ESOL/LEP COMMITTEE CONFERENCE FORM

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Appendix H – English
ELL COMMITTEE CONFERENCE AND PARENT NOTIFICATION FORM
Student Name _____________________________________ , ______________________________________
(Last Name)
Student # _____________________ School _____________ Grade _________
Program Entry Date ____ /____ /_____
(First Name)
Conference Date ____ /____ /_____
Date Entered US School ____ /____ /_____
Letter of Invitation to Parent/Guardian for Conference is attached.
Phone Call and/or Parent Letter of Invitation sent home on 1st attempt ____ /____ /_____ & 2nd attempt ____ /____ /_____
Reasons for ELL Committee meeting: (Circle applicable codes)
Placement (L01)
4th yr. Extension (L30)
Exit (L05)
Retention (L07)
Pupil Progress (L02)
5th yr. Extension (L40)
Re-Classification (L08)
ESE Intervention (L03)
6th yr. Extension (L50)
Re-Exit (L09)
LF Review Intervention (L10)
RtI (L11)
Spring CELLA or CELLA Form 3 Online
Test Date
FCAT
(3 – 12)
_____ /_____ /______ Test ID _________________
Listening/Speaking __________
Reading ___________
Writing ___________
Test Date _____ /_____ /_______
Proficiency Level _______
Reading Level ______
Proficiency Level _______
Proficiency Level _______
Reading Scale Score __________
*Proficiency Levels
B = Beginning L = Low Intermediate H= High Intermediate P = Proficient
Standards Based
Progress Reports
attached
(If applicable)
Other (L98)
Grades and Performance Levels (If applicable)
Language Arts _______ Performance Level ________ Reading ______ Performance Level _______
Math ________ Performance Level ________
Social Studies _______ Performance Level _______
A = Above Grade Level
Science _______ Performance Level _______
*Performance Levels
O = On Grade level
B = Below Grade Level
Committee Comments/ Disposition: __________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
Student Exits from the (ELL) English Language Learners Program by committee meeting.
Exit Date _____ /_____ /_____ _ (Basis of Exit code “L”)
Results of Conference were shared with Parent/Guardian by: Form or Telephone (Circle) ____ /____ /_____
___________________________________________
Parent/Guardian (If present)
___________________________________________
Administrator/Designee
Revised 07/17/2013
_________________________________________
Resource Teacher/Instructor
_________________________________________
ELL Contact
_____________________________________
Guidance Counselor
___________________________
Data Entry (Initials)
Appendix H – English/Spanish
ELL COMMITTEE CONFERENCE AND PARENT NOTIFICATION FORM
(CONFERENCIA DEL COMITÉ ELL Y FORMULARIO DE NOTIFICACIÓN A LOS PADRES)
Student Name _______________________________________ ,
(Nombre de Estudiante)
Last Name (Apellido)
_____________________________________
First Name (Nombre)
Student # ___________________________ School _______________ Grade _________
(Estudiante #)
(Escuela)
(Grado)
Program Entry Date ____ /____ /_____
Conference Date ____ /____ /_____
(Fecha de la Conferencia)
Date Entered US School ____ /____ /_____
(Fecha de Entrada al Programa)
(Fecha de Entrada a Escuela en Estados Unidos)
Letter of Invitation to Parent/Guardian for Conference is attached. (Carta de invitación a los Padres/Encargados está adjunta)
Phone Call and/or Parent Letter of Invitation sent home on 1st attempt ______ /______ /_______ & 2nd attempt ______ /______ /________
Llamada telefónica y/o carta de invitación a los Padres / Encargados fué enviada en el 1º intento & 2º intento
Reasons for ELL Committee meeting: (Circle applicable codes) (S322)
Razones para la reunión del Comité ELL
(Circule códigos aplicables)
Placement (L01) (Ubicación)
Pupil Progress (L02) (Progreso del Alumno)
Exit (L05) (Salida)
Re-Classification (L08) (Re-Clasificación)
4th yr. Extension (L30)
(4º año Extensión)
Retention (L07) (Retención)
5th yr. Extension (L40)
ESE Intervention (L03) (Intervención ESE)
6th yr. Extension (L50)
(6º año Extensión)
(5º año Extensión)
LF Review Interventions (L10) (Intervención LF)
Spring CELLA or CELLA Form 3 Online
Test Date ______ /______ /_______
Listening/Speaking __________
Reading ___________
Writing
___________
Reporte de Progreso
del Estudiante adjunto
(Si aplica)
(Otra)
Re- Exit (L09) (Segunda Salida)
RtI (L11) (Respuesta a Intervención)
FCAT
(3 – 12)
Test ID ____________________
Proficiency Level _______
Test Date _____ /_____ /______
Proficiency Level _______
Reading Level ______
Proficiency Level _______
*Proficiency Levels
B = Beginning L = Low Intermediate H= High Intermediate P = Proficient
Standards Base
Progress Reports
attached (If applicable)
Other (L98)
Reading Scale Score _________
Grades and Performance Levels (If applicable)
Language Arts _______
Math ________
Social Studies ________
Performance Level _______
Performance Level _______
Performance Level _______
A = Above Grade Level
Reading ________ Performance Level _______
Science _______
Performance Level _______
*Performance Levels
O = On Grade level
B = Below Grade Level
Committee Comments/ Disposition: Comentarios del Comité / Disposición: ______________________________________________________
____________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________
Student Exits from the (ELL) English Language Learners Program by committee meeting.
Estudiante sale del programa (ELL) Aprendices del Idioma Inglés por reunión del comité
Exit Date (Fecha de Salida) ______ /______ /_______ (Basis of Exit code “L”)
Results of Conference were shared with Parent/Guardian by: Form or Telephone (Circle) _____ /_____ /_______
Los resultados de la Conferencia fueron comunicados a los Padres / Encargados por: Escrito y/o Teléfono (Circule)
___________________________________________
Parent/Guardian (If present)
___________________________________________
Administrator/Designee
Revised 07/17/2013
_________________________________________
Resource Teacher/Instructor
_________________________________________
ELL Contact
_____________________________________
Guidance Counselor
______________________
Data Entry (Initials)
Appendix H – English/Kreyòl
ELL COMMITTEE CONFERENCE AND PARENT NOTIFICATION FORM
Student Name ______________________________________ , ______________________________________
(Non Elèv la)
Last Name (Siyati li)
Student # ___________________________ School _______________ Grade _________
(# Elèv la)
(Lekòl)
First Name (Non li)
(Klas)
Program Entry Date ____ /____ /______
Conference Date ____ /____ /______
(Dat Konferans la)
Date Entered US School ____ /____ /______
(Dat yo Antre Pwogram nan)
(Dat Ou Antre Lekòl Ozetazini)
Letter of Invitation to Parent/Guardian for Conference is attached.
(Yo mete lèt pou envite Paran/Responsab elèv la nan yon Konferans ak Fòm sa a)
Phone Call and/or Parent Letter of Invitation sent home on 1st attempt _____ /_____ /_____ & 2nd attempt _____ /_____ /______
(Apèl Telefonik ak/oubyen Lèt Envitasyon yo voye lakay paran yo)
Reasons for ELL Committee meeting: Circle applicable codes (Rezon pou reyinyon Komite ELL la) (S322)
Placement (Plasman) (L01)
Pupil Progress (Pwogresyon Elèv la) (L02)
4th yr. Extension (L30)
5th yr. Extension (L40)
ESE Intervention (Entèvansyon ESE) (L03)
6th yr. Extension (L50)
(5 ane Ekstansyon)
Retention (L07) (Retansyon)
LF Review Interventions (Entèvansyon pou Revizyon LF) (L10)
Exit (Soti) (L05)
Re-Classification (Reklasifikasyon) (L08)
Listening/Speaking ____________
Reading _____________
Writing _____________
Nou atache kanè ki bay
Rapò sou Pwogrè Baz
Estanda yo (Si aplikab)
RtI (L11)
FCAT
(3 – 12)
Test ID ___________________
Test Date ______ /______ /______
Proficiency Level __________
Proficiency Level __________
Reading Level ______
Proficiency Level __________
Reading Scale Score ___________
*Proficiency Levels
B = Beginning L = Low Intermediate H= High Intermediate P = Proficient
Standards Based
Progress Reports
attached (If applicable)
(Lòt)
Re-Exit (Re-Soti) (L09)
Spring CELLA or CELLA Form 3 Online
Test Date _______ /_______ /_______
Other (L98)
(6 ane Ekstansyon)
(4 ane Ekstansyon)
Grades and Performance Levels (If applicable)
Language Arts _______ Performance Level _______
Math ________
Performance Level _______
Social Studies ________ Performance Level _______
A = Above Grade Level
Reading _______ Performance Level _______
Science _______ Performance Level _______
*Performance Levels
O = On Grade level
B = Below Grade Level
Committee Comments/ Disposition: Kòmantè/Dispozisyon Komite a: _________________________________________________________
____________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________
Student Exits from the (ELL) English Language Learners Program by committee meeting.
Elèv la ap soti nan Pwogram Elèv ki ap Aprann Anglè yo (ELL) swivan desizyon reyinyon komite a
Exit Date (Dat li Soti) ______ /______ /_______ (Basis of Exit code “L”)
Results of Conference were shared with Parent/Guardian by: Form or Telephone (Circle) ______ /______ /_______
Yo te Pataje Rezilta Konferans la avèk Paran/Responsab la pa: Fòm oubyen Telefòn
___________________________________________
Parent/Guardian (If present)
___________________________________________
Administrator/Designee
Revised 07/13/2013
_________________________________________
Resource Teacher/Instructor
_________________________________________
ELL Contact
_____________________________________
Guidance Counselor
______________________
Data Entry (Initials)
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