School Year by lyl0SI

VIEWS: 4 PAGES: 3

									                                                                                               Assessment Decision Record
                                                                           The information on this form documents the reason for exemption as required by 19 TAC §101.1003.
                                                                           Keep this form and supporting documentation in the student’s permanent record folder.


                          Student Name:                                                                                                              Initial Date of Enrollment in U.S. Schools:
                                 Student ID:                                                                                                                                         Date Identified as LEP:

  School                         1. Summary of Evidence of                                        2. Summary of                                3. Summary of                                                     4. Assessment Decision
   Year                             Insufficient Schooling                                         Instructional                             Progress by Spring                                                           and
  in U.S.                                Outside U.S.                                              Interventions                              of Current Year                                                      Reason if Exempted
Indicate school   Fill in soon after initial enrollment in U.S. schools.                    Describe the instructional             Record this information in spring of year upon final   From the list below, indicate the applicable assessment decisions and reason if
year and grade.                                                                             interventions designed to strengthen   determination of need for exemption.                   exemption granted. Reasons are listed on back side of this form.
                                                                                            inadequate skills.
   Year 1                                                                                                                                                                                     Exemption not applicable; not                    Assessment Decision
                                                                                                                                                                                              enrolled at time of testing          (Subject) Eng TAKS Spn TAKS Exempt LAT


                                                                                                                                                                                              Student will take TAKS in one
                                                                                                                                                                                              or more subjects
(school year)
                                                                                                                                                                                              Student is exempt in one or
                                                                                                                                                                                              more subjects. Letter of reason
    (grade)                                                                                                                                                                                   from list on back: ______

   Year 2                                                                                                                                                                                     Exemption not applicable; not                    Assessment Decision
                                                                                                                                                                                              enrolled at time of testing          (Subject) Eng TAKS Spn TAKS Exempt LAT



                                                                                                                                                                                              Student will take TAKS in one
                                                                                                                                                                                              or more subjects
(school year)
                                                                                                                                                                                              Student is exempt in one or
                                                                                                                                                                                              more subjects. Letter of reason
                                                                                                                                                                                              from list on back: _________
    (grade)

   Year 3                                                                                                                                                                                     Exemption not applicable; not                    Assessment Decision
                                                                                                                                                                                              enrolled at time of testing          (Subject) Eng TAKS Spn TAKS Exempt LAT



                                                                                                                                                                                              Student will take TAKS in one
                                                                                                                                                                                              or more subjects

 (school year)
                                                                                                                                                                                              Student is exempt in one or
                                                                                                                                                                                              more subjects. Letter of reason
                                                                                                                                                                                              from list on back: _______
    (grade)

								
To top