EFTA01710166

PROT0 PROT1 too: Ly _., THE SCHOOL DISTRICT OF PALM BEACH COUNTY .---. NEW/RETURNING STUDENTS REGISTRATION ISTR:2511 TCHR:PUTIGNA, E TNER:163STOT: 13642421 a.. 03/30/00 0 - 08:3 408 Sc BEAR? 4:14> ANA-424 ' 1 STUDENT NUMBER: VERIFICATION FOR NEW/RETURNING STUDENTS: TO THE PARENTS OR GUARDIANS: NEW STUDENTS: Complete all non-shaded areas on both sides of form RETURNING STUDENTS: Please review both sides for correctness 01 typed information. If the intormaton printod is incOrrOCt, please correct it by carefully and lightly crossing out the incorrect information and writing the correct information above it C2,6 I-On II) STUDENTS LEGAL HARM (2) ALSO 'MORN AS i...ST 13) LOCAL ADDRESS (4, GUn IVG ADDRESS .C./.1 he mar MAW( a, ',We 41;ar orES Vrilt, 4• Ml s., 4. cn, sr *Tr t, car rrAW isi metiers SOCIAL SECURITY NO. (OPTIONAL) 161 HOME >HONE N0. il) I remAte 3 SEX F MALE (8) . e I RACE AMERICAN INNAN OP ALASKAN NATIvE. B NON-HISPANIC D A ttl iCti:IC ISLANDER I H HISPANIC 1 W yy:::,...,,,,..,<, 0 M v..,..0... (9) DATE OF BIRTH 000ro n'' (IEN PLACE Of BIRTH Art FL U$,,,, FL0RID4,,,", (II/ RES:DENT STATUS 3 0. FOREIGN EXCHANGE STUDENT I. OUT-OF -COUNTY RESILIENT I 2. OUT-Of -STATE RESIDENT 0 3. IN-COUNTY RESICENT 112E ENTRY DATE INTO USA 113) FEDERAL 9 YES 0 TES YES O HS YES iNVIACT A 0 SURVEY 0 NO A. THE I NU B. THE 0 NO C. THE PARENT 0 NO D. THE PARENT 0 NO E. THE PARENT IF IFS. STUDENT FESIDES ON SIAM PE SILES IN IS EMALMID IS MAIMED IS IN THE IS THE PARENT AIR FORCE UNIFORMED ON 0 FEDERAL PROPERTY. NW KENT HOUSING. DN LEDERAL ON .OW RENT SERVICES ACTIVE MITT? ARMY PROPERTY LOCATED HOUSING LOCATED OF TIE UNITED 0 YES 0 COAST GUARD IN IN 0 PALM BEACH COUNT/. PALM BEAN COUNTY. STATES. MO N MARINES 0 NATIONAL GUARD ll NAVY 1 41 HAS THIS OHIO REIN ENROLLED IN AN PRY srannt, C. CHAPTER I I C. PREK DISABILITIES 9 1. PRE-K EARLY INTERVENTION CEASE PLACE A DICKMAN( I jar SY EACH PROGRAM ATTENDED. WITH AN ASTERISK I *) NE PROGRAM TIM CHILD SAS 0 It NIAUSTANI 0 I li MIGRANT PAT-K 0 9 N. NON-SUBSIDIZED CHILD CARE ALSO, INDICATE IN THE LONGEST.) 0 OTHER S SIRSIPIIFIL El•Illl CAM OM IS NE STUDENT A SINGLE PARENT? 9 NO us 0 MO 116) CuRRINY GRADE lE4 08 TRANSFER INFORMATION: (II) NAME OF SCHOO. TRANSFERRING FROM (I8/ CITY OR IODATION (19) DATE Of LAST ATTENDANCE 120E GRADE LEVEL (211 LAST PUBLIC SCHOOL ATTENDED IN PALM BEACH COUNTY (22) DATE ATTENDED FREE OR REDUCED PRICE LUNCH AND HEALTH INFORMATION: (23) NAVE YOU FILLED OUT AN APPLICATION FOR FREE OR REDUCED (APPLICATION IS PROVIDED WITH THIS REGISIP.ATION IOW/ LUNCH? II YES Ill NO (24) HEALTH SCREENINGS: I GIVE PERMSSION FOR MY CHILD TO IN G AEN HEALTH THESE TESTS MAY BE GIVEN INCIVIDUALLY OR IN GROUPS. SCREENINGS. 0 YES NO 0 NO (251 $00iuM FLUORIDE: I GIVE PERMISSION FOR MY CHILD TO PART CIPATE IN TO PREVENT DENTAL DECAY. PERMISSION IS VALID THROUG1 THE SODIUM FLUORINE PROGRAM 0 YES GRADE SIR NO 0 no NEW STUDENTS TO PALM BEACH COUNTY: HOME LANGUAGE SURVEY UM WHAT LANGUAGE IS SPOLEN IN THE HON! BY THE PARENT or GUARDIAN. kri WHAT LANGUAGE IS SPOLEN IN THE ROME BY THE STUDENT? 28) DATE Of NM INTO THE ESN PROGRAM 129) LANGUAGE SURVEY I. IS A LANGUAGE OTHER THAN ENGLIST USED IN HE HOME? 2 OMIS THE ST,IDENT HAVE A IIRST LANGUAGE OTHER THAN ENGLISH? 3. DOES nit STUDENT MOST FREQUENTLY SPEAR A LANGUAGE OTHER THAN ENGLISH? OTIS ,YES OILS 0 NO El NO Ill NU (30) DISCLOSURES Ia lirst say MID Ellis SCHOOL DISTRICT HAS THE STUDENT EVER. I. BEEN EXPELLED FROM SCHOOL? 2. HAD AN ARREST RESULTING IN A CHARGE? 3. HAD AM JAVENILE JUSTICE ACTIONS? 0 YC 0 t> ll EL 0 YO 0 NU 0 NO PROT2 THE SCHOOL DISTRICT Of PALM BEACH COUNTY - NEW/RETURNING STUDENTS REGISTRATION BACK (31) STUDENT LIVES WITH (CHECK ONE) 0 BOTH PARENTS s MOTHER El FATHER ❑SHARED CUSTODY E OTHER (32) TRANSPORTED BY Swart em tie %raspy/IAA le/Lem EON', oy has ,I *Ow Than IMF OM/ T33) IS THERE A COURT ORDER BARRING EITHER PANEW INDIA REMOVING OR CON- ACING THE STJOENT DURING THE SCHOOL DATE 0 YES 0 NO IF YES, PLEASE PROVIDE THE SCHOOL WITH A COPY OF THE COURT ORDER (34) FATKER/GUAREHAN DOES FATHER HAVE CUSTODY, OYES Elmo YES (351 MOTHER. GUAR MAN DDES MOTHER HAVE CUSTOM!) D YES 0 NO YES ll MOKI LAM FL 33470 it' a a LAST FL 33470 NOME /430MSS CM STAR aCOOS e4JA. Kw (tAa OF ONUNNOWT MCI OP MaCinaDir NOM MOM Mufti LORI CO4 Fwom ARAM POI 1361 An D HIGHEST lEvEl OF EDUCATION COMPLETO (OPTIONAL) OAMINTAP• toga BO or 0 1003. C 0 0 litSOOL twat .r.e auers 1.1E. Featousvo 0 .....or.stc..... TIOAtiCALFTWOD E D ra,scsucmisot COSA I ., Mal, (311 NIGH.ST 'Eva OP EDUCATION COmPTETED )OPTIONAL) AD :r aj lni: IICH:a B 0 tan NO. til00( C [le SOCO. wawa 6.I. anuAto D 0 ",,, nnte `s- E 0 nal.'"jc aua 1310 LEGAL GUARDIAN PR AIM DOES LEGAL GUARDIAN HAVE CJSTODYT Ill YES n Na is L. .0.41 &OOMit CITY PATE IMERCIENCY HEALTH AND SAFETY INFORMATION PART I PERSONS) OTHER THAN PARENT AUTHORIZED TO PICK UP STUDENT 091 PASSWCRD OMIT 10 CHARACTERS) In NPLLe (II) NAME ADDRESS PHONE RELA'IONSHIP u C- 1 YES 0 NO OW NAME ADDRESS PHONE RELATIONSHIP n U YES 0 NO (431 NAME ADDRESS PHONE RELATIONS/4M U rl YES 0 NO (441 NAME ADDRESS PHONE EFL ATTONSHIP u I- 1 YES 0 NO (45) NAME POORESS PRONE PELAIK)ESHIP u rn YES 0 NO ICE) PART II F SCHOOL PERSONNEL ARE UNABLE TO CONTACT YOU IN CASE OF ILLNESS OR ACCIDENT. MAY WE HAVE YOUR PERMISSION TO CALL YOUR DOCTOR OR IMERGENC, SERVICES (III) POR TRANSPORT TO THE HOSPITAL' YES C3 N3 (41) EMILY DOCTOR 148) PHONE NuWEIER (49) HOSPITAL PREFERENCE ISO) LIST YOUR CHAD'S ILLNESSES, ALLERGIES OR CHER PHYSICAL ,IMITATIONS YOUR CHILDREN IN OTHER PALM BEACH COUNTY SCHOOLS: IS 11 NAME Of CH4 0 SCHOOL ATTENDING STOOP(' NO ICPTIONAI) GRADE BIRTH CATE 1021 NAME OF CHAO SCHOOL ATTENDING STUDENT NC. (OPTIONAL) GRADE BIRTH DATE 1531 RAW OF CHILD SCHOOL ATTENDING STUDENT NC. (OPTIONAL GRADE BIRTH DATE 154) NAVE OF CHILD SCHOOL ATTENDING STUDENT NC (OPTIONAL) GRADE BIRTH DATE (551 NAME OF Cm() SCHOOL AT TENDING STUDENT NC. (OPTIONAL GRADE BIRTH DATE 156) 1 VERIFY THAT TIN INFORMATION GIVEN IS TRUE ANO ACCURATE TO THE BEST OF MY INOVILEME SIGMATIRE 3) PARENT OR IF GAL GUARDIAN O..0 FOR OFFICE USE ONLY: DO/ SCHOEN ND 2511 (STD QOM; EMINTREA (St SITIOINT t A Main GE EN ED [CR VII ENTRY (001 E01 U2( ENTRY CATS 08/16/98 4B3L SAC tEVE 420A 184, PARENT, GLARCIAN LANGUAGE EN us 'lib/ GRADE LENT. 08 (561 CALM OR 01 Nil) TEACHES NE. 438) REASSIGNMENT CODE 0A, AOM 074SE 0B 7ESOL 010.M0G 1611 TRANSPORTATION 0 YES 0 N?,4 0 I I 3 4 s 6 70) tE 6 (CATION OF O.RTH 1 T 3 4 6 6 7 6 9 T 011 EMS z AEI ,GATE 72) DOE MINTATION CDECAUST misuNiZATiONS HECA ANN DATE WHEN gifttriel VISIMICATION Of BIRTH RECORDS El 'ATE BI CloATE SOCIAL SECURITY n NO OP ORAL la 'ATE PMCGICAL EXAMS OM DATA FERRI COMPIFT(0 St DATE: PBSO 0636 (REV. OM) PROT3 HE SCHOOL DISTRICT OF STUDENT NUMBER oat oks, \ 1 4e., K.. L ..",:";NEW/RETURNING .;7) / PALM BEACH COUNTY r STUDENTS VERIFICATION FOR NEW/RETURNING STUDENTS: TO THE PARENTS OR GUARDIANS: NEW STUDENTS Complete all non- shaded areas on both sides of RETLRNI form NG STUDENTS: Please review both sides for correctness of typed nforrration. If the information printed is incorrect, please correct it by CarefUlly and lightly croSsEng out tho incorroct information and writing the correct information above it. REGISTRATION ... ea Cl) STUDENT'S LEGAL NAME 21 ALSO PINONN AS (3) LOCAL ADDRESS )•7 L. .i 1.3 4' )Pn - • C 7 2 iligraffini r <T. /.. I . <foe IS) STIM(NT'S SOCIAL SECLIRIT, N) PTI NA. 0( S FEMALE 0 mA., MI RACE 0 I frOM R CAL P I AC sA ill AINtOi NATIVE 9 MAC .: 0 NON-HISPANIC I A PArIFNI: 1 ISLANDER I W w".".1(Hip,.., El H INSANE. C El M MULL RACIAL MOO. DAY ■ rA MD/ PLACE OF BIRTH en. La'Pi t 411 CA. F io t do, ..---, (15, III) RESIDENT I STATUS, DV 0 Fano IICIWIV STUOINT I. OUT -OF •CORNTT RESIDENT I Et 1 OM-Of-STATE RESIDENT 3. IN-:OURTV RESIN! ENTRY CATE IN70 USA 1131 FEDERAL 0 115 I I ll O fFS IMPACT AID Suarfir 0 NO A. TOE STUDENT TES 9 NO B. TOE STUDENT in ii NO C THE PARENT YES 0 NO 0 THE PARENT D NO F TN( PARENT IF YES. RESIDES ON RESIDES IN IS EMPLOYED IS EMPLOYED IS IN THE IS TIC PARENT AIR FORCE IECERAL LOW RENT ON FEDERAL ON LOW UNIFORMED ON ACED( I ARM) PROPERTY, VOWING RENT SERVICES GATT? PEOPEATT LOCATED IN HOUSING LOCATED IN OF THE UNITED 1:l TES I I COAST GEAR( PALM BEAN COUNTY. PALM BEACH COUNTY. STATES. NO 9 MARINES 0 NATIONAL GUARD I NAVY 04: HAS ll THIS CHILD BEEN ENROLLED IN ANY PRESCHOOL? C. CHAPTER I D. PRE-K DISABILITIES E. PRE-K EARLY INTERVENTION LPL; AM PLACE A CHECOAA4K Ike ST EACH PNONKAM ATTENDED. ALSO, ALIKAlt WITH AN AMMO I * I THE PROGRAM TOUR CHEM WAS IN THE LONGEST I I H HEAESTART 9 0 OTHER I M MIGRANT PRE -IL El S. su6ScIZED CHILD CARE I N. NON-SUBSIDIZED CHILD CARE libi IS THE STUDENT A SINGLE PARENT? I Iris NO IMO `[ARE IT GRAPE LEVEL -01 TRANSFER INFORMATION: (Ill NAME OF SCR( 01 TRANSFERRING FROM IUD CITY OR LOCATICN ILB DATE OF EAST ATTENDANCE (20) GRADE I WI 20 I AST POOL IC SCHOOL ATTEND) S IN PAi Ns RA AIN COUNT( (22 DATE ATTENDED FREE OR REDUCED PRICE LUNCH AND HEALTH INFORMATION: 123) HAiE IOU I DU 0 CUT AN APPLICATION FOR FREE OR REDUCED (APPLICATION IS IS PROVIDED WITH THIS REGISTRATION FORM/ MOO I IFS 134) HEALTH SCREENINGS: I GIVE PERMISSION FOR Mr CRIED TO BE GIVEN HEALTH THESE TESTS MAT BE GIVEN INDIVIDUALLY OR IN GROLPS. SCREENINGS. YES II NO 1151 SODIUM ILUORIOE: I RIVE PERMISSION ION MC ONItO TO PARTICIPATE IN TO PREVENT DENTAL DECAY. PERMISSION IS PALM EIROUGII INF SURMA *IMAM( PROAAM YES :RARE SIX. I NO NEW STUDENTS TO PALM BEACH COUNTY: HOME LANGUAGE SURVEY '25) WHAT .ANALIAISE Is. SPOKEN IN THE HOME BE THE PARENT re GUARINO& an WHAT IANCJAGE IS SPOKEN IN THE NOME BY TIE STUDENT" URI DATE Of ENTRY INTO TN ESOl PROGRAM 135) LANGUAGE SURVEY I IS A LANGUAGE OTHER THAN ENGLISH IMO IN THE HOME? 3. DOES THE STUDENT HAS( A FIRST LANGUAGE OTHEF THAN INDIAN, 3 DOES THE STLIIHNT MOST IRFOUENTI Y SPEAK A LANGUAGE OTHER THAN ENGLISH? IES II f( STUDENT DISCLOSURES FOR 1F THE SCHOOL ()STRICT OF Pf <5 o A COUNTY n iv 4 ;46 FOS THE STUDENT EVER S I BEEN ExPILLE0 HUM SCHOOlt 'f' 2 MAD AN ARREST RESULTING API 4. 3. HAD AND JUVEIIIII JUSTICE PBSO 0636 IRA7 $/97/ PROT4 THE SCHOOL DISTRICT OF PALM BEACH COUNTY - NEM/RETURNING STUDENTS REGISTRATION BACK IS)) STUD I LIVES WITH (CHICK OKI GOTH PARENTS 0 MOTHER 0 FATHER i SNARID CUSTODY Q OTHER 1 4 1311 TRANSPORTED OY $14.4*.a ..a 4.6 ucitspmned tylinr +w. kw C.. m• 4.4/ I646 p....1) CA CC:q- (B3) IS THERE A COURT ORDER BARROIC EITHER PARENT FRoirtEMONNen CONTACTING THE STUDENT DURING THE SCHOOL DAY'n YES OR IF YES, PLEASE PROVIDE THE SCHOOL WITH A COPY OF THE COURT MUM 74e F. IFER/Gu Al DOES FATHER HAVE CUSTODY YES 0 NO 13.5) MOTHER/GUARDIAN DOES ROPIER HAVE CJSTOOY' CipeES 0 NO C 7O VI ISLVD C OY1Q_ A H 1. im 4V L U 1 NB. t C 0 =try D 0 E 0 ...-rar,.:".... - 13 3•HiGHE R ST D LEVE. OF PCUCATiON;OMPTETEID ' ICPTIONAll C i ncl. lcbcc. 0 'ow Hn. : 7 4.6 ,0 • . E D it conauX4••••1 MARY,. •• mcms MN LEGAL GUARDIAN OP ANY1 DOES LEGAL GUARDIAN NAVE CUSTODY( 0 !Es 0 No 1 4664444 OT• VATS - 70 em 0•44. is/ INN ang/IT EMERGENCY HEALTH AND SAFETY INFORMATION PART I PERSONISI OTTER THAN PARENT A JTHORI2E0 TO PICK UP STUDENT (3)) PASSWORD fLIMT 10 CHARACTERS) a' 7"""ZW PO. 0•1001100 PICK/ PHONE RELATIONSHIP /YES Fa ea. 0 NO 1:11tTIONa Bp irec rn. 0 NO ADDRESS REEATIONMiro u I- 1 YES 0 NO IAN ma ADDRESS PHONE RELATIONSHIP u rl YES 0 ND 145) NAME ADDRESS PHONE RLLAIION Sm. r-1 u YES 0 No KM PART II f sa4001. PERSONNEL ARE UNABLE TO CONTACT YOU N CASE OF Ill NE SS OR ACCIDENT, ILAY WE HAVE YOUR PERMISSION TO CALL YOUR DOCTOR OR EMERGENCY SERVICES 19111 FOR TRANSPORT TO THE HOSPITAL, 'as 0 w o ( 71 F DOCTOR .9 d) ,... a-t C CS? e' S•ct ( 40) PHONE HUREER 1447 ROSiUAL PREFERENCE (50) LIST YOUR CHAD S BONUSES. ALLERGIES OR OTHER PHYSICAL LPArATONS I) 47 A.L. YOUR CHILDREN IN OTHER PALM BEACH COUNTY SCHOOLS: STUCE 4 NO (OPTIONAL) GRAN C•40Ct We ATTENDRIG ( I Intkon etmorl4cA 4n SCHOCt, ATTERVERG LOP4kovcido tAkrttle_ STUDENT NO. (OPTIONAL/ GRADE 14-'n SCHOOL ATTE Gr Loy.cmakevee etta Vet ery STUDENT NO. (OPTIONAL/ GRA tCHOCI. ATTENDING STUDENT NO 1011 AO GRADE IBS) NAME OF CHID 5010" ATTENDING STUDENT NO 'OPTIONAL) ORAOE IIRTI1 DATE 1661 I VERIFY THAT THE INFGRNATION GIVEN IS TRUE AND ACCURATE TO THE BE ST OF MT ENGEM DU 5's_ OO OA TI FOR OFFICE USE ONLY: - 5671 SCHOOL NO. (It 4TUDEN7 WImaiIi 1541 s3U011it AN AlAtf FIN (C0. 2611 TOOL 7 I TR( OS if 463) SAC CODE 64) 414(11T 611.1401AN 14.111,3461 1461 GRA 7k 14.11 IFS) CALENDAR %II TEACHER NO. HI REA SSIGNME 7 CODE CIF.M 1571 TRANSPORTATION 9 us 0 NO 701 SERIF IC A TIEN Cf BUM' II) IRS I 72) DEICUNIDITATION tMCNLIST (ClllCS AND DATE WN18 IDEATE HAmuNIZAT:066 0 CATE titY401 WMFICAT.044 0, 44148 RECORDS M.PAAG 0 I I 3 4 S 6 ) 3 4 5 6 7 S 9 7 A E Z Oo*TF inAi nSEaugI gar TY 0 CA TT PHySICAL BRANS 11110 Sy °ATE PROT5 ) 71ploot.:p;.\ Ixt - t PALM BEACH COUNTY PUBLIC SCHOOLS }-4 St PALM BEACH COUNTY, FLORIDA, t: c: 31 ,9 KINDERGARTEN REPORT CARD Saga ler-> // t e e,t C/ E/1-1 'ail Principal: - Lt-) iS The areas listed on the checklist as well as music, art and physical education are included kindergarten curriculum. The checklist is corn of skills that are essential for students to ma they are to be successful in the primary grad( activities provided in kindergarten lead towar attainment of these skills. The teacher determin€ appropriate time for the student to begin k instruction in each skill. An explanation of program is attached at the end of the first mai period. Beginning with the second marking pe. the checklist is used to report student progress. MARKING CODES E - Excellent S - Satisfactory VS - Very Satisfactory N - Needs Improvement HABITS AND ATTITUDES Miklos Pried Demonstrates self-control Respects the rights of others Respects the property of others Demonstrates good listening habits Follows directions Demonstrates consistent effort Completes assignments Works well independently Participates well In group activities Takes care of and uses materials properly ATTENDANCE Regular attendance and punctuality are essential for quality education. Days Present Days Absent Days Tardy INFORMATION INCLUDED TEACHER REQUESTS CONFERENCE I 2nd 4th *PLACENli tIT Grade Summer School Program 'If summer school program Is Indicated, grade placement will be determined by the home school. KINDERGARTEN CHECKLIST MARKING CODES El formal instruction has not yet begun R ' student receiving formal Instruction to meet specific needs and experiencIng difficulty with skill El student receiving formal instruction and making satisfactory progress IN student consistently performs skill accurately end efficiently The asterisks (*) indicate critical skills required prior to the student being considorod for promotion. CENTRAL PROCESSING BODY IMAGE Imitates Body Movements Identifies Body Parts Assembles Body Parts GROSS MOTOR Craps Runs FINE MOTOR/EYE NA Strings Beads Assembles Funk Copes Shapes klatthes/Pactres Shapec Cuts Circle Colas Objects Sequences Fingers VISUAL DISCRIMINATI Sons by Coor Sorts by Shape Sort by Size Matches Pictures *Identities Likeness&Ditterenon of Numbers 'Identifies Objects by Pelatonships Identifies Likenesses/Dalai ences of Letters tad 3rd 4th 1. t. 2 LANGUAGE LISTENING Recalls IV ormation Predicts Outcome ' Betels Story SPEAKING ' Stales Full Name 9 [repeated 3 times] 'ascribes Common Objects 1 :es Complete Sentences with Proper Speech Patterns ' 1EREADING wets Pictures ognizes Labels 4nties Own Name Vales Story owes Letters tt 11 11 II 11 WRITING Mimics Mastery of e Motor Skulls 12 -Reproduces First Name 12 or .1•4 ore ENVIRONMENTAL AWARENESS Observes Accurately Makes Comparisons Predicts Outcomes Phrases Siginticant Questions 13 1 13.2 13.3 13 4 2nd 3rd am Identifies Sire Pelabonmips VISUAL MEMORY *Recalls Colors Seqsences Shapes 'Sequences Numbers 'Sequences letters AUDITORY DISCRIMINATION Names Sounds Identifies Likenesses/Dittoraces of Words Identifies Hymn° Words Identities Licenesses/Ditletaces of Sounds AUDITORY MEMORY Repeats Sound Pattern Repeats Sentence 'Secuences Numerals 'Fathers Oirecticns 'Searences Letters MATHEMATICS NUMERATION 'remits One-to-One ' games Numerals 0-10 ' Matches Sets and Numerals to 10 identifies Ordinal Position FRACTIONS Identities One Half GEOMETRY Identifies Shapes MEASUREMENT Compares Objects 'Orders Objets nientilies Use of Measuement Tools Measures Objects SPECIAL TOPICS Identifies Coins States Values of Coins .oinsrSeparates Sets 14.1 14.2 11.3 14 4 '5 1 161 / l 'i 73 1/.4 18.1 82 83 2nd 3rif 4th I FIISO 0767 (FY 90 aevlslerfl Goldenrod/tat Period PInk/2nd Period yellow/3rd Period GreenbIth Period White/Moe Copy CC 364t4 PROT6 MIDDLE SCHOOL OF THE ARTS RECORDS REQUEST FORM Date irthdate h 10}k Grade Level 1-O)(C_AVCAC.k..e. 17"-zlernesAc-6 Previous School Attended Student Number (if known) C te_sf U3 o OO1 vYYjcile. sc.koc-) Palm Beach County Middle School you were scheduled to attend ESE PROGRAMS: EP IEP 504 Plan LEP Plan PROT7 /0,/,0,,,, Middle School of the Arts PROT8 Please return to your high school guidance counselor. right Future SCHOLARSHIP PROGRAM I verify that I have received and read the initial eligibility requirements of the Florida Bright Futures Scholarship Program for the year 2001. Verification of Receipt [This is not the Student Authorization FormJ NAME [please I fin SIGNATUR DATE II/ 13/O0 PROT9 I verify that I have received and read the initial eligibility requirements of the Florida Bright Futures Scholarship Program for the year 2003. Please return to your high school guidance counselor PROT10 Student Name I hereby give perm' card will be sent h Parent Signature 7 Teacher at school. I understand that the fingerprint PROT11 6-91 NARRATIVE RECORD Notations by educators, nurses and other designated personnel should be dated and signed. Narration section should include information concerning referrals, follow-up and special consideration to be given students in classroom as a result of screening, as well as teachers' observations, parent conferences, home visitations and services rendered. Educators need orly record information concerning teacher observation and educational decisions made for students in the classroom as a result of screening and other health informaticn. VA IL 9.a_ be_ 4fr iatc--zil-A1 --4--- rod --64a-ttat. -"at Oppi t a.A. 17C. .1.1v orm 3041, MAY 80 (31 PROT12 STATE OF FLORIDA DEPARTMENT OF HEALTH & REHABIUTATIVE SERVICES LTH EXAMINATIONS 9/ Date C • Prone Birthclate pi parent or Guardian A. HEALTH EXAMINATION (I) Normal-N; Abnormal-A N antlingnrA rmal irnirgriFi r 1. Amen:ice 2. Skin/Nose tC1/ 3. Head /SC* L.) 4. Eyes 42 5 Visual Acuity (R a Ll 8. Ears t../ 7. Auditory Aciity (R a L) 8. Nose / Throat 9. Mouth, Teeth and Gums 10. Chest / Lungs 11. Head 12. AtOornen c.-"/ 13 Genitals and Anus ,../ 14. Musculo-Skeletal ..-/ IS. Neurological 16. Alertness ...2 y , 17. Emotional / Mental/ IN:they:or Prob.) AV- 18. Handicap. Physical/ other (SPecity) 19. Activity Restrictions (SPecily) 20. Abuse. substance/ PhYSical / enbtional 21. Nutrition .-/, c 22. Other C " 7 B. HEALTH HISTORY (swim* messes urturiet expiai Sexes bum - (attach narratke il additional space needed) C. LABORATORY (as indicated) Hemogbbin/Hemalocrit ) Steel (0 6 P) T (-Mu Sickle Cell i Tuberculin test TITLE: ADDRESS: (Pleas* Print) LAKE WORTH, FLORIDA 334 NRS - I4 form 3040, Apr 87 (Replaces Aug ee edition Islock Humber. 6744.000.3040.2) n may be aim Mauna (Over) PROT13 1 E MUNIZATION (HAS 680 - PART A) Le 704 F Nap TS LS,: Mc • Ns CND MM. ai 4;1M'. Sinn LW" IGO II PH 5 Mils KOMI I -4 F)500 Faux:0 DO% OF on DT FTICTATACI vgaTE 6 ACCEPT***ti PERTUSS6 'Kat 6 11ECOLLY COTIWITICATE0 C D PAM C FDA 059 Anti! VACOM W 0A SE S OF TAPI fT711- 1 114 TKO eftlally DTSE or Iry ACRATASTMED Ogg OR Af ItM IN fapiTH WIDOAY A FORTH 005E * ROT KOINE° FIXO ATTCCITTE 6 OAT TEO FROM De WOWED PMURIZATTX OF OILMEN 18 *OS CF lames CR TER litr. An QUA I MST IMO a COOPED - IOC* AT 12 6006 OF AGE DR COERAAO Ai *TES OR LATER :RECCRATAFTetn AT IS la04, 1EASI.ES SIDE - 100if Al It MONTI* 0l AG1 M (LACIER luenIS6II Olt ARA • AEC05.44 NON AT 15 M(15 04•• MAPS SWal - 10050C AT It WINS* Mt IP MIER akitA - t DOSE Al I? home OF la OR OWER ALL APP4OPRATF tOSES MO OAFS ACED OFtod)Art 0.451 tit Milt40 110 TIE 04.010 AT TEED spa I Vat KMIEC ME ATOMS AVAAAEtE MO TO TIE BEST Of in KTATWIEDGE INF 00u0. 0EA5E8.1yV6 NO MAU* Milne) Ft ROCA LAW FOR SOUZA ATTE 4.J RICHMOND. M.D. & I MARCAUS. M.D P A cTANLEY Dr7.1' r- TILCT- 5 0 t• 1.RNO.ATT Matt Fa (MAST P l, CATI Of MTN I t I DADS WYE la) Ca n PAPSO CM maxima -NM°. A r II of Ns X01 MONO It 'Multi 0305 IrVIT I PUT l REAM COMPtill M11 M 510 C PS UMGMIAM ac WI 110 OM I Celtic THAT ATTAN24106 TEMPORARY MEDICAL EXEMPTION (HAS 680 - (PART 8) Tot Afar 040 *t wmu PECE,44 055 n 010Jis .6 TED &TLC?* Od) lAS TOTATTOCTO A SO4Cull 10 :OWE* 04 if OWED APASZAD016 Kam:Long__ AN TAIT WOULD' TWA INS T14 AW70",, 7 OE uAtCP1 OATE*54t5:. rult iiin OA '4, bit *0.05.01, *It ATO.Citn DATE A0260/* DTP DT AT POW MuR ion MIR i ni FOCI A WANES Paws '.ST MO a ,5 OmS AFTER 5411 AMOMWA • NSW. Fwv*Dai Olt MAMA MrNAFUM °Mt * GATIFY ion I Ulna PERMANENT MEDICAL EXEMPTION IHRS 680 - (PAR THAT 14 IMYSCM 0:40101. * IleS 040 6 SDI frA' MANZATIONSI 6 11(4.5:.t. trhrAiNVA7(0 MIT *CMOs. PM ILO Cilia ISMS DI HOC FurSCumS OComnftif CA75 PROT14 IT b. c FA R-14AblE STATE OF FLORIDA DEPARTMENT OF Note/ * inn ___N_ Health & Rehabilitative Services DISTRICT NINE I HVISSY CERTIFY THIS TO K A TPA COPY OF THE LOCAL Pr2r:.:23TRAR'S MitC000 SEAL TYPE OR MINT X POWST 011.0a MACIINC \Mamoru; ;Not vela unless the Seed aasi of trio Bureau of VW Matsfics S affixed.) manure r i PKIMITAI - MME O. e PALM PEACH COUNTY DEPARTMENT OF PUBLIC HEALTH 9O1 LWR40.14. ST. %VW PALS VLACH, R. 33401 ant T I rm.( Vitt MICORC.L' vfalT CERTIFICATnEo OF UVE RTH w BI (N rot rot In Otp l.i pn SPIV MC stn067 Bethesda Memorial Hospital, Inc. lowlife Wt IM 1111W olor 5. mrrxwe) ► CERXXER - MME Al III so Mildred Correll Record Tech. &SOOT - STATE COIAITT e, 10,01 in Florida eb Palm Beach Sc 100111ERS MMLIIG ACI0RESS - (I ism al stet ructio C001 idyl 33444 I ffrltly tMl OA personal am do OP IM1r1 IIt. 0. el female Y. TOWN OR CCATOT Of 5111 h l W 3b11:18 RA EMT Bo nton Beach 4, Pal m Beach MM( IMO MI( OF ATIEkkusT AT MAINE OTTER TM 0 No C4I tw lost Sine bpi Del ray Beath KALX tnf 011T AM er IM Octal 20 SIM sealry) INN 0llY UNITS Onal STATE Of MIRTH (if sot IT USA Florida soot'. ECN11Y swistft twin malty) PROT15 N Stude Address irthdal0 LTH EXAMINATI S hone Name of Parent or Guardian A. HEALTH EXAMINATION Heigh • -t sex_ (I)NormeleN; AbnOrrnal=A N A COMMENT: Abnormal Findings, by number 1. Appearance C r. 2. Skin/Nose ../ 3. Head/Scalp 4. Eyes 5. Visual Acuity IR & Ll . 6. Ears 7. Auditory Acuity (R & L) 8. Nose / Throat 9. Mouth. Teeth and Gums 10. Chest / Lungs 11. Heart 12. Abdomen 4". 13. Genitals and Anus 14. Muscio-Skeletal 16. Neurological V " 16. Alertness 17. Emotional / Mental/ Behavior Prob.) 4. 18. Handicap, physical/ other (Specify) 19. Activity Restrictions (Specify) 20. Abuse, substance/ phytical / emotional 21. Nutrition 22. Other B. HEALTH HISTORY (Serious Illnesses Injuries: explain) (attach narrative if additional C. LABORATORY Hemogbin/liemac Lead T r PEDIATIM CENTER, P.A. (Please Print) Stool (O a P) Sickle Cell Tuberculin test: re OH 3040, 10/96 (Riotous HRS.), Form 3040 which may Do used) (Stook tiumbor. 5744-0004040-2) gnature Date PROT16 SS_ _NM Certificate of Immunization for K-12 Excluding 7th Grade Requirements PART A-1 (Immunizations are complete for school entry and attendance grades kindergarten through 12 with the exception of the 7th grade requirement.) DOE Code 1 I have reviewed the records available, and to the best of my knowledge, the above named child has been adequately immunized against diphtheria, tetanus, pertussis, polio, measles, mumps, rubella and hepatitis 8 (for kindergarten effective with the 1998/99 school year) for school attendance as documented on the reverie side of this fain. Physician or Clinic Name: Physician or (Print or stamp) Authorized Signature: Address: Date: Certificate of Immunization Supplement for 7th Grade Requirement PART A-2 (Immunizations are complete for students who enter or attend the 7th grade after the beginning of the 1997/98 school year. Each subsequent year thereafter, the next highest grade will be included in the requirement.) DOE Code 8 I have reviewed the records available, and to the best of my knowledge, the above named child has received the following immunizations required for entry and attendance in 7th grade effective with the 1997/98 school year: tetanus-diphtheria boaster, hepatitis B vaccine series, and second dose of mearles vaccine as documented on the reverse side of this fonn (bared Address: THE PEDIATRIC CENTER, P WELLINGTON, FLORIDA 33414 Physidan or Signature: Date: a Ss Temporary Medical Exemption PART B (For preschool children, children in day care and school children who are incomplete for immunizations in Part A-I or A-2.) Invalid without expiration date. DOE Code 2 1 certify that the above named child has received the immunizations documented on the reverse side of this form and has commenced a schedule to complete the required immunizations. Additional immunizations are not medically indicated at this time. Address: xpirAtion ate osaasiltroexibmigilitkitiir Physician or Authorized Signature: Date: Permanent Medical Exemption PART C For medically contraindicated immunizations, list each vaccine and state valid clinical reasoning or evidence for exemption: DOE Code 3 I cent& that the physical condition of this child is such that immunization(s) as indicated in Part C above is medically contraindicated. Physician Signature: Address: LH M. 1196, obsolete earlier editions (Stock Number: 5740.0))4680-6) Date: PROT17 A FLORIDA CERTIFICATION OF IMMUNIZATION TATUTES 232.032, s. 10D-3.088, F.A.C. and s. 10M-12, F.A.C. PARENT OR GUARDIAN Directions: Enter all appropriate doses and dates below. Sign and date appropriate certificate (A-1, A-2, B, or C) on reverse side of form. If the child is presenting for the 7th grade requirerneikhthiihailaipreviously filed a Certificate of Immunization (680. or 680A-1) with their current Florida schsnKfilifiboted areas bel0W•aililannplete Part A-2 on the reverse side of this form. For additional information: See.lciniurilZatiencOOMCIiiteSifor4bliObraittEChijdtire Facilities for information and instructions on form completiorcand iibmpliiiatioiLreqUireinents.:Gnidelineirtie updated annually and are available from the local county health dinartnient.:.:7:-.. <4;14 - VACCINE &Gel? '`.,Dose Dose 5 /DAIYR- ' O/DA/YR MO/DA/YR DTaP/DTP2 DT' s. Polies 4Iya HIB6 MMR (Combined)' P:\ (Separate): G, FIRST MI DOB MO/DA/YR Child's SS# (optional) STATE IMMUNIZATION ID# Hepatitis B9 i The state immunization ID# is an identifiersupplied by the siateimmunizationiegistry (optional). 2 DI? 5 doses required. If the fourth primary dose is admihisteretorforifter the fourth birthday a fifth dose is not required. DTaP is an acceptable alternative for one or more doses of DTP. 3 DT (pediatric) is acceptable if Pertussis vaccine is medically contraindicated. (Complete Part C for Pertussis contraindication.) 4 Td (Adult) Vaccine is recommended for children 7 years of age or older. Polio 4 doses required. If the third dose is administered on or after the fourth birthday, a fourth dose is not required. IPV is an acceptable alternative for one or more doses of OPV. Polio vaccine is not required for children 18 years of age or older. 6 Hib is required for child care and preschool entry and attendance only. i 1st dose valid if given on or after 1st birthday. Second dose (measles) valid if given at least 1 month.after 1st dose. A second dose of measles (preferably MMR) is required for students in grades K-4 in the 1997-98 school year, and 7th grade entry and attendance effective with the 1997/98 school year. In each subsequent year thereafter, the next highest grades are included. s Includes single measles vaccine (G), single mumps vaccine (H) or single rubella vaccine (I). 9 Hepatitis B vaccine series is required for seventh grade entry and attendance effective with the 1997.98 school year and kindergarten entry and attendance effective with the 1998-99 school year. In each subsequent year thereafter, the next highest grades are included. PROT18 STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES CUMULATIVE SCHOOL HEALTH RECORD (This form is not intended for physician's use) Address Date of Birth Immunization Certification: Special Immunization Programs fcg • At Special Health Problems • See Narrative IA) Sex' School 44P>I CWee •Cser-4-4:kr ather's Name Mother's Name of Birth Bni in-ion Bch. NoO Birth Recorded: NoO A NARRATIVE NOTE IS REQUIRED FOR REFERRAL AND OUTCOME ENTRIES Screening and Assessment Grades K-3 K 1 Screening Date Referral Outcome ce c m 8 ou I' a) cc o 0 D 0 au ccc. Outcome Screening Date 15 0, cc6 [ Outcome Vision Hearing Height, Weight & Graphing Nutrition Dental Health Mental Health Communicable Disease Records Review Physical Assessment Other Other Screening and Assessment Grades 4.8 4 5 6 7 8 Screening Date Tr •-0 er CC Outcome Screening Date ro - rn 4. CC a) Outcome Screening Date Referral Outcome Screening Date 7. 16 •iii CC Outcome Screening Date 7_ 0 0 CC I Outcome Vision N 4, Hearing Height, Weight & Graphing Nutrition Dental Health' Mental Health Communicable Disease Records Review Physical Assessment Scoliosis Other Other HRS-H Form 3041, MAY 80(Replaces previous editions an PROT19 Florida Writing Assessment Program Florida Writing Assessment Grade 4 Spring 1996 STUDENT REPORT TYPE OF WRITING TESTED: WRITING TO TELL A STORY Student Name: Student I.D. No.: School: District: PALM BEACH COUNTY ATCHEE GROVES ELEM Description of Writing Scores 6.0: The writing focuses on the topic, is logically organized, and includes ample development of supporting ideas or examples. It demonstrates a mature command of language, including precision in word choice. Sentences vary in structure. Punctuation, capitalization, and spelling are generally correct. 5.5: The writing was given a 5 by one reader and a 6 by the other reader. 5.0: The writinnocuses on the topic with 'adequate development of supporting ideas or examples. It has an organizational pattern, though lapses may occur. Word choice is adequate. Sentences vary in structure. Punctuation, capitalization, and spelling arc generally correct. 4.5: The writing was given a 4 by one reader and a 5 by the other reader. 4.0: The writing focuses on the topic, though it may contain extraneous information. An organizational pattern is evident, but lapses may occur. Some supporting ideas contain specifics and details, but others are not developed. Word choice is adequate. Sentences vary somewhat in structure, though many are simple. Punctuation, capitalization, and spelling are usually correct. 3.5: The writing was given a 3 by one reader and a 4 by the.other reader. 3.0: The writing generally focuses on the topic, though it may contain extraneous information. An organizational pattern has been attempted, but lapses may occur. Some of the supporting ideas or examples may not be developed. Word choice is adequate. Sentences vary somewhat in structure, though many are simple. Punctuation and capitalization are sometimes incorrect, but most commonly used words are spelled correctly. 2.5: The writing was given a 2 by one reader and a 3 by the other reader. 2.0: The writing may be slightly related to the topic or offer little relevant information and few supporting ideas or examples. There is little evidence of an organizational pattern. Word choice may be limited or immature. Sentences may be limited to simple constructions. Frequent errors may occur In punctuation, capitalization, and spelling. 1.5: The writing was given a 1 by one reader and a 2 by the other reader. 1.0: The writing may only minimally address the topic because there is little or no development of supporting ideas or examples. No organizational pattern is evident. Ideas are provided through lists and word choice is limited or immature. Unrelated information may be included. Frequent errors in punctuation, capitalization, and spelling may impede communication. The writing is unrelated to the assigned topic orcannot be read, or there is no response. Your Student's Score Dear Parents or Guardians: The paper your student wrote in January as part of the Florida Writing Assessment Program has been read independently by two people trained to score this test. Each reader judged the paper against a set of standards and gave it an overall score. Your student's final score is the average of the two readers' scores. This writing score will help you, your student, and the teacher understand how well your student performed on this statewide writing test. A description of each possible score is printed on the left side of this report. Students were given 45 minutes to read the assigned topic, plan what to write, and then write their responses. The conditions under which your student writes papers in class or at home may not be the same as those for this test; therefore, the writing may not be the same. You and the teacher should consider the score on this test along with all of your student's other writing when planning activities to continue developing your student's writing skills. DESCRIPTION OF THE TOPIC: Students were asked to write a story about what happens after they walk through an open door. 50-19014300000403 PROT20 TEST RECORD INFORMATION GRAM . SIM AGE 8- 7 NMW .CTBS/4ANGN LEVEL 12 FORMA NAAlt Ort*Oe AGE 9- 6 MMEMOMATM CTBS/4 LEVEL 13 FORM A KANE CRAM ME 10 6 OTHER INECMATIM CTBS/4 LEVEL 14 FORM A NAME GRAM AGE 11 - 6 MERVIN:M=OE C765/4 LEVEL 15 FORM B NAME MADE AGE OTSCR GibWrA710,17 PUPIL14° CTBS/4 LEVEL 16 FORM A NAME AGE 13- 6 PUPIL NO O11MR nfOWATON CTBS/4 LEVEL 17 FORM A TRIATO4 GRADE SAT Program The College Board PBSD0280 stallETYFt SCORE Mil wmpit 1119 NW SCORE READ' EMT TOTL lir MATH TAD,'CONP OCA MATH CEA COMP COMP CEA !Kt/upturn TLF•Lt• LANG LANG: NG!MECH EXPR t : am • ••• • • Ie. •••••.. a. . 'bile e Abel mmi y - 17-747scan OIL 'READ READ. TOT! MATH!MATH NAIL scomwm COMP' LEAH TOTL CUMW rEA LANaIMPirk k NG HANGSCI - FYPR • FhlrF SOC AIM Nat =MS L TEIsSi TAD4T(34 irrE 12 SAT Program The College Board WI 01-9330 PROT21 Florian Comprehensive Assessment Test FLORIDA COMPREHENSIVE ASSESSMENT TEST (FCAT) 2001 SUNSHINE STATE STANDARDS Student Report Grade 09 This report shows your results from the FCAT Sunshine State Standards Test. Student Number and Number 2331 - ROYAL PALM BEACH HIGH District Name and Number 50 - PALM BEACH The FCAT Sunshine State Standards Test measures your performance on selected benchmarks in reading and mathematics as defined by the Sunshine State Standards. Scores on this test are one indication of your achievement of the challenging content that Florida students are expected to know. Achievement levels for this portion of FCAT have not yet been determined.. Student Achievement Level Descriptions LEVEL 5: Performance at this level indicates that the student has success with the most challenging content of the Sunshine State Standards. A Level student answers most of the test questions correctly, Including the most challenging questions. LEVEL 4: Performance at this level Indicates that the student has success with the challenging content of the Suninine State Standards. A Level 4 student answers most of the questions correctly but may have only some success with questions thatrellect the most challenging content. LEVEL 3: Performance at this level Indicates that the student has partial success with the challenging content of the Sunshine State Standards, but performance is Inconsistent. A Level 3 student answers many otthe questions correctly but Is generally less successful with questions that are most challenging. LEVEL 2: Performance at this level indicates that the student has limited success with the challenging content of the sunshine state Standards. LEVEL 1: Performance at this level Indicates that the student has little success with the challenging content of the Sunshine State Standards. Your scores are shown below. SUBJECT SCORES Student Achievement Level State Comparison: Thirds Highest Reading Mathematics Sunshine State Standards Reading and Mathematics Scale Scores range from 100 to 500. If you took the test again, your scores might be slightly higher or lower than the scores on this report. However, your scores would probably fall within a certain range. For reading, your scale score should be between 323 and 357. For mathematics, your scale score should be between 286 and 310. The check marks (1 ) show If you scored in the lowest, middle, or highest third of grade 09 Rorlda students who took this test. "TEID: To Be Determined Run Date: 04/28/2001 CONTENT SCORES Reading Words/Phrases Main Idea/Purpose Comparisons Reference/Research Mathematics Number Sense Measurement Geometry Algebraic Thinking Data Analysis Number of Points Possible Number of Points Earned State Comparison: Thirds Lowest Middle Highest The Content chart shows the number of points possible and the number of points earned for each category. Each question was worth 1 point. 0334681 PROT22 PALM BEACH COUNTY COMPUTERIZED CURRICULUM MANAGEMENT 1 - `v n Z O CO. eta C23 c3a cgto g63 <63 C73 cep C92 awl e WM% AO eta c23 ca. 043 c61 c63 c73 clo 492 STUD LO. CO2 Ha c2a c33 ea c63 c6a c73 c63 cep 811 IA UPDATE FORM CM IIII CC. NM N M CF. CO. CIO c I a ea 0(3 aa ,..- 14AT4 CODA NAPE WRITE UPCATE COOT HOPE 4 :remota MATHS GRADE clAa AMAlegC6 cA3 • ASIgred <pa te• student *beganeHATItl. - e Student tetoptiteit•HkritrZ TEST - ate "'ROOM/nal - - tow:7 - V7-1 HAP. -2 3 AP; PROT23 PARI 6101 COUNTY TESTED ibLICCTIVES feat WOE 1 MANDIATICS CIMPTIII 1 1.2 Identify Se antral, 0-10, that represents the timber of given objects. 1.5 Ideatlfy *Sett that are to specific cedinal positions, first throe. Seventh. 1.7 identify the gnat« or lesser of too sobers throat 1CO. OPPTII2 2.2 Aod basic facts, urn to 12, ghee In horizontal end vertical wetter,. 2.5 Identify the addition sentence for a slaty prallen. 2.6 Solve rebus problems In.olving addition. DINTS 1 3.2 Subtract belle facet. minuends to 12. given in horizontal as vertical notation. 3.5 Identify the subtraction sentence for a story problem. 3.6 Solve rebut and word problems involving subtraction and/er addition. aura 4 2.2 ads basic facts, suns to [2, glees in horizontal and vertical notation. 3.2 Subtract basic feats, *linel. to 12. Oren is horizontal and vertical notation. 12.1 Reed end interpret tittles to solve problems. 11.3 Identify punter sentences for story problems. SAM* S 2.2 Add baste facts. sons to l2, given In horizontal and vertical station. 3.2 Subtract bopc faets, aliments to 12, given In horizontal and vertical notation. 1.4 ?Webpairsof related addition ved sebtrection matinees. OUPTEA 6 LI Cowl orally. read, wile, mad rear carats to 100. 1.7 Identify the greeter er letter of two nanbtr$ throtiitb 100. IS Count by ores, twos, floes, and tent to 100. 1.10 Count picturedobjectsWien groused Insets of tens and ses (objects to 1001. ClIAPTS 8.1 Tell tine oa the hour and half.howr. 9.2 identify the wales of a col leak. of colas. 5-6 CmiPmb velvet of groups of otnniel. nlctets. and dines. OUTER 8 2.2 Add basic ruts, tal to 11, given In horizontal end vertical notation. 2.2 subtract basic facts, sivuends to 12. given la horizontal end vertical notation. 3.4 Match of related addition end srbtraction tintieres. 3.6 Solve rebus and word problems Involving interaction a4/or addition. 13.3 Identify nurober sentences for sap Problems. 0(1110 9 IS identify silting numerals or objects In repeating pattern televnet. 6.1 Identify pictures Set show equal parts. 6.2 Identify halves. thirds, end fourths a reglenO. 10.2 Identify plane ~stele floats (circle, square, triangle. rectangle/. 10.4 Ketch «ninon% figtres. OSPIER to 2.4 Add I- and 2-digit ~news to 2-digit meters, without regrouping. 3.3 Subtract 1-digit toters and 2-digit arbors free 2-digit ~es, without rt7m0PI^9• 3.6 Solve robas and heed problems Involving subtraction ved/er nddition. 9.5 add end subtract say to 99t. Oldfa 11 8.4 Mavere length In ~le milts nth., iactet, centimeters, and non.itanderd units. 8.5 ~are liquid measures wiling elms. Pints. quirt, , mid littra- DINTS a lbere Is ea Plastery lest for Cheater 12 at this level. PROT24 In - In progress • Huth MeItenatits CONNECTIONS - GRADE 2 k5Ii - completed aorta 1 • sumrs4 maw a ern I. 20 Son SS IS wn •• womb oa Can.. es wrath a Se BP 0 Ss Cain lonsl seel trail • St Si. NISI wpm rain Naiμ US Illoil almnyb le ales a Ina YM ._s__ •••0 I.060 sea •U Olarttl ••MM. in SISTRACTINI PM ISSN LH es • Ilse I 400 Afters wt % 0505 ': I. me snow tan.t Seel MOM. Tall Ilvo•9k ll Cagle •Mkil••00 Nam t ins 5 aiee Seoul Fells • ran. ulte, Wes •• calm wed MetalsOW corr.' 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''are Vet eat • 04.4 -,'e n Cern% PROT27 CHAPTER II PEIVEL.1 4 t• wits dunes In Luton mei meti era *CI sat :1-en mat bona w C. > nI - :0 to co 4 leans dank ifi ase WWI 7 lee Ceske Ss' .. rt. re tees ortes 01171.1 It INETIPIIIIG P I In PHIRDIS 0.041/2 2dgl eattOrtds hr 14I! Merl .Ste OM 7491 le • wa. 3/44 obob:rds tt laid ',tees n .rs 3494 Me Meet be tag eaters .,b. 'Neel trees n r.a.ae scum Care:. 'Teeter. Int t,ne Ibti Iren re NW eke tenet Itm pig is w I :KVYk. Ix ;rot*** Z W. DIA•Tell ER IIVICHIG IT I OillimatelitS • • pm Enna. el • et se st n.s .:r e.0-•• :me 1 ad 20,1 04:ent: 0 i 144.i am s teunn A I .19 wee& elf 7.0.10•0041 I/ lop' G 3 Riese • 2<til p:e. 1 Ins ••••, 'el' :.....s.10yronints 0e In" , • i SW pains a ;tabu reap WHIG Spat in "v4W• SINS Tr* Ca PROT28 - II 0 1 2 3 r. r. 7 A 0 1 2 3 4 5 6 7 B I ) 3 c 5 6 6 1 1 3 4 PALM BEACH COUNTY COMPUTERIZED CURRICULUM MANAGEMENT NAN STUDENT I D N g, intio n rr WNW! 9 , LO I.D. 5 0 7 0 I!_sBL .___BB __j UPDATE FORM es MINTE I8 IIIII 0 MO E G H I J Cl> InW"A me: uni C017 COX 110W GRADE 1 to student began READING 117,_ / ate student ccapieted READING rjr../n/ij TEST DATE RETEST DATE(S) LEVEL LEVEL 5 / / !Ara 6 LEVEL / / LEVEL 8 LEVEL 9 LEVEL 10 / v PROT29 Me NMI COUNTY TESTED OILXITIVIS (OM GU« I COMMAICA1101, 54131.5 MINIM! tint 4 4. I. I V Reed [welt voftbrisay words. 4. 2. 1 Y ynderstand em use [nix vocabulary wires. LEVEL S 4. I. I w 4144 Mtn( wee4Sulavy toads. 4. 2. I v uodeettand MO ace ball( some:platy wards. Len I 4. 1. I Y Rea basic vocaPriory owes. 4. 2. I Y Lindwilland ead ese basic exatelary «net. S. I. I C Identity the ash, idea 0! the pictere(1). 5. 2. 1 C [Kali 014111 lee. Met. ~re. Near ireith. ho.). 5. 3. I C Salute(' *feet 41, 64 itictufei 8. I. IC ~steel . tttttt tic wiedioe. 10. I. I S 144emate the lettera a the alphabet. MIN(' LIVE 7 4. I. 1 V Rod basic vocebulary morel. 4. 2. IV ileitrileid fed ate basic ,Ktlulri wards. 4. 2. I V Uodevstied ån4 .14 01.041 44.4% 444", is t 4" S. I. 1 C UMW, the mein 1414 of the oictuvelt). S. 2. 1 C Miceli det4lis tone. neat. Mere. MM. Skid.. M.2. O. I. I C ~sire a reelittic selection. 14. 1. 1 t tech a decIsr4the sentence .lth 4 capital letter and eon with 4 Mri00. MIMI Lein 0 4. 1. I V Readbasic aau1Np words. 4. 2. 1 Y U•OrritiA4 M4 ute basic .:‹4b.lary opt". 4. 2. 2 Y Identify &tiniest of netkrowa words hs using ptetest clues. 5. 3. 2 C SeQueste and ndeesln4 tee use of Nest/let and before/ .flex. 6. I. 1 C Identify a pareffiwas4W MITI 1604. 5. 1. 2C Uoderatend . fantaay selection. Id. 3. 2 L Sepia an Interrogative teotent4 with a capital letter 4nS of with a eiestio• red,. FIRS: 4[10(R LULL 9 4. I. I V Rea Wife{ veCa>,Icry ~4%. 4. 2. 1 Y Under$146.4 ind Ne 44%1C Neatelary words. 4. 2. 5. I. 2C 144•011 the te.lf.te Mat erOwistes the mal• ides of a pwasree. S. 3. 2 C Sequence and Ndrrttand the use of firti/latl ant, tefore/after. 6. I. 2 C 8. 1. 1 C Viderst.nd 4 realistic %Neste». 10. I. 3 5 (into', Wes by categories. 10. 2. 15 Interret a weiti .5th airier, sypols. 11. I. 15 Ceesiete å fore .pusling mew and ope. 14. 2. I L Ioentif2 ads that net people. pleelir ard FIRST 4110(1 Still 10 4. I. IV lead basic vocabulary an. 4. 2. 1 a Ilpertln0 4,4flete4sit 'Nebular, weds. 4. 2. 5 e U60avtlihnd ad ese contraction. 6. 2. 1 C OI6tyalsh Pets«. rtidity ael fantasi. 6. 3. 1 C (Maw a C06<lø$4,1 fro. Reim facts. 6. 3. 2 C Predict the tetra of . si ttttt oft. 8. I. 3( ippett444 . !tethai selection. ID. 1. ?S Alohabelife Net to the first, setae. ✓d third letters 14. I. 2 L identify a[tiO, words. Id. 2. I L I4.11fy•PP,4 ,14te ditcrIbing wards. PROT30 PALM REACH COUNTY Student OBJECTIVES - GRADE 2 READING Teacher These :anguage arts Unified Curriculum skills are to he taught in grade 2 Fill in the date when, in your judgement. the student has consistently demonstrated the skill. The skill may be demonstrated through observaton. informal assessments, or formal assessments 2' READS DATE UNIFIED CURRICULUM SKILL I ilq / 9Y 4. 1. 1 Read basic vocabulary words / f 4. 1. 2 Spell basic vocabulary words I I 4. 2. 1 Understand and use basic vocabulary words. 4. 2. 3 Understand and use plural nouns ending in s or es. I I 4. 2. 9 Determine the meaning of sentences that contain negative words. 5. 2. 1 Recall details (who, what, whore, when, which, how). I 5. 3. 1 Sequence events using pctures. I 5. 3. 3 Sequence sentences that describe the events in a picture story. 6. 2. 2 Distinguish between real and unreal actions or events. I I 6. 3. 1 Draw a conclusion from given facts. 8. 3. 3 Identify clues leading to a conclusion. I 8. 1. 1 Understand a realistic selection B. 1. 2 Understand a fantasy selection. 10. 1. 2 Alphabetize words to the first second, and third letters. 10. 1. 3 Classify items by categories. 10. 3. 1 follow one-, two-, and three-step directions I I 14. 1. 1 Match sentence parts :o form complete sentences 14. 1. 3 Write a declarative sentence about a picture. 14. 3. 3 Use a period or a question mark to punctuate a declarative or an interrogative sentence 14. 3. 4 Capitalize the first lette' of the first word of a sentence, the pronoun I. and the first letter in the name of a person. PROT31 2. READER DATE UNIFIED CURRICULUM SKILL 4. [repeated 5 times] 1. 1 1. 2 2. 1 2. 6 2. 7 Read basic vocabulary words. Spell basic vocabulary words Understand and use basic vocabulary words Understand the use of inflectional endings s. es, ed. and ing Identify words that describe people. animals, and things. 4 2.10 Recognize that words can have more than one meaning. 1 1 4 2.11 Identify antonyms for given words. 1 1 4. 2.12 Identify synonyms for given words. 1 1 5. 1. 2 Identify the sentence that expresses the main idea of a paragraph 5. 2. 2 Identify details supporting the main idea 1 1 5. 3. 4 Identify the sequence of events when signal words are stated f 1 5. 4. 1 Identify the cause of a given event when signal words (because. so) are slated 1 5. 4. 2 Identify the cause of a given event. 1 6. 5. 1 Complete simple analogies 6. 6. 1 Identify paraphrases for given sentences. 8. 1. 3 Understand a folk tale 8. 3. 1 Understand a play. 1 10. 2. 1 Interpret a map with picture symbols 10. 2. 2 Read and interpret pictographs 1 14. 1. 4 Write an interrogative sentence about a picture I 14. 2 4 Determine whether a sentence needs a singular or plural noun 1 1 1 14. 2. 5 Use the verb form that agrees with the subject noun in a sentence I 14. 2. 6 Use the correct verb form in the present and past tense. 14. 2. 7 Use appropriate describing words to complete sentences Il / I 15. 1. 0 Write legibly using manuscript letter and numeral forms STUDENT TRANSFER in order to assist the student's new teacher with planning for the student's continuing language arts instruction. nase provide a brief description of the language arts materials the student has been using in your classroom If possible. include the name of books or basal levels that the student has completed PROT32 FLAT hler;aa Calutpraminnhre å $$$$$ mat hail FLORIDA COMPREHENSIVE ASSESSMENT TEST (FCAT) 2000 SUNSHINE STATE STANDARDS Student Report Grade 08 This report shows your results from the FCAT Sunshine State Standards Test. 2611 . ',DOLE Sa1004. OF 4435 (Tara Wawa owli hwy. 60 - PALM Wes The FCAT Sunshine State Standards Test measutes your performance pi sekstal benerniens n reading asd matremeties as defned by the Sundial?. Stete Standards Scores en this test are cne rick -4~ of yner achievement of the challenging content hat "lada students ate expected to know. On the FCAT, you can attain one of fve possible achievement levels. The table beau shows the scale score ranges lor each Studer' Achievement Level. Student Achievement Level Descriptions LEVELS. Per /orate I«r.s semi indicates fra: the mudent Men sceceriS with tre most ~Ion^ COnfalnl of tie &Mahn, SOO 5tanaa,as. A Level 5 infant answers rant or Ire test Ocentims correctly, rnouchne Me most enfilionferNifoninlime- LtVtL•: Performance al sn] reeer mouton last .lie Waler4 ren sm......ms we, tre isnierne canard st tine Surname State Startle/Os A Level a alueent an:Mars most Of Vie QJOhtons correctly NA may have coy some %Wen with dueStiOns that felted the Most chmensing Coolest. LEVEL 3: FCAT Student Achievement Levels Scale Score Ranges kewlino Vedta naus Level 5. 394-5W 3/1490 Lapel ♦. MO.») 341-S70 Lama 3: 310-349 316344 Level 2. 2)1.309 280-3a Lama 4 lems70 Your scores are shown below GleflOWNInCe at Ins Meer indicates 'Nat the Student has parbal suaassaMr ila racearene content of ion Surdun State Standen?) tel ~again° a muse. stem A Laval 3 .1~ answers neny of tie Wheaton, op/redly WA e 9✓remerY Man nmominci wahl1WWWW, mal v. moat chafenpreL LEVEL 2: PertternanCe at ins level indicates Mat !NI student has line« fume's with the cha tenorng roman( et the Sttaa.a. SUM Staneerør LEVEL 1: 'aberrance at ths leper indicates Mat the student run nNa success with lee cframentm, cotton of the Sum-Tyne State SlalOarn SUBJECT SCORES CONTENT SCORES Reading Mathematics Sement Achienenlif nt Lerel Sc:. SCO'C wwml Middle Nyry;. State Ccmponson hirOS yout001 tre test /wan. art saxes mynt oe shontw rirqner ot icrwor Mir , the %OW, ua Ne moon Hemmer, your 300/el would ot Wadi fall within ace am range. For re40, 0- yak« mete scoie siesild be ~moan 351 are 389 For mathematics. you scab score sr.:, w WWWOW $19 0.J 315. Tee mitti maths ( J ) area it yve Meted in the KWCII. !riddle. of highest niro or Wade Off Apnea 'Manta Who Ica Vas Iast firm Pale 00/21r2O00 Nu ober of Points Possible Number of Points Earned Stato Comparison: Thirds Reading Lowest Middle intimation Literature Malnematics Narnbel sense ~cement ~nary Aesranin ~wine Data Anaryfra 'Ihe Content Omit stows tr. Mane« Of >NM% polimee and Me nurnbei Or pCk nth earned tic eat, c.iewiy. emir question was worth from 14 prams. The cargnat teste) is deSetilMO or, The Creek of I es report 0271551 PROT33 RØ Contusa Fintad / °rodea FCAT Readrn osen ~me« of the &ostia* Sta Standards in madtg The Literata cohen oree condes campes su& as hacina, etmas. poems and loor teles The trildmatices contare ame ~teme Destapes such as mapaane and nevespaper arbcles abad anos hittory oc orner topes FCAT Reading amemos Me tened ~as merenar the menor d In ban on flød eres arens% ~ vi dd l est ~wing conclurione nip tern amt had stadium dum and rerg orponinbonal perlens or ~bed mim don crt sund menage, det s:a libi ~a purre« aixtror pon t d VeN Cht03fig ben) , and eracy of ~ten trom research tincluhno eng Dal end OginOnli. NM% week arguments. and the influens of an a.Åhore pasfoil tast On lod) MCOnarb the Isa d CainniOn end ntrast venten =F itlimPler *møres d tand neludng padl nynne, agning, chetaere, oxids. and leanen urdeatantend Isave character and red a..kaamd. pant d va t ard tone ate used in 'sut selectrtint recopniongi n« and siTad comparro arear centrado duesolen, sertince and wonis as ptesented vens teds naniana and interpretinp valen seannon for a vestg d purposes senge venety Orreleresida notende bang index« enen. nemmes, and pas's. to Wild rrtcnnation for a vanety of aromen sYntheerand and sederalind collected information ato utal ~doners. LØ a yanety d lechnemes Mathematkil COnbitnt 'Usted !Grade 8 FCAT Mathematics m an amanere al die Sabe* Sta Standards in nathemses FCAT badenes manee Øer from the INIcuand ateas Rumsar Son& Concepts. and Operations Comprensión numérica. conceptos y operaciones denthring Operan (•• -. x •t ard tne enecis ot nenas dentereoón de °perennes e. •, Y, 4) y Ittie rectos de has mismas determinar tarmle cremación de resultados irno.nrio has enes are represerted end sed cama« oorro estén representada los Manero* y su tao Irteasurement «Mitin reapnunne measurements ard unes ol memoren« recabarme° de medidas y de unidades de ~idas cromparing °cerastro and convertir« measuremerts comparación y conminaron che medidas Geometry end Surel Senas ~menta y conminen, espaciales abarrn9. traen° en la or nentltYlrg. ard analyn no n.o and three-ciimensional shas" ir,: ont nr GapnenthomtAn y anáñsm 0:orae Oe non y be. ~monee 'inmolar° and ibis:rateo changos in al pes ch.yylkra, Cc: e : cabe': em de CambiOS n using ccordnee peomeny k , be. Je {leer-44,a yyyedmedd Alpebak nilnkIng Razonamiento algebraico desalo% analltrg. une Odnetallang partem,* velaron*. ano fundan oct.: lop tinh anclen y itenenizacetin de patrona relaciones y funciones vait nor aro usng exotismo/1s. «mahón irle:tunee grapra. and lamidas ese. t t:..d y ugy de e Y ;Y mactia. •DLISC•dnalå &apandados grifas y Mandas Data Analysis and PM:Bah" Analista d date y probabilidades nat Orpenumg. ard «optan° data aneo" o icsnasc gr nuaceón • interpneleteCn 0,3 Clata turorme and rnalong presidas. inlerences. ard valed cceolustans de patrones de COnduCte y haciendo preoic~. ntederenCise Y se to ard *tatas omakeelones ~ vende prObablediklei y eetadlebraa La Prueba be EaliluaCitel Continnana del Emde La FlenCla (Yen') mide el rendimiento de: ebt u0 ante segur atienes especifico. en ~de lectura y maternales.. be cuales están eepecrécados en las NO!~ 8~ Echada del Estado de la Monda (Sumieres Staros Standards) Debe normas establecen N ~Ida conocenierrta ore los estudiantes del estado de La fl orida daten tener y aber arar El estudiad puede alcanzar uro de los cinco rumbas de lendenent0 POS4Yen. en balara° caleciecOn total El ~arde pues» alcanzar una caltlasción entre 103y 5W en Cada bree de MIrd0 reb l5 Yele ~de yeranelb nace ont el Mane re lilanted) Oda reglad emir de <0•4Cenenbe eVetreC30 en Nomas Blanca Ettlecene dal iban» de Le nena Une/aula 011 14441 nlantene • b trewela de be pegånlintereCtweeerile ~yendola me cenpicean 1~4 Esa nvel Ce nirtinelo che el ~den* seeneend lalnlacknamerle ed mal de ccrocentelos ene:~ en le eirnis ton» Rtetrabea del Efte:00 de le aman Un adenia del HM 4 respo-air • e mole do les breguen earreneinere pene roan:~ leartednes ~le • elgsnes~ in negree% . 44 Conekånre Mel] EL, ~4 de naden" enea pa el pesen re aleen:~ de ae miren. panteenerl• setereebni renl hatiocereentee ~oda fe tes Nones allece• Erra del (~00 O* La nace ~ab rx, ~enenet Un ~no bi Nivel) responsamos...de SS Pagian Pi" en ~Scene er~ reines ente bel nene Mee En mol e» nirdirmet ~a tia MILOAINI• tri meren breen he acedo ~ir el ~1 cercanenr» essisociar ea ha ~mes 6,4•Kin Ensayes del Elido de Le nenes eAl Ene TM de rerdereento ingle CIS eadirl• ~e cae esto en ~Ver al ~do Contna ~do eles ~a Beticas bayredhet EMPO fle up ron» Contenido de le Prueba de Letnus Orado 8 La pruebe de Lectura FCAT es la pruebe cale edens las Norms alocas Encentar" ce Lectura del estado de la Florida (Sunshme Stat. Slanderds) La mecen de Literatura incenie leeos de ltee n poemas y d euertai kddoncos La sección de trylormacein indino artista ide rentase y lodos seta ~Cele nstona u otros temas La prueba de Lectura de FLAT edshis lo mosto andar les sordeacks de un testo viendo Menean <Len analizar pareas y ',dos. Indpar a conclunn ose ~menos Naves del tea/ y de la ~urs de palabras y reconoce patrona ',paz aceras SOMOS be idea pandeaba. raudas o en etla. o et mensaje mee importanle de im ledo dentecar el «Denlo yro el punto de mita del aria remar dpuuse la vvedamarrete de revnbpacrones ima vine y nasa 00 Out relee Ls Kb ladón de heces y opinan y Winnentos amnantee Y secundara, Y la mastererse que las «monee personal«, de un aula Lene en un redel reconocer el iza de la comporscadi y el cortroste en un len reamar las elementos complots di un ledo lo dar incluye la trama el lamine lb», donde ocurre is atoren, el desarma° de los pelsormes su coniliet0 Y el °Menee, comprender lea Mata manen en que se usen el desarrollo de los personales y de la trena, el punto de sota y el tono en latentes Untos reconocer el uso de causa y efecto comprender las semetarusts y ~ronces este los ~nafta N lugar donde Mire b len y be aCantearraentOe Ud como se presentan en Oferente. Mitos ubicar. apencar y ansiar intormsciOn menta pera referentes uso* murar nfonnecdri de ~ tuertas de ~e teles cono han, renda* y perstdicos. para diferentes usos sentar y dedicar en in orden dedeo d ~macen reunida ~ando eso de ~entes tecnecio Contenido de la Prueba de Matentiticas / Orado La pnrebe de MaternbtiCaS FCAT los la pruebe orla eallia las Nana BISEducatmss de Naternation del estigio de La Manda (San. hne Stat. Stardards) Esta Nudo ~era be bandea rapante, PROT34 FIAT I kal. (ser rItergra Als!~ Tul FLORIDA COMPREHENSIVE ASSESSMENT TEST (FLAT) 2000 NORM-REFERENCED TEST Student Report Grade 08 This report shows your results from the FCAT Nationa: Norm-Relerenced Test. Eir e - Naam rea Maat WI • MOOIE SCHOOL Of MITS pad r.. al Nats tp-MAIy KAM The FCAT Norm-Relerenced Test rreasures your achievoment on a test thai was pioen to a national sample OT students Your norrn.reierenced scores in Reading Comprehension ana In Mathematica Pokten, Solving describe your perlormance in relation lo tro performance of etudonls throughoul th° namn. Voor scores are showt" below SUBJECT SCORES Scale Score Reading Comprehension Mathematics Problem Solving Nat onal Percentile Rank Stanine The USO Score altpreneS your partema ce and aLows contfarelOnt hart yxar Ic year. amiong COnaerenSign Scala Scores rang* non 51010 624. lidatnernatics Protsten sovina sta mam fonts horn Sfs m aY Ine Nataal Percerrile Hand, and Mantra> alfa° ytor relativa »anor g II fonts« aa to Om Nataal rearen provo. gaan., Percenbe Ranks range trom 110 stanines langs Wem 110 If 100k tre lest again, your gatend, Portable Rare mirt be tlattly NOV Or bar Man statte nare. Nalever. yOur Nataal Rareellite Kan WIM prowoly al witten a gaten tango- Fel/ amant) rarorrtnenson, your Nataal Percentite Rank anould be between OS and ta Fa itathermucs Pim*" Sotung. vox Nekpa Pettere Rank leid te ~men 30 anoSti Run Cate owainoco CONTENT SCORES N intbor of Po rits Possiblo Ni, rnber ot Points Earned 'Jambe, of Questeons Attempted Reading Comprehension Nubal Unctersianong trimpretabon Ontval Altai«,,. btraregitio Mathematica Problem Solving Menuremert EStrnabon PrOCettM gelang NtItaber RalatiOnnarn Nomina Sytakens pan•Wns & Randen Naba Statistici Protettity Geonatry The contant halm Is descieee on the bark of tras report E•sh gaston was worm I »FA OCMW PROT35 Grades 5, 6, 7, and 8 The FCAT NRT Reading Comprehension Test assesses the following objectives: Insta! Understanceng • Demonstrate tho ability lo cornprehend explicitly statal folabonships in a vanety of reading ~bono Interpretaran • Domonstrato thc ability to kim an interpretation of a varrety of reading selectons basad on explot and imitad information m tho seloetions Cnacal Anetyso • Demonstrate the ability to synthesao and evaluato explica and implica informaban in a vanoty of reading soleaban% Strabgas • Demonstrato Vio ability b ~izo and apply toa lactas and reading strategies n a vanety of reading ~tono Tilo aboyo °bocines are measured within the following contad: Rotterdam*/ • material typicaily read loe enioyment Textual- material baca), hond in grade-appropriate textbooks and other 10IMC05 ditlf0101.12,011 Funcbonal - material typically oncountored in ovoryday Ido 'guasona The FCAT NRT Mathematics Problem Solving Test assesses the following objectives: Measurement - Demonstrate an undentanding of thé principios of measureinent Estmanon • Determine rho reasonablenoss of rascas and apply estimaban in probbm solving Problem Solving SU:negara - Domonstrate an undorstanding of ITIO bocas, of sobrina convenbonal and non-routine agobian, Number and Number ROICI7P7ShIp3 Represen, and use numbers in equivalent forrns in real•world and mat.mabcal problema, and 0.mi:ostral° number sonsa kg wad* numbers, tractors. decimal,. and int fiers Number Syslems arad Number Theory Demonstrate an undrymancling of relationships arrima arlarnetc aportan' and apply concopts of numbor tneory ca panes. teclees. and mulbples in real-world and rnathemahcal problema P•MOrrIS and Funchons • 'denles), numerad and geometric parten,' and hinebons and use bonito sobe probetas. Algebra • Demonstrate me ability lo ~ate exiXOSsiOns and sobe linear aquations Statstics • Delfilatlabal0 an understancing data relabonshipc in data sets Probigiáty • ~pm:Arate en ~andina bine taren gamma chanco GaIne • Oamonstraloanundagalinthng off Oaxnetric enmieles Grados 5, 6, 7, y 8 La Prueba de Comprensión de Lectura FCAT NRT evalúa los siguientes objetivos: E Mamantona> - Demostrar su habilidad para comprender eyplicatamente ol contando y la relación entro si dentro do una variedad de selecciones de lectura Interpretación - Dementar su capacidad interpretativa dentro do una variedad de selecciones de lectura. basándose en infamación oxplkrta o imanada en dichas selecciones Andaos critico - Demostrar la habilidad para sintetizar y evaluar información emplkita o mal iota en una variedad de selecciones d• Natura. Estrategias • Demostrar habilidad para reconocer y aplicar el contenido dial texto y estrategias utilizadas en una variedad de selecciones de lectura. Los obetivos anteriores so ovaban on loa contextos siguientes Recreativo - material utilizado para entretenimiento Textual • matenal utilizado en hace de leido del grado apropiado y en otras ~dios informativo Funcione/ - material ublirado en te vida diana La Prueba para Resolver Problemas de Matemáticas FCAT NRT evalúa los siguientes objetivos: Medran • Demostrar sus conocimientos de los principios de medir Estimación • Detemenar cuan razonados son los resultados y aplicar la estimación en la solución de problemas E3171k3Qi03 pare resonar problemas - Demostrar comprensión de/ proceso de resolver problemas convencionales y fuera de lo canon. Números y relaciones entre rameras - Representar y usar llamaos en formas equivalentes en problemas do matemática y de la vida duna. y demostrar senado para las fracciones, los decimales y los numero, enteros, posan,» y negativos Sistemas y borla de bs numeros Demostrar conocimiento numérico de las relaciones entre las operaciones de aritmética y aplicar conceptos do la tea la de No numeres tales como mineros primos, factores y multiplos en problemas de matemilbca y de la vida diana Reina y 'tocones • klentifkar bribones y pautas numéricas y usarlos para resolver problemas Algebra - Demostrar la capacidad para evaluar expresiones algebraica, y resolver ecuaciones lineales Estadistica • Demostrar ~comento en procesamiento de date Probalatrcled - Demostrar conocimiento de las leyes que gobeman el azar. ~molde • Demostrar conocimiento de los ~cipos de geometrb &a SdAdIss• TM Sea ama talaCsaYiallmobad PROT36 FRS TO- FLORIDA CERTIFICATE OF IMMUNIZATION (HAS 680 - PART A) (11 Rpm, Mahon 232032, MPLETED ALL REOURED IMMUNIZATIONS SS* :OCIDI PMT A OF IRS FN116 BB ONIT IF 'HE ORO IM RECU40 ALL MAID 0046/A11011 IOU MON I NIT. SIT NAME St/ ./Z OTP - 5 MD ROXIO IA1 IF THE F)uRli PRIMARY OCISE CF DTP IS APANISTERED ON OR AFTER THE WIRTH RAMAT A FIFTH DOSE LS NUT REOLMEO CT FEDATMO YAWN/ 6 ACCEPTABLE F PERTuSSIS YACCNE 6 MEXALLY CONTRAMMATE0 COI.M.CTE PART C FOR PERTUSSTS CarTRANOCATEN 1 03'T TO (ANATI %GCSE IA SEFIES OF 3 00451 6 ACCEPTABLE APO RECOMMENDED FOR MORN 7 YEARS OF ME OR OLDER. (C) MIA (VT) - 4 DWI KOMI° 111 •I MO OA YR MU VA III MU Lak Tx MU LM I THE Nolo pRNART DOTE OF OPV 6 ADANRSTEREO ON CR AFTER THE FOURTH ormiDAY. A WITH DOSE 6 NOT REOLN1E0 FV 6 AN ACCEPTABLE ALTERNATIVE f CPI/ IS IC Remo POW WOK 6 CAACTECIFROU DE REM/TED IMMINZATENS OF OILMEN IS YEARS OF AGE BI CLOEk REMUS at 40 ItIMU - Falai% RWEUA MR MINED - Isl005E AT 12 MONTHS CF ACE CF OLDER (iECCIAMEN0E0 AT 15 NONOCI aro DOSE REOLNE0 Filai TO KICERGNITEn ENTRANCE (VALID IF OWN AT LEAST 30 DAYS AFTER Ist 00%) -OR- MMUS SSW - 1sT DOSE AT 12 /MATHS Or ACC CD CEDER ,RECOMNENIXD AT IS BOERS) (4•I 2ncl D)SE REOURED NCR TO KIKERCARTIN ENTRANCE OrAir IF GIVEN AT LEAST 30 DAYS AFTER Is! DOSE) MAWS SDOSLE - 1 DOSE AT 12 1A0616 OF AGE OR CLOD KT MO DA YR RuSELLA, SuCCETTECCANICAT i2 NOOKS VAC Ca CT-CUT raCTITCV: ALL APPROPRAIN Ce6ESHAND oars INCT BOITTOATE MUST BE ENTERED. AND THE CERTIFICATE SIGNED BELOW BY A PHYSICIAN OR AUTHORIZED PERSCN ONO DATED IN ORDER FIR nit CHT..0 TO ATTEND SCACX I HAVE REVIEWED THE REMOMISAMALABLE ANC TO THE BEST OF MY KNOWLEDGE THE ABOVE NAMED CHILDH0413EEN ADEQUATELY P.IMUNIZED AGAINST DIPHTHERIA. TETANUS PLWSS040. MEASLES. MUMPS. AND RUBELLA AS araulTrellgrri MAN. F nig SCHnn mT AIDANCE Vg PAM NO. .,PRONE 079004 re Prr64AN OR O$ NAME otEATE Fara; ITh tleik-as OR ADPMint SENATuTTE JUL 2 '6 1498 ONE DOE AUTOMATED STUDENT DATA BASE CODES: • IMMUNIZATION STATUS CURE / • VACCINATION COOS PROT37 DATE OF RRTH DELOS NAME iHNOEU SS* m0 DA YR PARENT OR GUARDIAN DOCTOR. THE CHILD HAS NOT RECEIVED THE REQUIRED DOSES LISTED IN PART A PLEASE COMPLETE PART B OR PART C. AS APPROPRIATE, AND SIGN AND DATE TEMPORARY MEDICAL EXEMPTION (HRS 680 - PART RI (2') FOR PRESCHOOL CHILDREN AND FOR SCHOOL CHILDREN WITHOUT ALL IMMUNIZATIONS REQUIRED IN PART A I CERTIFY THAT THE ABOVE NAMED CHILD HAS RECEIVED THE IMMUNIZATIONS LISTED BELOW AND HAS COMMENCED A SCHEDULE TO COMPLETE THE REOUIRED IMMUNIZATIONS ACCATIONAL IMMUNIZATIONS ARE NOT MEDICALLY INDICATED AT THIS TIME AZ /3 *4 es TYPE MACRE EMS' DATE HIBOANR) DATED/DMA/YR! DATE IIADAIVER) DATE IMONTATERT DATE (M0f0A/VR) OTP A OT 8 IC C POLO D HO E WAR F ANGELA (MEASLES) G IMAM MI (MOBAJYR) MOWS H ISICIAD BE *DAYS WIER NEXT APPENDANT) RUBELLA I EWSIDIAN OR AUTHORIZED SIGNATURE DATE PERMANENT MEDICAL EXEMPTION (HRS 680 - PART CI (31 I CERTIFY THAT THE PHYSICAL CONDITION OF THIS CHILD IS SUCH THAT IMMUNIZATIONIST IS MEOCALLV CONTRAINDICATED LIST VACCINE(S) AND STATE VALID CLINICAL REASONING OR EVIDENCE FOR EXEMPTION FOR EACH VACCINE. PHYSIDAN CR CLINIC NAME (PLEASE CIINTI PHYSCIAYS SGNAID4E DATE mum, (.50 J 93 CP410Coli Ma, 0 I diet ...Kb t* uSeCtl ISocck Pores $)40-0O3-0610.6) PROT38 School District of Palm Bead Courty VERIFICATION FOR SEW/RETURNING STUDENTS eksocada(51The TO THE PARENTS OR GUARDIANS: new SrupeNtS - Conpwe a ncr, - svoied Merl to. FET1.41MNG STUCENTS, Pens tuna* taro `°e"" 00ifeetta444 of IKAP3 atormanon Øtoicv. ad on the other aide If the witormatiOn pinned it incorrnt Olen. COtreCI It by Careful., and Is/3103 CrollsoC out the snecniict atconasut ard 'ants to CrreCt intornatiCti above IL lea NEW/RETURNING STUDENTS REGISTRATION alltUTION. 1101 Taft: CHIL3LR. Thick : bc,7 SIRS 507 aeisse 4/15/90 STOT: 18642421 li Ifutatili ilL4 ••ei tb At )13 tare AO ri mousse 1441(5% -rn LoXANATOott FL 33470 ar '8 «... SO V ffi rOl ) Ultlit 31:"Ti SO Cfrflarl , aiS Noa a 17; III r 0, r,, 0 .... 4 0 0 B 0 w ...O.L^. El A :::::::c .5....0«. 0 W r.s..... .0.... 0 H *" 3....‹ <II WITT 01 ~To .-:. 'Ls" *. ea . rLORIOA on FL US t In 031014T WSW 2 ri i .ofial SOM.'S{ ST•01111 0 Ott Min HU 14101]! ,Iil IIITERM Wan tit 34144t 11 lassiCalliii fa« (i. Tit itIll• CON .0l! WI <MM outri nirnors. " •Wa rts%314117::G."" Ili lust not tent alit itril40 s no , 411(4337 I OV-01•CalleTir omen 0 2 Otr•01•ITSTE ILISOUNT 0 3 iasSt"eats Motet" CI 0 , tr. r.7....... nee w p.n, . *MN, 6. iisist• se 14••••11 a 1 1i~ -0.4iin Lo •• ter Derr ter •• arr.« sawn win. MM . CliikluSin 001 I, no ...rem iyaoi se 44.(4. se 'Yen. I * i O. PM. li• yo. (1.114 OM • IF *MO/ I et watt i 0 be SMUT Mi-I ,,w it to stand 100SIIICII *MIMI? 0 0 ,4", 0 I 5rior rift: r ~roe., PirrT. rar ~Tr' ~an', ii..... a.h. Car 0 a sear. rssa .. 4.41•Stal Priory on« •• vilf, M. • ssins4 w " esss Elo ne.. DIS•litiTit> 0 s estri- stestrimo CUID (al CI tt" !MT larItt3Ilasee O 3 011est 0. oållSIMIT Li s totrane Oro :Jr US) 41.4/4 stilt 05 TRANSFER INFORMATIOPV. .":::Tia . t sth RAW 30401L TiliAlditldinit litthi ilis tat Mt IXCATith s`IR pAti a 555t årtiallan U. 1.4411 Lint tn. toT1 vol..< :.MKK ålltåriD LO Rai um ((FAT, {.21. sift Clue» FREE .OR REDUCED -PRICE LUNCH AND HEALTH INFORMATtOtt" (53' *111 /01, I il I " 07, SA ith KA TICAI Ia OW es, elosxla MO.' u.t.,..zela n terra or 4., ....In...* T•oo' 13 ,, ID or inst. tleilear.$ be ' v" in ,"'" I• ", ''', u. " tia "^" Iss.FF't s ea, I. t••-• at. e.t.a, O . 4,.., E rt D< fl 1.1:0;l1 .1004.114 No I at, inesissat his D. Mil If /.14.... A II. nOH. n•.... P.I.I. 4 ri", u, NEW STUDENTS TO. PAM BEACH COUNTY: 113ME LANGUAGE SURVEY i2as ems' Imr.a4c1 It HWY Ili 111 Merl ST Or /Mr be Lealthas CT "it tATIQM.1.1 IS SI•011. III Ile KM tar Tel snotrin fa. OCI a WI/ in re Eta 1.11,C84.11 CI ly E,,, 0 ,,. C 't, D. .. FOR OFFICE USE 0NLY: OM mot sc. 1101 dt la sell 18642421 33 ITPIerl Ltreshici EN 03. cc* US 1344 Han UM ECti (Wien? 4.47, 05/21/06 du :a Cl2CE 4200 d floss; IN at COM OIL OS at coma 01 ad 114045 a0. 507 nu talsomurr ISM 0 ails 0 1411 Ep.ise 011-1414 Tahlril01114Trel N 0 us 0 a as s 1 3 4 5 0 I 44X ~CAT« a 1 s 3 1 I 4 1 1 7 '44,Z T, Ill isle OKI4.fnT0. Oistnitt elect 344 Oa11 w.44 mum.: 0° ' eitizaria as• wauwana4 U rart s at 0:4 ,,t :',',." 4str C Lasts_ ..O<.. «Awl 134å WA ant taapititi St 0411: on I Mtn Tatt he wateattrite GNU, IS NW /410 "Callstl TO Tol Nit II Ni ~OCT 5410 Mr MI I. Og PROT39 0'°o- moons 0 N1101 U I. 0.040 0,000. me rigniv.a.ro 0 ....w1 I...A...y...4 1. •,...........wi.... .i a.. am. ,..o. II LB ncri A C030 CatIll bANUld MICR 0wery , 1041 PIIIIovigr c0040••• !C SOOEO 0000 The SOON OW ns OW • rts. Kim ironot on toa too • con a no coon alit 1S01 'D 0.0..0000.11 000 Mb.' OH CsatoOO Ljir tj lb YES MD 11004.1)011,001i OCO moner nod cora Oa 0 ots YES al M LOIAPKTCHEE FL 33470 LOSAIL4701tE FL 33470 94• am 1 TI'S &A r. ,,,,. as 1011.041, LINIt 0/ 10.10k E D A O w..... sm......a CO z"--- ITA .1001 5015 0 10000. COI/LIM OPTC1M0 A O B 0 =Tr MSS= lJJ D0 Eon SW tCa 0.1000.6 IS 000 LEW 0.4010•A 0450)1' Ores a •na SOME IDS iDtEMEtiCV HEALTH Ate SAFETTAWORMATION A.INC./IC • o nc• w. geom. 1114 HT/0M - .mm- 11.1•1 ar *glen S 0"3 0 TES 0 PK) 0 nil 0 ND 0 YES 0 NO a nor • noes ....a •• .••••..1•• . repay ...r+II If is west, • lie leg., CM/O.O . OS 1OM1AL 1•0010CI 0 0 ." C .6. in" .14.... At 1/000 Int IM*R' RO. 1OOOw_ )0 0404 In1 men aR uwlti , PROT40 S1UDE LOOM SEX p II/SAL/ETHNIC GROUP rV/hia. Noe ENSNamic 0 Hisponk 0 Ain/Irian Indian/Nein. Alaskan 0 tack. Not Hinank 0 Asion/Pocilm Wonder STUDENT NUMBER ..111.1 PHONE NUMBS BIRTHOME Vor bed try 13,rin e ow 0-Yos IF Not What Type Commamt on/ NAME OF PARENT(5) OR LEGAL GUAROMN OR OTHER RESPONSIBLE ADULT AT HOME p 0 OA BIRTNKACE, Bom n+on Beach , Pt. CURRENT SCHOOL: Iwo until in t 's spow. IMO (mil NOM* Sliest CiEf Y 0 Cate Fiat Entered This Daria A = ' a Withdrowal Cat. Withthsval Cato Withdrawal Due FLORIDA PERMANENT RECORD CARD CATEGORY A • Education Records GRADES K.5 1 and. tad., scmottoxariathe.e. osKzi w....: Roo i r9 (weak.... i( rilb, gryro.n c..., i -Ng lin 8 .n 2. 1Gtil;r3Gr Gynve.4 EL Scrawl Tron HIS1-...-19-gat Srhooaor:II-9.1-411-15.- &Mortar: I) .1 V---- &Mel Wm le -MS-. State:flan:II -9o(...- Oa Dors Omar fro oat. Mora 0 Dar Parent I-74 Den Mane I Dow Prosom ..179 Omar t Dan Con Moat /13 O Pna ns I f ti 080Mara 5 Sodom T Ow la* Sublet. Teach., 1.46.1. SOHN mailer mat &Nal Sub*. Mg Pt t r treirmaiiiam /r4rarK4-1...111 arilEral I' enranTEMINIM trflEMINIMIIIIIIII a i p IrEMINOMNI M/TaallIIIIMMEI fitcCAIMall CCRICIMIRIMI in L" • L t. a. u.delll 737=1;11110 MN 11 ..u. • 1 0 - woo ....6EIN -M III SCIENCE one sERAVOR CODE • RAP in6cme, PmenNo (E) Rotau, IHAVIOR COOS R ENAMOR CODE BEHAVIOR COGE SCIENCE And Mali. 4ISSRHR Prcarall•IPI wain IN3 4Tfar.-• ^ c.c. LARrabil0 10e. IbRitta Tarry tlii School OWN SCAXM Owl, Scrod: Sc Gm& .1 SacarVom, II .11 brorfom J--/- Se Grey Sara Wm It ralltra-...- Stood ri m 11)--.I9. - School Tow I' MI Oefocpm Ores tern , Goys ninon: Data Matt Oen Malta Dm Ablest Days haunt Orabb.rabtal: ORIRPOra•Pb DM HARM Subtod TWINY SAAONA Twit*. Met SYStea TralitItst Milk roabor tart Srabiltt %Woe Mark tatilra Hata morn rmICS MAINPMANCS VAINMAAMY'S REACNNO REAOING ADAM r i A41=AIICS URGING ANOVArE LANGUAGE LANOVAGE LANGUAGE LANGUAGE <SILL PM SPURNS RM. RCS Mauna APELONG HANDWRIPPIG ItAROPCOVT1NO mAROPeRtlitta Nomowritosi raIRROVolraftiNG SOCIAL SWOP'S SOCIAL STUDIES NOOAL STOCKS SOCIAL twcc SOCIAL MOMS SOENCE ire PERON SCIENCE NS ' ,CRISP SCIENCE sad PrAtTP SORP.C.1 and HEM Tl. SOUK: end t4PAITP OVIAtton COLDS MEN AS% OtiamOn CON WAAGE oCHAVIOR COOL AVIRACE senAvioncooe "EMC. sownos CODE AVIPACt Inept Up Pcomota 01 Main (RI Scram. c- SLm I.00l(SS, Indicate: Rona* On [Win I Sown erra School RSI Praf.carar Roam* MI FicoNetIFO Somem. <thew tStl %Scum Puna 1P ROW. (R3 Sumac., tchoNISSL train. Pica-NE DI Roblin (A) &ow , Ishii, NSF ESS00032 PROT41 STUDENT NAME: CURRENT SCH00L: (use pencil In this space. until rival) Nano. Siteet City Scheot Clads School - 49 - Coms PME011t Otlyll Meant Schicel Timber Wet THATTENtolia IWAMOTO LANGUAGE_ SEX RACIAL/ETHNIC GROUP 0 White. Not Hispanic 0 Black. Not Hispanic SubNci TolChor 114A SPFI (RIO ANCMTVOTING SHCTEL.StUDIES SOltitt and OttA1114 BEHAVIOR COOE *WAAGE IN:C.It•. Prom ale (P) Amain (P) Soorner SchoolMST O HiSpOCOC 0 American InSan/Nalma Abstall 0 Asian/Pacific Islander Sines Gras: SCI.01 Ye. 19 --I - Ores botany. Ocos MIMIC SWJect TeliChtd Mart MATHEMATICS PEAOHG LANGUAGE STUDENT NUMBER OIRTHOATE Swint, Toochor Mark SPILLING HAiioweiliNG social ttutelS SCIENCE and HEALTH BEHAVIOR root AVERAGE endows PHT•o101h) R0414 IR) Summer School ISS) PROT42 Pl.P.tmall..PE"aInt.oprrcArk) CATION OF IMMUNIZATION 2.032 5.61D-3.011 -.LC and s. 65C-22.086, F.A.C. PARENTORGUARDIAN Child's S.Stt (optional) STATEDDIUNIZATION 104P Directions: Enter all appropriate doses and dates below. Sign and date appropriate certificate (A-I, A-2, B, or C) on reverse side of form. If the child is presenting for the 7th grade requirement oily and has previously filed a Certificate of Immunization (680A or 680A-1) with their current Florida school, fill in boxed areas below and complete Part A-2 on the reverse side of this form. For additional information: Sec Immunization Guidelines for School and Child Care Facilities for information and Instructions on form completion and immunization requirements. Guidelines are updated annually and arc available from the local county health department. VACCINE CODE. DraPIDTP1 DOE . Dos I 2 Do 3 . Dosed tom 5 A DV B Td' C Polio' a i s a l i i D IMP E KKR (Combined)1 F (SeparatO G.H.I Measles (dose Afeada(icve 2) Rabat, Hepatitis B' The state immunization WO is an identifier supplied by the stain immunization registry (optional). 2 DTP 5 doses required. If the fourth primary dose is administered on or after the fourth birthday a fifth dose is not required. DTaP is an acceptable alternative for one or more dnc.c of DM DT (pediatric) is acceptable if ?Metals vaccine is medically contraindicated. (Complete Pan C for Pertussis contraindication.) s Td (Adult) Vaccine is recommended for children 7 years of age or older. Polio 4 doses required. If the third dose is administered on or after the fourth birthday, a fourth dose is net requited. WV is an acceptable alternative for one or more doses of OPV. Polio vaccine is not required for children 18 years of age or older. 6 Hib is required for child care and preschool entry and attendance only. tat dose valid if given on or after 1st birthday. Second dose (measles) valid if given at least 1 month after 1stdose. A second dose of measles (preferably WAR) is required for students in grades K-4 in the 1997-98 school year, and 7th grade entry and attendance effective with the 1997/98 school year. In each subsequent year thereafter. the next highest grades are included. Includes single measles vaccine (O), single mumps vaccine (H) or single rubella vaccine (I). Hepatitis B vaccine mries is required for seventh grade entry and attendance effective with the 1997-98 school year and kinder- garten entry and attendance effective with the 1998.99 school year. In each subsequent year thereafter. the next highest grasics are included. PROT43 LAST NAME FIRST MI DOB tmonamYtt) Certificate of Immunization for K-12 Excluding7th Grade Requirements PART A-I (Immunizations are complete for school entry and attendance grades kindergarten through 12 with the exception of the 7th grade requirement.) DOE Code 1 Ihave reviewed the records available. and to the best of my knowledge. the above named child has been adequately inutuonsed against diphtheria. tetanus, penussis, polio, measles, mumps, rubella and kepands II (for kindergarten effective with she 1998199 school year) for school attendance as documented on the revere side of this fomt Address: Physician or Authorized Signature. Date. Certificate of Immunization Supplement for 7th Grade Requirement Part A-2 (tmmuni rations are complete for students mho enter or attend the 7th grade after the beginning of the 1997/98 school year. Each subsequent year thereafter, the next highest grade will be included in the requitement.) DOE Code 8 1 have reviewed the records available, and a the bnt of my knotsieclge, the above named child hat received the following immunizations mauled for entry and attendance in 7th grade effective with the 199708 school year: tear.uPdiplithetio booster hepatitis It vaccine penes. and second dose of wades vaccine as docrimented on the reverse side of this form (boxed areas). Physician or (Print or stamp) thorized Signatu Date. Nan Temporary Medical Exemption PART B (For preschool children, children in day care and school children who are incomplete for immunizations in Part A-1 or A.2.) Invalid without expiration date. DOE Code 2 I ern* that the above named child has received the immunisations donimented an the averse side of thitinnt and has commenced a schedule so complete :he required immunisations. deldmonal barn:natation ore net medically indicated at this nine. Expiration Date: (Print or Stamp) (I 5 days after next Inuounixation appointment) Physician or Address: Authorized Sig attire - Date. Permanent Medical Exemption PART C For medically contraindicated immunizations, list each vaccine and stale valid clinical masoning or evidence for exemption: DOE. Cede 3 I cent that he physical condition of this child is such that inwunizationWas indicated In Pan Cable is medically eantraindiened. Address: DK 6$0, TM, opine euklicr calf. &ea Sta. en: 57.04:40-44144) Physician Signature: Date. PROT44 Mairdge SAT YOUR SCORES STUDENT SCORE REPORT REPORT DATE: 4/08/04 ( HIGH SCHOOL COPY - 101493 ) Test Date: MARCH 2004 • PAAseMng rry velay Math:. Prillf=1 I WHAT DOES YOUR SCORE RANGE MEAWI No single 'tome/Nat score can end% rePresecd yaw reasoning skills. If you had taken ctlferer4 *Sons of the test within a that period of time. your partormance would probably vary somewhat on the 200 to TOO thole. HOW DO YOU COMPARE WITH COLLEOE.BOUND SENIORS? PercenOks ingrate what or tentage of lest taken earned a scan lower than Wars. The natlanal Percentile for you verbal seas a 400 Is 38 . indinding Tel did Leer than 38 'A of the national gimp or collegrehounl seniors. The nadong percentile for your math score of 4t0 N 16. indIcallno you did boner than *6% of U.. national pro,* of e011efle0 OUnel SOMOrS• DID YOU DO BETTER NI VERBAL OR MATH? Your scores Inc:scale that you performed hetes on the verbal test than on trio main test HOW DID YOU DO ON EACH TYPE OF QUESTION? AnWetie AM ,RWW41.94teeionet9 GteSleDIS gejednIng SUMMARY OF SCORES SAT e Reaseelef Teal SAT II: Suekei Tars :.a el, I: •C . - 1 • " ..s..1 1. a Tall tn erg,* iii " eel ,..1 ril• n: £tI UsleniellV 1 3 1 if i. ;WO - Thar ..:.:..Scare Per 04111 I t. 41Id 410 lise alum hoe ensure. LOXAHARTCHEE FL, 33470 WHAT'S THE AVERAGE VERBAL OR MATH SCORE? For codepeesound scram In the CUISS 012003, the aserfge verbal :are was 507 and the average Math score WaS 519. WILL YOUR SCORES CHANGE IF YOU TAKE THE TEST AGAIN? If you lase the test again. especially it you study between non and then. your stores IneY 00 UP. Among Medea with verbal stars of 480, 56% soma higher on a seccnd warn, 13% score OW, and 9% receive the same score. On average, a person with a verbal score of 480 gains 13 pangs) on a second taring. Among StunallIS with math scored 01 410, 65% ecore hither on a second testing, 27% score lower. and 7% racche the sense wee. On aver090, a versos keth a math SONO of 410 gab! At pangs) one second bang. Tow responses to seen c types of Winans se presented as numb+, right. metro* wrong, art/ menet omitted. Raw scores aro based on the specific eth lOn a the tad that you 100k. You cannot compare raw math en dIderent editions of the test cr across different types o4 questions. For each type a Question, you Can Compare you peelernletICO lo conope.bound seniors whO to* this test. Iris percentile la an estknato of the per. centege Of CO•egmbemd seniors who earned a raw score lower than yours on each type of question. ID INFORMATION To We saddle:id tests you Can rerthitste by Malt Or by phone and use visa. MasterCard. Arntrk n EXPreSS. DOCOyer. or JCS. You will need M registration number below and the test due (see above). To send more score repents you se; I nets 100 bsslitutiews 4.Cgtt Cara. See the back of this report for IMMIX/Jona On IOW to request three settees. • 4 . 1 d7. i 44 PIN STARth : SeepitiSPOIelti iltfareilibitie • theritef-' .. - Tem.ommee". , 'Afikaii7.4V !: s. '" lit e• 0 04 00:1404144 .47 F 10740 ROYAL PAIN BEACH COMMAIETY HS 101493 re.• E n (.0 et 0 ert O 0. O 0 -4 -a 0 3 0. 0 ID IIDD 3 3 0 PROT45 1 SID oUs t'7' *i %.:11:IIM Acilill11143$13,1thOU1013.133031iRECEIV111-A SC0030II104144,.&4 A .V.1004;i00I lleallh'' A41.30 W1•361C0III.030.101! 019111, ,Ilr'44 31, . A.T.." ..,Calo"n tritiur oilfirost iocthof. 2eti nne " onrgr ilY .r4;' : No information about colleges or scholarship programs is provided here because you did not ask binciatheel tr C•1101•3 P0/110 us to report your scores. Many students have not yet decided to which colleges they will apply. If you need help making that decision, try some of Coed the following: is gii4aertitfrt ilai UMW : IlnOeclaaa • talk with a guidance counselor at your high school gets*.. tarp °Its In state • talk with your parents or other adults whose opinions you value i 00/mIly el Ft re•lilent 0111Innift Cltlien -R. 'Chili lathe • talk with your teachers g 00 a 'wales plans • talk with your friends, especially older ones that Vila Iliselnet• Newt may be further along in the process or have even and odds been through it before glad: ..,int • -' g Awr•s• • look at college guidebooks (we publish our own, the College Handbook) found in your library or 1.1 Jilin School 04eiriet 10 guidance office in ' tallish • Cnillni • ask whether your school has computer software ,g: g 11.0. 00.4igning. 2 Facelift lift,. 3 Seth that will identify colleges that meet the criteria ilsivratklinal 3 ltetutel $01. you select u. -.Sochi Salute 4 Satlal Silence ..s" Ani.nieila . Out*. knit 0 :iegmessi 'Cowles. uldfsio• Cdiede ri .•Xi/MAW Repel •s• 1 fr. Deadline .Stank GSM* te% /cad - : iia • SE: FresnmiA. ,SUniU•lowSi4 1 ' Akfulus ..E:einkrip, O . Sales AAAA by .:twensti • 1.00iein4i140, 1.iimmthi..14).1 Ho o Is IntormoUon you provided: Ulm tursuago. a glish only Telephone: 561.753-5472 Raiigico: want Seastli SUNOS: YES PROT46 TEST: IOTA MIDDLE CTBS/4 LEVEL 16 FORM A oust: 06 OAT( OF TESTING; STOUT SUMER: 4/20/98 TESTS MOMMUF RAMS OMN SCORIUMAS AVERAGI LW MGM MOUT TOTAL READING READING COMPREHENSION READING VOCABULARY TOTAL MATHEMATICS MATH CONCEPTS & APPLICATION MATH COMPUTATION NMASOF 1-25 PROMMI MOCOUU MOM MMS PUOMMI thN NOMMUF MHO MOSUL! Dear Parent/Guardian: This spring, Nicole was given the Comprehensive Tests of Basic Skills/Fourth Edition (CTBS/4). This report explains Nicole's test results. When compared with students across the nation, Nicole scored in the highest range on Reading Comprehension. Nicole's scores were in the high-average range on Math Concepts 6 Application. Additional information about these tests can be found on the back of this page. If you would like more information about Nicole's test scores, please contact our school. Sincerely, Principal ScMOOD:AGOF. PROT47 SCHOOL: MT: SOTA MIDDLE CTBS/4 LEVEL 17 FORM A mwm, 07 WTEOFTESIDG: 4/13/99 STANT TESTS READING COMPREHENSION MAIMO,LE mats UMW KOMOWALS ATCRAGE Um mm ANIMIT MATH CONCEPTS & APPLICATIONS TOTAL LANGUAGE LANGUAGE MECHANICS LANGUAGE EXPRESSION SCIENCE SOCIAL STUDIES MMISOF MKomil Rams 1-25 rmamac 34-50 KRUKTME 514s KKOrTat 74-m MMInnE Dear Parent/Guardian: This spring, Nicole was given the Comprehensive Tests of Basic Skills/Fourth Edition (CTBS/4). This report explains Nicole's test results. When compared with students across the nation, Nicole scored in the highest range on Reading Comprehension. Nicole's scores were in the high-average range on Math Concepts & Applications. Additional information about these tests can be found on the back of this page. If you would like more information about Nicole's test scores, please contact our school. Sincerely, Principal lisi4ptg44 PROT48 tai DEPARTMENT OF HEALTH & REHABILITATIVE SERVICES EALTH EXAMINATIONS Dale 4/3o/ 97 Addeo Race S ales Binhfare tur Ftfl Phone Name or Pore or Corcoran A. HEALTH EXAM NATIO N Roo. &cod Pressure (/) Hormalceb AbnonnelcA 1. A0PearMIO N A cc' 2. Skit/aka. a mead/Scab 4. Eyes V .7 0. Visual Assay U B. Ems 7. AmIllery Artily (12 a 1) 8. Nom Twat 9. Mae. Toth and Gams .7 10. Ovate / Lunge 11. Heart 12 Abdomen ra EOM. and Ann 14.tiuscaloaeletal 16.Naurraoskrel 10. Marinoss 17.Emolional / Wenral/ %Iwo( Rob) 18. Hencraux plokal/ other ISoreelly) 19. whey Rostectiona ISoebly) 20 Mane. *Amnon claysoml/ errobteral 21. MA/Mon 01- Nit iv* 22. Other • norm. I Findings, by number B. HEALTH HISTORY Iwo= WICSOM Wadi narrathe a acklabnal scow needed] NAME: 1111E: ADDRE (Please Prim) ShMI(0 am 7uberculb lett SON CO ed Si,nalure Dare irdS•X Form 3040, Mar 91 (Crateletes previous editions) (Stock ember: 5744-0))-3040.2) PROT49 Loxahatchee broves 20 Oldc0100cenol. analChee. FL 33470 7954061 (407279:4318 School: 1 me:ha4c_hee to the parent or guardian of This report is co advise you chat your child Ls making unsatisfactory progress in: Elementary interim Report of :45aris(accory Progress Date: 9 ',CI -C14) sucrose!). PrOf101. PonConol M.Y2ie Jo Young. .S tan! Principal Judy HeSSe40n. ASSslanl Pro10024 Grade: 5 ( ) Mathematics ( ) Reading C ) Leagues C ) Spellin ( ) Handwriting■ ( ) Social Studies ( ) Science/Health III) Behavior In order to improve, your child needs to: ( ) ascend school regularly ( ) bring the necessary supplies and materials co class ( ) listen carefully and follow directions ( ) complete classroom assignments ( ) complete homework assignments ( ) work independently ( ) develop better study habits ( ) Improve class behavior ( ) other: We need co work together. Please discuss this report with your child. Please sign and return the portion below the dotted line. Student's Signature Dace - Parent's Signature Parent's Phone Number(s) PROT50 Records Request Form OO 3,Ao I stir OCT 2 9 nen Siudad t Date of Illrat High Scfioo f ?'total. Weadi C01111111117ity Wontegkpmlmall Dab! Itequod: Second Itudiest M .. Ad/ A_ Proviona School Alleaded School Address ilds above named modem has availed in ow school. Please tend the following to Records et your earliest CANIVUliCAICC. Treitscaint of ray& grades liate of enrollitteca and withdrawal __Taal eunmidive atom= for year to dale Grades to dale of withdrawal Garai !emends (linmunizations) ____Intratreedion of yam marking system _Achievement Test Scram Copy of Strada MCI' Graduation recirammerds, if senior jitydratogical Itepart ((fart hem i ['kinglet Ildilation %dont) Pracra Signature Staid IlAticalion. PATNII SitItAllliC MINI/CUM SEND WITHDRAWAL. GRADES Think you for your (^titration in this miner. Federal law 99.21 Slabs: "No pans& eignalwo is requirrat for oduratiOnal records rail In trantlict allati(111111 agency? 106011 Okralinfort Onsifroan' Royal Pa fin Meade, grotitia 334.1.7 Tionste: (5611 7S:3-4000 Ya.c.f061)7S.4-4015 PROT51 ame Sesta TH EXAMINAT1 osectiOD RA N Arkhael--- t2o3 Raeie-- Sex Name of Penal or Ouardbn Scheer A. HEALTH EXAM NATION Heinle °bed Pr.r 1:614ermal4N; AboormaleA &Omens COMMENT: Mumma! Findings. be number 1. 7 r/ - 2. Skin/New elead/Sorto 4. Ewe 5. MRS Amity IS &I.) S. Ears 7. AuStery Molly iR a L) &Now / *Rook 9. Mouth. Teeth and Gums 10. Chest I Lungs 12. Oixboon 13. derails and Anus 14.1ArsodoCkeklal /7/ IS. Nourdoeical 0. MarInest 17. Emodocul / Mental/ Belovere Prob Nenoexp: rthyse.k/ 0"&"11Seeem 10 Act,nty Pastnctceas (Specify) -anal ovnical/ emc4o 21 moisen 22. Ober B. HEALTH HISTORY (Wks Mama Nutlet euvraln) Colleen narratke a ad6Omal sox. Deeded) C. LABORATORY H)croglobin/Hemslocri Lea] NAME: TITLE: ADORES (Please Print) A horized Signature 0141040. 16/94 laneKnr 145141.1 inn 3040sen, nor M non ISInk Mann 514400P11.4.21 SloolIO & Stlk Col II Tutercut4 test. L PROT52