 7th grade effective with the 1997.98 school year: tetanus-diph and second dose of measles vaccine as documented on the reverse side of this form (boxed areas Physician or Clinic Name: Physician or (Print or stamp) A thorized Signature: Address Date. Temporary Medical Exemption PART B (For preschool children, children in day care and school children who are incomplete for immunizations in Part A-I or A-2.) Invalid without expiration date. DOE Code 2 I certify that the above named child has received the immunizations documented on the reverse side of this form and has commenced a schedule to complete the required immunizations. Additional immunizations are not medically indicated at this time. Physician or Clinic Name: (Print or Stamp) 7r-r-77;""—Expittition Date: (I5 days after net immunization appointment) Physician or Address: Authorized Signature. Date. Permanent Medical Exemption PART C For medically contraindicated immunizations, list each vaccine and state valid clinical reasoning or evidence for exemption: DOE Code 3 1 certify that he physical condition of this child is such that immunizationts)as indicated in Part C above is medically contraindicated. Physician or Clinic Name: (Print or stamp) Physician Signature. Address: flit 610. 8:98 , replace, earlier edition, i Shwa. unibtr : 5740400•06110-40 Date. EFTA01709795 THE SCHOOL DISTRICT OF • NEW/RETURNING STUDENTS REGISTRATION BACK 131) STUDENT uves WITH ICHECIL OKI RIBOTH PARENT} ❑ MOTHER II ----I FATHER 9 SHARED CUSTOOT 0 011iePt (33) "IlAkSPEATE3 DE 6441/43 ,.I 54 InNopomo4 lo/Lom, schml In Comm N ether dm. pmon0 2.1/435 1331 13 THERE A COURT ORDER BARRIO EITE4R PARENT FROM CONTACTING THE STUDENT DLIRING DIE SCHOOL DAY> 0 IF YES, PLEASE PROVIDE THE SCHOOL THE COURT OROFR Ilf/A0EIN4221 YES IS NO WITH A COPY OF 13A) FATHER/GUARDIAN DOES FATHER HAVE CUSTODY> DYES in NO YES 1351 MOTHER/GUARDIAN DOES MOTHER HAVE CUSTODY> 0 ',Es 0 NO YES ..., TA.. AQUA LAST OPST WA NOW Lau ST ICF0.'non va.s4 Tar RAU OS INII.004INT M RAU CV INP.OTHINT l. Ill IIIIMOSS 443.4 NIGH I VVL U A N l A 0 lmom SOFFAX B 0 SORK FRO. Slat C D. A. O'N 0...• iosAFE, T. of soar° D 0 Tom Tost-FavAwr (ITOFAICAUCOU1411) E 0 TOFEFAA•mtFT•FF.Fm RHAFAIS or MOW H. t 1 ,A El 0.04INTOIT 1004 B Amman T.* D soma rOsTF2ECONCART rrecooscAUcoasoc E I It 0 El SOW re SPOOF Tanta • FFF c 11 t"---. II "c'ICAcc."“ COADUATI •• ESORIT 1361 LEGAL GUARDAN (IF AND DOES LEGAL GUARDIAN NAVE CUSTO ❑ Y D NO num RANI MOORS t. CCOSETTTA MALL Of LISEDDLINT ITALALIS MY , EMERGENCY HEALTH AND SAFETY INFORMATION PART I PC4500151 P 139/ PASSWORD 'Liu T I) C0ARACTERSI (40 mincsalo Poi ellINIIN(Y nba, 14'I NAME PHENF RR AT IONSHLP En an YES E] NO -racielonoin ADDRESS RE.ATIONSHW F—D y YES ENO Au A+ ADDRESS RELATIONSHIP riethei ILA 0 YES No ADDRESS N. RE.ATONSHIP Ur•I YES 0 No 145) NAME ADDRESS PHCNE RELATIONSHIP UMI YES D NO (46) PART ll E SCHOOL PERSONNEL ARE UNABLE TO CONTACT YOU PI CASE OF ILIJESS OR ACCIDENT, MAY WE HAVE YOUR PERMISSION TO CALL YOUR DOCTOR OR EMERGENCY SERVICES 191 II FCR TRANSPORT TO DIE HOSPITAL? 66 yes 0 NO (A7) FAMILY DOCTOR RID PHONE NulABER 14H HOSPYAL PREFERENCE ISO) LIST YOLR DOW'S ILLNESSES. A.LERGiEs OR OTHER PHYSICAL LMITATIONS YOUR CHILDREN IN OTHER CHOOLS: :Ill NAME OF CHILD SCHOOL ATTENDING STUDENT NO. (OPTIONAL) GRADE OATH DATE tl 4IN — STUDENT NO. (OPTIONAL) GRADE 1531 NAME OF CHILD SCNOOI ATTENOING STUDENT NO. (OPTIONAL) GRADE BRIM DAVE 1641 NAME OF CHILD 6614001. ATTENDING STUDENT NO. 10PDONAO GRADE BATH DATE . 1651 NAME OF CHIO SCHOCH ATTENDING STUDENT NO. 10PDOMIJ GRADE OREN DATE 1661 J VERIFY THAT THE INICAMATION GIVEN IS TRUE ANC ACCURATE TO THE BEST OF MY KNOKEOGE. S' -(2247 %?' DATE t FOR OFFICE USE ONLY: tsb ttwich. NO. ! I!La iTubENt IFUTTHEI (1.11 STLInNt LANGUAGE EN GO) on US tot) paw GoOf EO1 (Oa (OTIO 0A11 08/19/98 103) SAC COOT O88C (64/ PARENT/GUARDIAN LANGUAGE EN 155) GRAD) (DEL O8 IGO CALENDAR O1 Ibl/ TUCKER 110. an) REASSI13110 DA•ADIA OIDESOL 131.1•1441 I COOP 0 F 3FSF WI TRANSPORTATION OTIS 0 wg 0 1 2 3 6 5 0 1;01 ITRIFICATION Of BIRTH 1 13 1 5 6 ) 5 5 T 911 NRS Z A B 2 021 POOAUNTATION °intuit CHEER AND DATE Mi., AMMO; ['CATE IIWALIMEA -FONS 0 DATE VERS:CATi00 OT PINT.. ARCORDS 00ATE SOCIAL. SECOND ( n NC tOITTIGNA. Li 0*IC 64.1251CA4 CAAMS 1131 DATA ENTRY COMPUTED ID. DAIL 1 4636 OM 3/51) EFTA01709796 THE H L DI TRI T F i STUDENT NUMBER: VERIFICATION FOR NEW/RETURNING STUDENTS: TO THE PARENTS OR GUARDIANS: NEW STUDENTS: ;omplete al non-shaded areas on both sides of form RETURNING STUDENTS: Please review both sides for correctness of typed information. II the information printed is incorrect, please correct it by carefully and lightly crossing out the incorrect information and writing the correct information above 1. EW/RETURNING STUDENTS REGISTRATION DISTRIBUTION: GRADE: 06 STDT ...^•, A 2 in a (I, STUDENT 5 < Eat 717.1)f I (2) ALSO RNOVER AS mr 3 LD AL ADC RE SS III MARIN: LIONESS ..,„, , „ 1/2: SIY L3 LOXAHATCHEE FL w,4.> s Dui ....off yr iv* Uri ITY/1 li :oor triV STY.1 Iiii OM IS STUDENTS SO:IA I. SECURITY NO ,OPTIONAL/ :61 HOmi PRONE NO IT SF x F FEMALE MALE -OF IR) . . I FACE AARICAN momm I OR ALASKAN 'miner NLAcA B NOR-HISPARiC I A grFI:RISLANDEP 0 H MSPANIG 0 W mowtEHISPANIC I M muLTLPAGtAL IS. DATE DE BIRTH MYCliii Hs ,101 PLACE GIRTH U%An (II) RESIDENT STATUS E 2 EMT 0 0 FOREIGN EXCHANGE STUDENT 0 3. IN-CO./NTT 0 I OUT-OF-COUNTI RESIDENT -YE-STATE RESIDENT RESIDENT III) ENTRY DATE MTV USA 113) FEDERAL ETES TES' DYES 0 YES 0 YES IMPACT AID SURVEY n NO A. THE STUDENT n NO B. THE STUDENT M 110 C. ME PARENT 5 NO D. THE PARENT C NO E. ME PARENT il Its. RESIDES ON FEDERAL PROPERTY. RESIDES IN LOW PENT HOUSING. IS IMKOYED ON FEDERAL IS EMPIOYED ON LOW 4EN1 IS N THE UNIFORMED SERVICES IS ME PARENT ON ACTIVE DUTY? AIR PONCE 0 ARMY PROPERTY HUSHES OF I COAST LOCATED IN PALM BEACH COUNTY. LOCATED IN PALM BEACH COATI. THE UNITED STATES. I `ES D NO GUARD D MARINES 0 NATIONAL GUARD I NAVY 1141 1445 THIS CLEO BEEN ENROLLED IN ANY PRISCHULIL7 0 C CHAPTER I 0 U PM-1( OISABIIIIIES DF PRE-I EARLY INTERVENTION I H. HEADSTART E M E II NON(PLEASE PLACE A CHLUMARA ( jor BY EACH PROGRAM WITH M. ASTERSK I 1k) TM PROGRAM ELM CHILI MIGRANT PRE-II -SUBSIDIZED CHILD CARE ATTENDEE. ALSO. INDICATE WAS IN THE LONGEST) I 0. OTHER 0 3 3USSIDIZEC CHILD CARS (IS) IS ME STUDENT A SINGE PARENT? 0 YES NO NO 'IS) CUREItilt GNAW LIAR 06 TRANSFER INFORMATION: (I7) ' (IR. A I N (19) OA'E CF LAST ArENDANCE 3.one off' iqq g (23/ . . 3kS. it AT- (RR, OA' ATTENDED FREE OR REDUCED PRICE LUMI IMIIIIIIIII M (231 HAVE YOU FILLED OUT AN APPLICATION FOR FREI OR REDUCED LUNCH? (APPLICATION IS PROVIDED WITH IRIS REGISTRATION FORM/ YES 0 NO WE REALM SCREENINGS: I GIVE PERMISSION FOR MY OVID TO & GAN HEALTH SCREENINGS. THESE. TESTS MAY BE GIVEN INCIYIOUALLY OR IN GROUPS. gi YES YES I NO (251 SODIELA FLUORIDE: I GM PERMISSION FOR MT CHILD TO PARTICIPATE IN THE SOCIUM FLUORIDE PROGRAM 6if YES TO FREVENT DENTAL MCAT. PERMISSION IS VALID THROUGH GRAM SIX. YES I NO NEW STUDENTS TO HOME LANGUAGE SURVEY (26) WHAT LANGUAGE IS SPOSEN IN THE HOME 51 THE PAFANT or GUARDIAN. En‘isk (27) WHAT LANGUAGE IS WILDE IN THE NOME BY THE STUDENT? .Eng\ ‘ 31-N 1281 DATE OF ENTRY INTO THE Mt PROGRAM 129) LANGUAGE SLAW I. IS A LANGUAGE OTHER THAN ENGLISH USED IN THE HOME? 2. DOES THE STUDENT NAVE A FIRST LANGUAGE OTHER THAN ENGLISH? 3. DOES THE STUDENT MOST FREDUENTEY SPEAR A LANGUAGE OTHER THAN ENGLISH? ,YES OTES ITES Ei NO g NO rAl NO (30) DISCLOSURES lot ION *Nov Imo this SCHOOL DISTRICT HAS THE STUDENT EVER: I. BEEN EXPELLED ERDM SCHOOL? 2. HAD AN ARREST FESU.TING IN A CHARGE' 3. HAD ANT JUVENILE JUSTICE ACTIONS? I TES OYES OYES RI NO J NO ri NO EFTA01709797 THE SCHOOL DISTRICT OF - NEW/RETURNING STUDENTS REGISTRATION BACK (31) STUDER' IDES WITH COCCI ONE? VBOTH PARENTS D MOTHER 0 FATHER :1 SHARED CUSTODY E OTHER 12) TRANSPORTED BY Stirlen will be tonspertod to, lien I by elem. if ellr thee poten0 (131 IS THERE A COMB ORDER BARRING EITHER PARENT FROM CONTACHNG THE STUDENT OUITUNC THE SCHOOL. DAY) 0 IF YES. PLEASE PROVIDE THE SCHOOL THE cnURTDROFR REMOVING OR YES D NO WITH A COPY OF lialigig m DOES FATHER HAVE CUSTODY? OYES ONO , DOES MOTHER KAYE CUSTODY? D YES 0 NO YES YES FART NAM mom LAST Nor lame MOLT TART CON (A 55 4 , m Clete\5 of OCO.PATNN aP4ATAT al unlit...tr.\ thr-%L.:4-43 ry.e. op aNnoToRTNT — II ORII Mats. nee ROPY PEON OWNS,. NOt LIB/ HIGHEST LtVtl OF tDUCATION COMPLETED (OFTIOYAL) A D ....7........x. ..... t0en B ❑0 ,r„,,'„.,r, C 0 PRAINJATO D El 1.0.4 POTT•Sitaear mares. rmaren E 0 ritoNRCAL/COUTOI 01.01.0 n anvil (34 A HIGHEST LEWL OF EDUCATION COMPLETED .OPTIONAL) Ill 0.0.004 9000. BOSOM/ .0. $000 10.104 iNis C 217,..,....,,, D0 !ow .44tortusy E II 710.1•CWCaltal 11411 LFOAL GUARDIAN OF ANY) DOES tEGA. CIAARDLAN NAVE CUSTODY , ❑ c 0 No — CON STAT. VP oa .,...” .fa.-N_ utp, .... cNIflos. ... EMERGENCY HEALTH AND SAFETY INFORMATION PART I PERSoNIM OTHER THAN PARENT AuTHOILZEC TO PICK LP STUDENT . 39) PASSWORD AMR 10 CHARACTERS) %ea AcT1.41,44Pah 1.5•004-• (III RAW ADDRESS It oaci PRONE RELAT/014SFur 6-rn.-.1 'non", IWYES 0 NO f-li In YES 0 NO ADDRESS PHONE RELATIONSHIP nonf P Cl ADDRESS PHONE RELATIONSHP cc-, en's'2 YES 0 NOALNLAttSE pnulit RELATIONSHIP U ri YES 0 NO (45) NAME ADDRESS PHONE RELATIONSHP fl YES D No filiti PART II If SCHOOL PERSONNEL ARE UNABLE TO CONTACT you LN CASE Of ILLNESS CR ACCIDENT. MAY NvE NAVE YGJR PERNISSON TO CALL TOUR DOCTOR OR EMERGENCY SERVICES 1911) FOR TRANSPORT TO THE HOSPITAU g YES 0 ND (47) FAMILY DOCTOR (44) PHONE NIARIER (45) HOSPITAL PREFERENCE • Cy c THER PHYSCAL LIMITATIONS Y-L O./‘ YOUR CHILDREN CHILDREN IN OTHER • CNOOLS: 1011 NAVE OF (MILD SCHOOL ATTENOPIG SELL:W.1 NJ. IUPT)NAI GHADt WEIR LATE SILOEhT NO. 1OPTiDNA,) GRADE (531 NAME OF CORD SCHOOL ATTENDHC. ST. °PAT Na (OPTIONAL) GRADE BIRTH DATE 1041 NAME OF (MILD SCH004. AT TENDHG SILULAT MN. (OPTION/NO (*RADE BIRTH DATE 155) NAME OF CHILD SCHOOL ATTEIONG STUDENT ND. (OPTIONAL) GRADE BIRTH DATE (66, I fERIFY THAT THE INFORMATION GIVEN IS TRUE AND ACCURATE TO THE BEST OF MT KNOWLEDGE RI' 16 -99 DATE FOR OFFICE USE ONLY: (5); SCROth NE. ISS/ OVERT Nuni0E4 MI sTUCild LAIIEW,TtE EN LW tou US 11,1191iR( tun E01 161) nem JAII 08/16/99 (NN) SL Loaf 088C i6E GRADE ltett 07 (SW CAUSOAR 01 WI TEAMR ND. MU PARINTISUANDIAN LANGPAGI EN Ill) MASSIC/04tHT CODE CIA•AOM CLUE OD-ISO? OM-MAG (G, TRANSPORTATION al" 0 N4 0 I 2 3 4 0 6 1)C/ 11Alf ICATON OE BIRTH 1 1 3 6 0 0 TS I, TA In, lin; Z U: (72) DDCUMENIATION tnipaiST (NEC% AND EATS WHEN EatvED, DOME IMMUNIENTETINE C 0AT£ VERIA.CAHON of °NTH itecorta5 004.1 SIWIA1, SeC11.41., 0 0A.E PIYSICAL EXAM) NO toproNAL, 1KO DATA tNTRI COMPLETED It; :ATI 0638 Mai. LEST EFTA01709798 T C STUDENT NUMBER: VERIFICATION FOR NEW/RETURNING STUDENTS: TO THE PARENTS OR GUARDIANS: NEW STUDENTS Complete all non—shaded areas on both SideS Of form HE I URNING STUDENTS: Please review both sides for correctness of typed information. If the information printed is inCo red, please correct it by Carefully and lightly crossing out the incorrect information and writing the correct information above it. EW/RETURNING STUDENTS REGISTRATION icSTR IMITCHR Theft 0 09/0• NA oAtl GR6E 1700700 660103 OLDC10i I II/ STJOENT'S LEGAL NAM: / Cl) ALSO KNOWN AS rAc I.n. ...far I:n LOCAL AIDURESS III MAILING ADDRESS _2zarraigt_r________,„„_ LOXAHATCHEE FL •C .4r M) S}Nf.....1 APT 4 <n • I r• in. 7., , IS/ STUDENT'S SOCIAL SECJRITY NO. IOPTIONAJ IS) HOME PHONE NO. (7) IFFIAALF IMALE SEA F (8) . . 0 RACE I AIWErtiCEEN EWAN E OR AL...UM NATIVE 8 MOM-km.s.AN c 2 0 A PlICIFI:3RISLAMOCR H HISPANIC I I W rerosen.ic M MULTIRACIAL IS) DATE Of BIRTH ....,. .... OW PLACE EA biNEN Ut,„ . (II/ RESIDENT STATUS 3 0. FOFEIGN ExCHANCE MOM I. OUT-OF-COUNTY RESIDENT I II 2. Or 3. IN-COUNTY -OF-STATE RESIDENT RESIDENT II2/ ENTRY DATE INTO USA (131 FEDERAL IFS YES YES YES YES IMPACT AID SUFWEY I NO A THE STUDENT I NO D. THE STUDENT 0 NO C lit PARENT I NO 0. THE PARENT I NO E THE PARENT IF YES, RESIDES ON RESIDES IN IS EMPLOYED IS EMPLOYED IS IN THE IS TN( PARENT II AIR FOEICE FERFRAI LOW RENT UN PEEtRAL ON LOW UNIFORMED CFI ACTIVE I ARMY PROPERTY HOUSING. PROPERTY RENT HOUSING SERVICES OF ouTr Li COAST I LOCATED LOCATED THE UNITED YES GUAR) IN PAI. IN STATES I I FE ACH [MATT PALM BEACH COUNTY_ NO MMINES I NATIONAL GUARD I NAY( UV HAS THIS CHILD BEEN ENROLLED NI ANY PRESCHOOL? C. CHAPTER I D. PRE-K DISABILITIES 0 E. PRE-A EARLY INTEREENTION (PLEASE PLACE A EHECKMARK I A.NEBY EACH PROGRAM WITH AN ASTERISK I *I THE PROGRAM YOUR CHILD I II IICADSTART I M. MIGRANT PRE-K I N. NON-SUBSIDIZED CHILD CARE ATTENDED. WAS I I ALSO: INDICATE IN THE LONGEST.) 0. OTHER S. SUBSIDIZED CHILD CARE 11S. IS THE STUDENT A SINGLE PARENT? NO I TES I Nu EIS) CURRENT GRADE IKEA 07 TRANSFER INFORMATION: (Ili NAME or 3cicUoc MANN ERRING (RUM 1110 CITY UR LOCATION CIA DATE OF LAST ATTENDANCE (20) GRADE LEVEL rEll LAST PALM SCHOOL ATTENDED IN PALM BEACH COUN'Y 122) DATE ATTENDED FREE OR REDUCED PRICE LUNCH AND HEALTH INFORMATION: 123/ HATE IOU FILLED OUT AN APPLICATION FOR FACE OR REDUCED LUNCH) kr YES (APPLICATION IS PROTEIN() WITH Tills REGISTRATION TORMI I NO 24) HEALTH SCREENINGS: I GIVE PERMISSION F04 MT CHILD TO BE GIVEN HEALTH SCREENINGS. THESE TESTS MAY SE GI4N INOWIDUALLY OR IN GROUPS. YES I Di 9 ND (ISI SODIUM Co/ORIOE: I tiSt PERMISSION FOR MY CRIED TO PARTICIPATE IN THE SODIUM FLUORIDE PRCGRAM TO PREVENT DENTAL DECAL PERMISSION IS LAUD TNROIFGH GRADE SIX. YES I Et) I NU NEW STUDENTS TO HOME LANGUAGE SURVEY (26) WHAT ANFMAAF II SPOKEN IN THE MIA) 127) WHET I ANADAGE IS SPOKEN NI THE PARENT or GLARCiAN IN THE HONE BY THE Mean? an DATE OF ENTRY INTO THE ESOL PROGRAM CIS) LANGUAGE SURIEY I. IS A LANGUAGE OTHER THAN ENGLISH USEC IN THE HOME? 2 DOES THE STUDENT HATE A FIRST LANGUAGE CITIES THAN EXCUSE? 3. DOES TIE STUDENT MOST FRECUENTEY SPEAK A LANGUAGE OTHER THAN ENGLISH? I YES I YFS DYES I NO I N) I N) OW DISCLOSURES lot Ilru entry sou alt SCHOOL DISTRICT HAS THE STUDENT UFA: I. REIN IMMO FROM 501001? 2. HAD AN ARREST RESULTING IN A CHARGE? 3. HAD ANY JUVENILE JUSTICE ACTIONS? Ills I IS III NO I NO 1I NO EFTA01709799 THE SCHOOL DISTRICT OF 9-12 Academic Improvement Plan (AIP) SY: 04 SCH: OUti: FNRT: FCAT: NAP: PRIM: COM GR: 11 ASS: 5 RET: 1 MATH: READ: 360 MATH: 314 5.0 AIP: R-ZL it- Z1 M-LF S-FE LLP: 504: 0 READING ID WRITING ca S21—,-. an oa of❑ Textbook Assessments E) EDL ❑ FCAT Diagnostic I Practice Tests ❑ Diagnostic Software O Other (see attached) n Palm Beach Writes ❑ Portfolio O Performance Assessments ❑ FCAT Diagnostic/Practice Tests ❑ Diagnostic Sothvare O Other (see attached) roMATHEMATICS Textbook Assessments 2,efolici 0, SCIENCE ormance Assessments FCAT Diagnostic/Pradice Tests O Diagnostic Software El Other (see attached) gtenter Sense. Concepts and aeons cement aY ac Thinking ata Analysis and Probability O Reading in Content Area Specific Concepts arsodbook Assessments ❑ Porddio wPerfamance Assessments FCAT DlagnostidPractice Tests ID Diagnostic Software O Other (see eteched) 8'1 g Phonemic Awareness ci Rhyming O Syltabkation O Segmenting/Blending Phonics ❑ Sound/Symbol Correspondence ❑ Decodirg/F_ncoiing Fluency CI High Frequency Words El Rate Vocabulary O Structural Analysis O Word Meaning Text Comprehension O Questioning O Summarizing Types of Writing ❑ Ward/Sentenx writing O Paragraph Writing ❑ Compositor) tinting Awareness/Application of FCAT Writing Rubric ❑ Foos ❑ Support ❑ Organization O Convections Compositions E Narrative E Expository ❑ Persiesive A.$0.-Vlekt IstAC rtc•• O The Nature of Matter O Energy O Face and Motion ID Processes that Shape the Earth 0 Earth and Space of Life How Living Things Interact with their Environment IX The Nature of Science concepts Reading In Content Area SpecificConcepts 11,4O;,,o Tutoring O During School Day ❑ Afterte'ore School / Saturday inshictional Alternatives ❑ Temporary Skil Groups D Cooperative Learning Groups O Guided ReadingNWiting Groups O Technology O Other (see attached) Assignment Alternative o Time ❑ Quantity El Product Requirements O Child Study Referrals O instructional Reading Tutoring I:1 During Sdlool Day ❑ AftodBefore School / Saturday Instructional Alternatives ci Temporary Skill Groups ❑ Cooperative Leaning Groups O Guided Readognitrig Groups O Tedmology O Other (see attached) Assignment Alternative O Tine O Quentin/ O Product Requirements O Chid Study Referrals El Instructional Language Ms Tutoring OD School Day ore School/ Saturday lns ctional Alternatives O T Skill Groups ooperative Leaning Groups ❑ fectnology O Other (see attached) Assipment Alternative Winne O Quantity O Product Requirements O Child Study Referrals O Instructional Mathematics rrigitoring LJ During &hail Day El After/Before School / Saturday Instructional Alternatives O Temporary Skil Goole alive Learning Groups Gulled ReadingAYriting Groups O Technology O Other (see attached) Assignment Alternative ITime Quantty Product Requirements Child Study Referrals ❑ Instructional Reading Student progress will be monitored throughout the school year, and student progress will be reflected on the report card, O Successfully Remodeled El Requires New AIP Next School Year O Special Senices / Placement O Other (see attached) ❑ Suddessfully Remediated O Requires New AP Next School Year ❑ Special Services i Placement O Other (see attached) ❑ Successfully Remediated O Requires New AIP Next School Yea- El Special Services I Placement ❑ Other (see attached) O Successfully Remo:Gated ID Requires New AIP Next School Year O Special Services/Placement O Other (see attached) O Deficiencies due to non-attendance (refer to Attendance Specialst) Parent/Guardian CommItment/Contribution Check all that apply. ❑ Monitor Attendance / Tardies O Check Homework O Encourage Reading at Home O Reinforce Skills O Attend Parent Conferences O Sign Daily/ treekly Notes ❑ Attend Parent Curriculum/ Information Meetings 681 (REV. 8/12/2003) ORIGINAL - Cumulative Folder COPY • Te SIGMA! ant 0. r'AlteNT IGWNQAN er r-• •aren ua wan [Alt EFTA01709800 Studer! leacher: School: Principal: TH FLORIDA KINDERGARTEN REPORT CARD Vnnr 10 C) The areas listed on the checklist as well as music, art and physical education are included in the kindergarten curriculum. The checklist is composed of skills that are essential for students to master if they are to be successful in the primary grades. All activities provided in kindergarten lead toward the attainment of these skills. The teacher determines the appropriate time for the student to begin formal instruction in each skill. Beginning with the second marking period, the checklist is used to report student progress. NONACADEMIC BEHAVIOR GRADES $5 This grade reflects the students overall conduct in all school activities. 4 = Very Good 3 = Good 2 = Fair 1 = Poor Parent conference requested Parent conference requested • Marking Period Isl 2nd 3rd 411 Noracadomic Behavior 2- 3 ,-.5 3 ATTENDANCE Marlon Peri3d Regular attendance and punctuality are essential for quality education. 1st 2rd 3rd 4I1 Days Present 3q 41 42 ihd Days Absent i .5 00 Days Tardy 0 0 0 0 INFORMATION INCLUDED 7 TEACHER REOUESTS CONFERENCE 'PLACEMENT Grade Summer School Program It summer school program is indicated, grade placement will be determined by the home school. KINDERGARTEN CHECKLIST MARKING CODES formal instruction has not yet begun student receiving formal instruction to meet specific needs and ex- periencing difficulty with skill student receiving formal instruction and making satisfactory progress student consistently performs skill accurately and efficiently Tho asterisks (*)indicate critical skills. CENTRAL PROCESSING BODY IMAGE Irritates Body Motements Identifies Body Parts Assernsles Bocy Paris GROSS MOTOR Creeps Ruts Jumps Hcps Balances Gallops Barites/Catches Ball HAPTIC Moves Through Obstacle Cense Follows Commands Using Body Identites Othects by Touch 3.3 Sorts/Matches °Betts by loud' 3 4 FINE MOTOR/EYE HAND Stings Beads 4.1 Assert:ties Puzzle 4.2 CAP :`s Shapes 4.3 Matches/ Pastes &rapes 4.4 Ci.ts Circle 4.5 Cclors Objects 4.6 Stgueaces Fingers 4.7 2 2.1 2.2 2.3 2.4 2.5 2.6 2.7 3.1 3.2 tZNQ VISUAL DISCRIMINATION 5.1 5.2 Suns ay Color Sorts ay Shape Sorts by Size Matctes Pictures 5.4 •Ichntilies likenesses/Differ- vv. Dci ences of Numbers S.5 'Identities LlbleCis by Relationships •Idwitities Likenesses/Differ- ences ol Letters 5.7 Identities Sue Relationships 5.8 5.3 2nd 3rd 4th VISUAL MEMORY 'Recalls Colors Sequences Shades 'Sequences Natters •Sequences Letters AUDITORY DISCRIMINATION Names Scunds Identities Likenesses/Diger mum of words 7.2 6.1 6.2 6.3 6.4 Flan' 7.1 MN Identities Rhyming Words 7.3 Identities Likenesses/Differ ences of Sounds 7.4 AUDITORY MEMORY Avows Sound Pattern Repeats Sentence 8.2 'Segue hes Nuptials -Fratorrs DlItC100.1 'Sequences Letters LANGUAGE LISTENING Recalls Information 9.1 Predicts Outcome 92 'Retells Story 93 SPEAKING 'States Full Name 10.1 Descnbes Common Objects 10.2 Uses Complete Sentences with Proper Sarsech Patterns 10.3 PREREADING Interprets Pictures 11.1 Recognzes Lapels 11.2 Recognzes Own Name 11.3 'Illustrates Story 11.4 'Recognzes Lepers 11.5 PREWRITING Demonstrates Mastery A Fine Motor Skills •RW0Ckhes First Name 12 I 122 2n0 3rd raoll NEVI MBA ENVIRONMENTAL AWARENESS Obterves Accurately Makes Comparisons Predicts outcomes Phases Siondisant Questions 13.1 13.2 133 13.4 2nd 3rd 4th man MATHEMATICS NUMERATION 'Matches Ole-D•One 14.1 'Names Numerals 0-10 14.2 'Matches Sets and Numerals to 10 14.3 'identities Ordiral Positron 14.4 FRACTIONS •Identifes One-Nall GEOMETRY Identiles Shapes MEASUREMENT Canons Objects 'Orders Objects Ithohles Use of Measurement hots Measures Objects SPECIAL TOPICS Identifies Cohn States Valt5 01 C0003 dons/Separates Sets 2nd 3rd 4th CO*: IS NJV. MI 15.1 16.1 17.3 17.4 Goldenrod/1st Period Pink/2nd Period Yellow/3rd Period Grnn/41li Pried WhIlo/Oltlee Copy SC 6307 EFTA01709801 SCHL: TCHR SAC: ooec AHA CHEST VISION: F DATR/4,4 ?}DARING : (P7 DATE/A ?4, SCOLIO : P F DATE Health Codes if A ri I Sh aside t Hip Urn IlingOwn Caga Hump Shoves, Spine Scapula RH, L Lumbar tiverp Plaits& Seri - esc14 We Myrna -....r EFTA01709802 2 Address /Address CONSECUTIVE SCHOOLS ATTENDED Date Enrolled Date Withdrawn Signature Sending School* -(4,1, 1'195' TRANSCRIPTS SENT Dm Sot Sigsittri Sanding SChOol* principal or designee of the sending school will sign to Indicate the irds are in compliance with stated requirements at the time they are SECTION 3 CHECKLIST OF CUMULATIVE DATA Contents of the Cumulative Folder should be arranged in the 'onowirq order. Date' q 69c 31.flonda Permanent Record Card - Category A K-8 2.Florida Permanent Record Card - Category A 9-12 3.Special Characteristics Card 4.Notice of Psychological Evaluation stapled to back of Special Characteristics Card 5.Registration Forms - most recent on top 6.Cumulative Health Record - Immunizations. Birth Certificate and Physical Examination stapled in- side 7.Other legal information, such as court order, affi- davits and correspondence from community agencies 8.Standardized Test Data Card 9.State Student Assessment Test Record 10.Special Education Information (Staffing, Psy- chological, placements, etc.) 11.Suspension letters/discipline record 12.Teacher/Counselor comments (behavioral ob- servation, anecodotal records) 13.ESOL Student Reporting Form and ESOL Student Record 14 Student Progression/Summer School Informa- tion ELEMENTARY 15.Kindergarten Checklist Purge after 6th grade 16.PREP (SIR) folder Purge after 6th grade 17.CommunicatIons Skills Record Purge after 8th grade 18.Mathematics Record Purge after 8th grade 19.Chapter I Purge after 8th grade SECONDARY 20.Honors and Activities 21.Work Experience 22.Driver Education Certificate 'The individual responsible for the introduction of each item will place initials and date by that item in ink. •• • 4•11•••• • /Or -raft. WN 01-9350 EFTA01709803 ALGEBRA I IX A=SUPERIOR WORK b=ABOVE AVERAGE P.PRT: TS4652 YEAR: 01-02 STUDENT: SUMMER SCHOOL CENTER: HOME SCHOOL CENTER: • SUMMER SCHOUL STUDENT GRADE REPORT PUBLIC SCHOOLS FLORIDA DATE: 07/24/02 TERM: 5 GRADE: 09 FL-I: FL-IO: ----COURSE TITLE---- --COURSE IU-- ----TEACHER---- ABSENCES GRADE CREDIT • 1200310 C•12 314 Pii . TOP COPY: STUDENT COPY A C=AVERAGE D=bELUM AVERAGE MIDDLE CuPY: F=FAILURE W=W I THORAWN I=INCOMPLETE SUMMER SCHOOL LAST COPY: HuME SCHOOL EFTA01709804 &Rape d- nsr "31 4 ma' 7-10 Pala ODIERIWORMATAM CTBS/4 LEVEL 12 FORM A 404 nRars 03 wwm= 4 AGE 8- 9 RIPE NO OIMP INFORMATION CTBSi NAME ,VILLA TUT CATE MY 9- 9 mum:. cireit r5/4 " LEVEL 14 FORM A NAME alum Kit 10-10 r"" CHI f luf MVIION inald CTRS/4 LEVEL 15 FORM B<COEN TEST RECORD INFORMATION TUTL READ READ COMP KEAVIUIL VOCA MATH MAIM CEA MAIM COMP 74 Q3 Q747 READ uMP ' 95 92 t Q4 Q4 T'PE REAE COMP VOCA MATH LEAH 21E MECH rXPR r Q4 9 I 0 TOTI 6FAO RFAD TEM CCDPE SCOPE 4 11 — 9 "" PROWAI ,DN IBS/4 LEVEL CEA 'COMP 64 "ATM ATH ENCE STUD [srr KtAu MAIM rre MIL lANa LANE MFCH LAmis FYPR (multi) 86 04 6 08 3 ..._.. ___. . ..._ . ..._ scont nye UM KtAV EAD COMP tAU OCII LULL MATH MATH MATH LEA COMP IMYAW 6 FORM A I 'Pe c17,1r. c87I Q4 __. _ . _ I I L_._ ___. 73 Q3 M)280 01-9330 •-- .. ••••••••..i...manws, urnina •-•••••••• •••• ute,jt ntormon„ arsine. 6, I 01 13m3 Jona ISOdn 01 alit 1AORItt WIRD* Mai 01 Rail 1A0011 VIVIHOR ISM') 01 atm JAONIN JARMO' ISOAK1 01 11,01 JACHla '1AISINOlt 15003 01 /Dal 3A0H3/ ADHESIVE REMOVE LIIIEll SO EXPOSE ADHESIVE, REMOVE LUILk ro EMS( AOMESERE MOVE Erni TG EXPOSE itONEPATE, itEMOvE LINER tO EXPOSE ADHESIVE REMOvE LINER tO UPCSE ADHESIVE. REMOVE 01 Awl 110m3$ OuSittav nom cu n3N11 IAOH33 MOO 01 Stial 1A0111 '1AISINOv 1S)dX3 01 luau Mtn tRAIS)HOR ISOAT3 01 $3111 MOW 'IMMO Ma) 01 Owl WPM EFTA01709805 Pose, of, IONE Wetlnbmary.) 2005 215 PM YOU NEED TO COME TO GUIDANCE NO LATER THAN 2/10 WITH THE GRADE AND IF BOOKS WERE ISSUED FOR 2/9,2005 EFTA01709806 eaiirt-TS1576 Grade Sex 11 FEMALE The School District of SECONDARY STUDENT WITHDRAWAL hool Year 04/05 FL Race WHITE Birthdate Withdrawal Date Code Printed -02/08/05 FORM This is NOT an official transcript. Please send request to school center for an official transcript. Reason • crtra-4,,,,,. EACH TEACHER: Mark grades to present date. Record number of unexcused absences in upper left half of absence box; record total absences in lower right half of absence box. Collect book(s) and note return. Do all work in ink. Prds Course Sec Bldg-rm Title 01 2001340 001 ENV SCI 04-214 Signature of 02 1001400 004 ENG IV. 01-222 ^". Signature of 03 2102380 203 AMERICAN 02-103 P 5 7 Signature of 04 8301620 003 WORK EXP 04-108 Signature of 05 1001370 015 ENG 03-217 Signature of 06 8301650B 001 WORK EXP-OJT CC-OJT Signature of 07 8301650A 001 WO CC-OJT Signature of ECON EXP 3D7 III 1st Abs 2nd Abs Ex 3rd Abs 4th Abs Book Gr Ex/Un Gr Ex/tin Gr Gr Ex/Un Gr Ex/U Rt'd A 9 11/ 15/ I r IF 10/ 2 F 10/ N 17/ IF IC I c Title of books'not returned Book* Condition Price Other. Outstanding Obligations Media Specialist: Assistant Principal: Occupational Spc: Counselor/Stdt Serv: Data Processor/Date: - / / Parent: Form# PBSD 0756 (Rev. 9/90) 7r sa(74)42 7 EFTA01709807 Rprt-TS1576 The School District of • SECONDARY STUDENT WITHDRAWAL FORM hool Year 04/05 Race WHITE Cp Printed -02/08/05 This is NOT an official transcript. Please send request to school center for an official transcript. Grade Sex Birthdate Withdrawal Date Code Reason 11 FEMALE E t a/V.:2r b_a5- EACH TEACHER: Mark grades to present date. Record number of unexcused absences in upper left half of absence box; record total absences in lower right half of absence box. Collect book(s) and note return. Do all work in ink. Prds Course Sec Bldg-rm Title 01 2001340 001 ENV SCI 04-214 Signature of 02 1001400 004 01-222 Signature of 03 2102380 203 AMERICAN ECON EXP 02-103 P 3 Signature of 04 8301620 003 WORK EXP 21)7 04-108 Signature of 05 1001370 015 ENG III 03-217 Signature of 06 8301650B 001 WORK EXP-OJT OC-OJT Signature of 07 8301650A 001 WORK EXP-OJT OC-OJT Signature of Gr Ex/Un Gr Ex/Un Gr Or Ex/Un Gr Ex/U 1st Abs 2nd Abs Ex 3rd Abs 4th Abs tIgpr '4 15/ / IF IF lc Ic Title of books/not returned Book# Condition Price Other.Outstanding Obligations, Media Specialist: Assistant Principal: Occupational Spc: Counselor/Stdt Sere: Data Processor/Date: - / / Parent: Form# 0756 (Rev. 9/90) EFTA01709808 ;Page: 1 Document Name: untitled PANEL: STDT: START: A17. ABSENCE DETAIL Tuesday February 8, 2005 8:52 am 011005 PERIODS A DATE DLY 12345678901234 011005 AAAAAA 011105 A AAAAAAA 011205 A AAAAAAA 011305 A AAAAAAA 011405 A AAAAAAA 011805 A AAAAAAA 011905 AA A 012005 AAAA AA 012105 AAAA AA 012405 A AAAAAAA 012505 A AAAAAAA 012605 A AAAAAAA 012705 A AAAAAAA 012805 A AAAAAAA 013105 AA AAAA YEAR: 05 SCHL:IIIIIGR: 11 ST: A CAL: VIEW: SCHL CAL PF1=HELP 3=EXIT 5=REFRESH 6=KEYBOARD 7=BKWD 8=FWD 12=ESCAPE PAGE FULL...CONTINUE. FY 01 05 01 05 01 05 01 05 01 05 01 05 01 05 01 05 01 05 01 05 01 05 01 05 01 05 01 05 01 05 TERML: DQ36 Date: 2/8/2005 Time: 8:53:29 AM EFTA01709809 Page: 1 Document Name: untitled PPM: A17. ABSENCE DETAIL Tuesday February 8, 2005 8:53 am SCHL: CAL: PERIODS 12345678901234 SCHL 01 CAL YEAR: 05 GR: 11 ST: A VIEW: _ FY STDT: START: 011005 A DATE DLY 020105 AA AAAA 01 05 020205 A AAAA O1 05 020305 A AAAA 01 05 020405 AA A AA 01 05 020705 AAAAAA 01 05 PF1=HELP 3=EXIT 5=REFRESH 6=KEYBOARD 7=BEND 8=FWD 12=ESCAPE NO ADDITIONAL PAGES. ..NEXT? TERML: DQ36 Date: 2/8/2005 Time: 8:53:32 AM EFTA01709810 Page 1 of I From: Sent: Wednesday, Februa 09, 2005 7:43 AM To: Cc: Subject: W/D W/D 2/8/05 due to non-attendance Please come down to Guidance and sign off on this Withdrawal Thanks • • 2/9/2005 EFTA01709811 FCAT Huila Comprehensive Assesmnil Tnt Spring 2003 FLORIDA COMPREHENSIVE ASSESSMENT TEST (FCAT) MATHEMATICS SUNSHINE STATE STANDARDS PERFORMANCE TASKS Student Report Grade 10 This report provides your results on the FCAT 2003 Mathematics performance tasks. Each performancetask on FCAT requires you to respond with either a short response or a longer, more detailed response. Short-response tasks are scored on a 2-point rubric and extended-response tasks are scored on a 4-point rubric. One of the short-response tasks Is shown below with a copy of your answer. The number of points you earned for your answer Is shown in the box to the right. FCAT 2003 MATHEMATICS PERFORMANCE TASKS Student Name Student Number School Name School Number District Name District Number This Performance Task Response Al Mathematics Performance Task Responses Points Possible 2 16 Points Earned 0 4 • The students in the senior class at Paradise Island High School have decided to raise money by selling graphing calculators and geometry tool kits. They have set aside 53,000 to purchase the items they need to selL They will spend 515 for each calculator, and 520 for each tool kit. Prom past experience, they know that twice as many students vii0 buy the calculators as will buy the tool kits. The inequality and equation below can be used to determine the number of each item the senior class should have available to sell, where c is the number of calculators and t is the number of tool kits. 75c t 20t s 3,000 c = 2t How many tool kits should the senior class purchase? Show your work Number of tool kits a a. Data Run Date: 05/07/2003 0063696 854200035 EFTA01709812 Spring 2003 FLORIDA COMPREHENSIVE ASSESSMENT TEST (FCAT) READING SUNSHINE STATE STANDARDS PERFORMANCE TASKS Student Report Grade 10 This report provides your results on the FCAT 2003 Reading performance tasks. Each performancetask on FCAT requires you to respond with either a short response or a longer, more detailed response. Short-response tasks are scored on a 2-point rubric and extended-response tasks are scored on a 4-point rubric. One of the short-response tasks Is shown below with a copy of your answer. The number of points you earned for your answer Is shown in the box to the right. This task required you to read a passage about an American zoologist's attempts to rehabilitate two young gorillas in Africa. Describe how Coco and Pucker change as a result of their experience with Dian Fossey. Use details and information from the story to explain your answer. FCAT 2003 READING PERFORMANCE TASKS Student Name Student Number School Name School Number District Name District Number This Performance Task Response All Reading Performance Task Responses Points Possible 2 12 Points Earned 1 5 CP-cs) ona roc arm \-NeraWnycx- ott "rnesi lecon -‘-ruc:A. bun/O.ns. CC O. Data Run Date: 05/07/2003 C033897 853200837 EFTA01709813 Florida VirtualSchool Official Final Grade Report • 2/26/2004 Student: Student Number: Course: Biology I Grade Level: Course Code: 2000310 Date of Birth: Instructor: School: Student Address: Fl District: Honors Credit: No Semester: Final Grade: WM Credit Earned: 0.0 FLVS Code: 71.0600 prg • This is to report your Final Grade for the above course. Your grade is being mailed to your district to be included on your official transcripts. EFTA01709814 FCAT Reports Separate reports are produced for the Sunshine State Standards tests in FCAT Reading and Mathematics, Science, and Writing. A separate report is also printed for the norm-referenced tests in Reading and Mathematics. FCAT Norm-Referenced Test (NRT) Report The FCAT NRT report shows reading and mathematics scores on a Florida version of the SAT9 (published by Harcourt Educational Measurement). Student scores are compared to a national "norm" group, where a percentile rank score of 50 is average. Sunshine State Standards (SSS) Reports The FCAT SSS Reading, Mathematics, and Science reports show test scores from Florida's tests of academic standards. These reports contain subject scores and content scores. Subject scores describe the overall achievement, and content scores give the number of points earned in specific skilt areas. Success on the Reading and Mathematics tests can be best understood by using the achievement levels where a 3 or higher is on or above grade level. Achievement Levels Five categories of achievement describe the success students have with the content tested on the FCAT Reading and Mathematics. Level 5 is the highest and Level 1 is the lowest. Since science achievement levels have not been determined, science scores are ranked as to whether they fall in the lowest, middle, or highest third of statewide student performance. 5 This student has success with the most challenging content of the Sunshine State Standards. A student scoring in Level 5 answers most of the test questions correctly, including the most challenging questions. 4 This student has success with the challenging content of the Sunshine State Standards. A student scoring in Level 4 answers most of the test questions conectly, but may have only some success with questions that reflect the most challenging content. 3 This student has partial success with the challenging content of the Sunshine State Standards, but performance Is Inconsistent. A student scoring in Level 3 answers meny of the test questions correctly, but is generally less successful with questions that are the most challenging. 2 This student has limited success with the challenging content of the Sunshine State Standards. 1 This student has little success with the challenging content of the Sunshine State Standards. FCAT Certificates Students who earn Level 5 scores or whose science scale scores are greater than 400 receive Certificates of Achievement. For writing, certilicates are given to all students with scores of 5.5 or 6 and to fourth graders with scores of 5, 5.5, and 6. Certificates are not awarded based on the FCAT Norm-Referenced Test scores. Informes FCAT (Spanish) Se preparan informes separatlos para los exåmenes del FCAT de lectura y metei/Alices, ciencias y redaccien según las normas estatales Sunshine State Standards. También se imprime otro informe por separado para los exåmenes de lectura y mateméticas de acuerdo a las normas de aplicación nacional. Informe sobre el FCAT cefiido a normas de aplicación nacional (NRT) El informe del FCAT NRT presenta los resultados de lectura y matemåticas en una versión del estado de Florida del SAT9 (publicada por Harcourt Educational Measurement). Los resultados obtenidos por los estudiantes se comparan con el grupo modelo o "norma', en el que la dasiticación es de un 50% del promedio. Informes según las normas estatales Sunshine State Standards (SSS) Los informes según las normas estatales SSS del FCAT presentan las calificaciones de los exåmenes de lectura, matemåticas y ciencias de las normas académicas de Florida. Estos informes contienen calificaciones por materias y calificaciones por contenido. Las calificaciones por materia proporcionan un resumen general del rendimiento y las calificaciones por contenido que proveen el numero de puntos obtenidos en åreas de habilidades especflicas. El éxito de los exåmenes de lectura y matemåticas puede entenderse mejor utilizando los niveles de rendimiento en los que una calificacien de 3 o superior astå al nivel del grado o por encima. Niveles de rendimiento El éxito que un estudiante ha logrado en el contenido examinado en el FCAT de lectura y matemeticas se describe por medio de cinco categorfas. El nivel 5 es el mås alto y el nivel 1 es el mås bajo. Como los niveles de rendimiento en ciencias no se han determinado, las calificaciones de ciencias se clasifican con respecto a si entran dentro del tercio inferior, medio o superior del rendimiento estudiantil a nivel estatal. 5 Este estudiante tiene éxito con el contenido mås diffdl de las normas Sunshine State Standards. Un estudiante del Nivel 5 responde a la mayorfa de las preguntas del examen correctamente, incluyendo las preguntas mås difíciles. 4 Este estudiante liens éxito con el contenido däld de las normas Sunshine State Standards. Un estudiante del Nivel 4 responde a la mayorfa de las preguntas correctamente, pero es posible que solo tenga cierto éxito con las preguntan que reflejan el contenido mås difícil. 3 Este estudiante tiene un éxito parcial con el contenido clinch de las normas Sunshine State Standards, pero su rendimiento es inconsistente. Un estudiante del Nivel 3 responde muchas de las preguntas del examen correctamente, pero por lo general tiene menos éxito con las preguntas que son mås dificiles. 2 Este estudiante tiene éxito limitado con eltontenido difícil de las normas Sunshine State Standards. 1 Este estudlante tiene poco éxito con el contenido difícil de las nornas Sunshine State Standards. Certificados del FCAT Los estudiantes que se clasifiquen en el Nivel 5 o cuyos resultados de ciencias seen superiores a 400, reciben Certificados de rendimiento. En redacción, los certificados se otorgan a lodos los estudiantes que han obtenido calificaciones de 5.5 y 6, y a los estudiantes de cuarto grado que han obtenldo 5, 5.5 y 6. Los certificados no se otorgan basados en los resultados del FCAT cefildo a normas de aplicación nacional. Rapò FCAT (Haitian Creole) Yo prepare rap& apa pou egzamen lekti ak matematik, syans ak redaksyon FCAT bay swivan prensip Sunshine State Standa