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)
