Form Ats-102 - Review Committee Documentation Form Page 2
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2Classroom Participation: A written teacher summary of student performance in the classroom, which
should include cooperative learning participation, projects, extra effort, remediation efforts, homework,
and growth made during the school year should be included.
Items to be included in Student Portfolio:
Reading
Mathematics
•
•
Writing samples (represent 2 of the following modes: narrative
Writing samples depicting problem solving strategies (2)
•
(personal or imaginative), argumentative, clarification, persuasive,
Responses from 2 teacher made tests depicting different math
point-of-view)
strands
•
•
Responses from 2 teacher made tests depicting usage of reading
Responses from 2 commercially-made tests (Benchmark Tests, etc.)
strategies, reading selection tests, etc.
•
Responses from 2 commercial-made tests (Benchmark Tests, etc.)
Exceptional Children
Limited English Proficiency
•
•
Written statements from the exceptional children’s and regular
Written statements from the ESL teacher and classroom teachers
education teachers that address student’s current progress
that address the progress the student has made during the academic
•
year
Student’s current IEP & EC placement folder information
•
•
Work samples demonstrating progress in all academic areas
Recommendations on waiver from the IEP committee
•
Any additional measures demonstrating student achievement
All Students
•
Students Report Card – copy should be included in the cumulative
folder
•
Include any other information which would document student
performance and support granting the wavier.
Attendance:
__________________________________
__________________________________
__________________________________
Teacher’s Signature/Date
Parent’s Signature/Date
Principal’s Signature/Date
Committee Member’s Recommendation:
Date:___________________________________________________
To Promote_________ to grade__________
To Retain__________ in grade__________
Committee Signatures:
Principal:____________________________________________________________________________
Teacher of Current GradeLevel:__________________________________________________________
Teacher of Receiving Grade Level:_______________________________________________________
Central Office Representative:___________________________________________________________
EC Representative:____________________________________________________________________
LEP
Representative:_______________________________________________________________________
Parent:______________________________________________________________________________
WCS Testing Department
Review Committee Documentation
ATS-102, page 2
08/27/10
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