PEP

							                                                     Bladen Lakes Primary School
                                                     Personalized Education Plan


Student Name:
Grade:
Homeroom:
Quarter:       after quarter 1       after quarter 2               after quarter 3
Note: attach form for each quarter to the first form of the grade level
     Indicator:            Indicator:             Indicator:           Indicator:            Indicator:           Indicator:
   SuccessMaker         SuccessMaker             ClassScape           ClassScape            Classroom             Classroom
                                                                                           Performance           Performance
      Reading                Math              Reading             Math                 Reading               Math
Need based on:         Need based on:         Need based on:     Need based on:         Need based on:        Need based on:
Prescriptive          Prescriptive          Benchmark         Benchmark             Report card grade    Report card grade
scheduling report,     scheduling report,     Percentage         Percentage Correct
more than ____         more than ____         Correct                0-25%              Behavior             Behavior
sessions need to be    sessions need to be        0-25%             26-50%
proficient by the      proficient by the          26-50%                               Other                Other
end of the year        end of the year                           Other
Not performing at     Not performing        Other
at least 65%           at at least 65%
Other                 Other
Strategies:            Strategies:            Strategies:        Strategies:            Strategies:           Strategies:
Increase sessions     Increase sessions
to __x per week (no    to __x per week
more than 10)          (no more than 10)
Tutor in delayed      Tutor in delayed
skills                 skills
Increase session      Increase session
length to __ (no       length to __ (no
more than 25)          more than 25)
Other                  Other




       Parent copy                          Homeroom teacher copy                          PEP file in principals’ office copy
                                                   Bladen Lakes Primary School
                                                   Personalized Education Plan


Additional Strategies:
Student is attending/will attend 21st Century Afterschool Program

Student is attending/will attend afterschool sessions with teacher

Student will be involved in flexible grouping within grade level

Behavior Intervention Plan (BIP) in place; Initiated by school counselor

Individualized Intervention Plan (IEP) in place; Initiated by Exceptional Childrens Department Lead Teacher

Other Recommendations/Comments from Teacher:


Parent comments:


Parent signature:
Date:

Regular Education Teacher signature:
Date:

Exceptional Children Teacher (If applicable) signature:
Date:

Team leader signature:
Date:

Principal signature:
Date:




       Parent copy                        Homeroom teacher copy                       PEP file in principals’ office copy