General Education Teacher Questionnaire
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1South Bend Community School Corporation
Special Education Services
General Education Teacher Questionnaire
Student Name: __________________________ Grade: __________TOR: ______________________________
Poor
Below Average
Average
Above Average
1. School Skills/ Work Habits:
Attendance
Attention skills
Class participation
Organization
Self-advocacy
Work ethic
Homework completion
2. Social Skills/ Behavior:
Interaction with peers
Interaction with adults
Behavior (comment below if
poor or below average)
Personal Care
3. Academic Progress:
Reading
Math
Written Expression
Classes/Subjects (list)
Grade
%
Reading Level
Acuity
Study Island
ISTEP/IMAST/ECA scores
IREAD3
Pass
Fail
What accommodations are effective in your classroom?
Comments (Please comment on student’s speech/language skills in the academic setting if student receives
speech/language services only):
Please return to __________________________________________ By ________________(date)
8/6/10
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