Case File
efta-01709902DOJ Data Set 10OtherEFTA01709902
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01709902
Pages
71
Persons
0
Integrity
Extracted Text (OCR)
Text extracted via OCR from the original document. May contain errors from the scanning process.
THE SCHOOL
ALM B
BOARD OF
EACH COUNTY
PAL
BEAFLORIDA
CH COUNTY
PALM
KINDERGARTEN REPORT CARD araia.
tr
r_ 5-
KINDERGARTEN CHECKLIST
MARKING CODES CiVat ematanctlan tila MI Stal
l.
r'sliagiaikeigargestsriaradlaaWA Pea needs a es.
\ NN\ '14 a sagisikellaillia ctureallinililagaelhiaballadirle
h
ta aisinCrialassis sea
IS ausetlis Ws Ma*
DA estrisks is; Ma- a aided a.
The areas listed on the Outsells! as *au as music.
art and physical educat on are inciLded in the kindergarten curriculum The check! st n comiad
01 SktilS mat are eSSertial for students to Malted they are to be successful in the primary grades All
activities provided .13 kindergarten lead toward the attain-I-rent 01 these Puts The teacher determines the
appropriate time le Vie study.
to tegm Iwnral onstruChOn in each slue Beginning with IM record marking per rod, the C haCk I nt is used to report modern progress
NONACADEMIC BEHAVIOR
GRADES 1.5
This grade reflects the studs is OvereN conduct IR all School activities
4
Very Good 3 . Good 2- Fair I e Poor Parent sonteronda requested
Parent conference requested Nonscademir Pnhayin.
ATTENDANCE Nag PON
IN !al Lin lEa Sates Peer
Regular attendance and punctualirr an eaddellal for uafl ieduC Alen
IN IN 34
a
Days Present nnun Days Atwell Days Tardy
INFORMATION INCLUDED
TEACHER REQUESTS CCHIVEMENCE 'PLACEMENT Seat _I.__
Sumas* Stec. 090.99, 'I* warned edjappi Wows ern is a.c.Caled. rade peewee.,
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THE SCHOOL DISTRICT OF
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REGISTRATION '701 TOOL I NOR'. 504STOT 1002127 I
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STUDENT NUMBER:
FOR NEW.SETURNING STUDENTS:
TO TIE PARENTS OR GUARDIANS.
NEW STUDENTS Complete a: non-shaded wen on Doth S1MPS Of Town
RETURNING ETVGENTS Please r *e?. both ides foe correctness of typed snforrnatton If Use nSorrnaton
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,,,ATA VERIFICATION FORM ..,--t-* NEW,RVURNING STUDENTS
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WÓJT. RI SECICENTGO---- 1761 . ENTRY CODE
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ENTRY DATE
OB/23/93
SAC CODE I MADE LEWE 9.210
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TRANSFSR INFORMATION.
MANE Cf SCROOL TRANS/ERNS FRCW
CIYOT LOCATION
DATE Cf LAST KIENSINCE
GRADE LEVEL
LAST xUOUG SPOOL ATTULE0 N PAW MAW GWINTY
CATE ATICH0( O
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FOREIGN STUDENT INFORMATION: This Illoenudien Is volLertery aru used solely lot th. pumom ol ableinItsd Pewni MI6%
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NEW STUDENTS TO PALMREAOF CORRY ONLY:
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DOCUMENTATION CHECKLIST: (Check wee ANN ody aro notheet)
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LAI BEACH COUNTY
STUDENT I
STRATION 1 NEW STUDENT TO PALM BEACH COUNTY 1 RETURNIN3 STUDENT
-1 UMA ENTRY GOMPLETEO
U all non-Shaded areas and verity the resident address by your signature below.
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ENTRY DATE.
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Due
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RESICMT STATUS Us Out ace Q L art CFCCWIT at MIIIIIINT
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GRACE:
Y--
CALENDAA:
TEACNER113.:
TRANSFER INFORMATION:
NAME OF SCICOL !RANEE/MG FROM
LAST Mime 5C}OX ATTEN00 IN PALM MACH COUNTY:
FREE OR REDUCED PRICE LUNCH;
an OR tOCEION
DATE OF LAST ATTE1CANCE
GATE ATTENTCO
GRADE LEYL.
IWO yto NW al SIT apposor aN a RN a MOAN Fete theme (Apircason N DWAIN MD Dlis Regento: FINN) OM arm
SCREENING AND ASSESSMENT:
I re perriSSbn lot ny UNTO lo b pee screemel an/ eseuesowl sets atm :unary Sy what MI NNW; Wesel/TN ray t• Omen INIYMAIN an "cum an
CI No
SODIUM FLUORIDE PROGRAM:
GM permutes b my NMI es pet pa n SN Scan Rade Flown b CreNtt bit ORM MAMMA veld Swoop grade sot
Uva alle0
FOREIGN STUDENT INFORMATION:
ITN inlernmton b eosins, and Mad whIsty lot tat Armee at oblate RAS ItevEres
a
ENTRY INTO USA SCHOOL say
STUDENT OR
STATUS (ORM Ow) 1 E 3 5 6 7 I mieeMent Pan hasesteehave kin
341chtnNt Man Sall40.9m tAEntan 1:51.1A0 ertirsigreel
(Condon an =Mb matisnm 0 0•10ninn2 arm)
NEW STUDENTS TO PALM BEACH COUNTY ONLY:
r
ran4 nS Jr
WHAT LArMailr S SPOKEN IN RE NOME BY RE PARENT CA GAMOW*
C /LIG
1. pi a Linguica veer Tan Engash undo Sr non*?
j ifs WO Ckd no Iltdert Yunnan! beguage Ohm tan ENAAni
a
YES WO
3. Does Ye syden mom lreoartly gain language caw NnEnosh:
tans &Kb F NO CITIZEN Cf MET COWRY?
ENTRY DATE USA
Mel
DAT
YEAR N WHAT COINTRY WAS THE STUDENT BORA?
WHAT LuGUAGE IG SPOKEN N THE KW BY TIE SLID Nil /1/ Co
DOCUMENTATION CHECKLIST:
=our
UNMADE
Eu
CUMnius
LAND:Hot iCs covsun or
NATORt.
Oft
Ma AND GATE ONLY WIEN RECENV.0:
SCE:
mmaKnom 9/ Li man HARMAN
CSIATE
-
MICA/ MUMMER nein!
- 111100FIRMOIROLE
SCC1AL IMAM NUMSCR
I VERIFY THAT THIS REGISTRATION INFORMATION S TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE
PESO ms ammo Gm I _0(muitia
PROT5
STJDEnT NO
SCHOOL BOARD OF PALM BEACH COUNTY
STUDENT REGISTRATION FORN-Pmx2
STUCCO WOE
PARENTAL INFORMATION:
KW MOE NLUBER.
TIMNSPORTATIOM L'IfiS
SOKIenl
1
wit TWAIN' Wan schCci Py Itilec• 01* Pen Per --)a
SMOOT WES NM (CIRCE OM:
g BOTH PNIVCS
D
MOYER a MCI U WSW CUSTODY
j
OtHEP
IS THEN A COURT OMER IPARNG EMIR PARER ROM WRY* OR CONTACTING ME Ma
Ca
114E SCHOOL DAY?
D
YES j100 if YES RENE Komi n4 SMOG WIN A COPY Of DIE WC OMER.
FATHER
M
Rea l (s ide Iree6
-Li
MM. MT.
OCCIPATOI
RACE Of DOLOYMENT
BUSINESS ROM
MOTHER 1 -e- OC 4 r f M0. PIT.
°carom
PLACE Of EMPLOYMENT
MANESS ROM
LEGAL GUARDIAN (F ANY):
LAST NAME
MST
a
NT.
OCCUPATION
PLACE Of EIMLOTIMEN
DURESS RCM -II OM
EMERGENCY HEALTH AND SAFETY INFORMATION:
PART I: Pomade) other than parent authorized to pick up student.
P
CP - Gti,4,5
/0
RELATICNIMP
MS
ACCPASS
PIIDNE
Mi
gsl
Ell
I
6 'Writhe -I be r
PART II: Parson(s) to contact In the event of an emergency It portals cannot be reached. Thom listed all also authorized
to maws. student from campus In an emergency silualion.
jOrieck Weer. 'Oration o Ire Salle acre's! r Canyitle Pan i d Mort( iron Pa. SKr ed n Pay I
XAIE
TONE SS
MOM
RELATIONS.
I
PART Ill: N school la unable to contact you In can of "nese of accident, may am nave yore pennlasion to call your
doctor pr take your child to the hospital 3.111MI 0 MO raw CORM
Peoria ihNIER
NOSRTAL PRESSMAN rrood &Irian
Jon
If pouf child Sullen tern any Enna co hal any physical Moth mat as Mould be swan al Mem at
YOUR OTHER CHILDREN IN PALM BEACH COUNTY SCHOOLS:
YANTIS? Of CIALDITEN 5D0001 ATTENDED
I
GRADE Mini DATE
4h
LO:Pi 171 ..) rid ii hit /0 I VERIFY THAT THIS REGISTRATION INFORMATION IS TRUE AND
ACCURATE TO THE BEST DF MY KNOWLEDGE.
POOP PDS (RR. AIN
RAE a vAPfNT a LEGAL ?hi II
A
I 1
S
t 1't'`
PROT6
O
tl VI
0
it
I
i
COL DISTRICT OF A 3ECH COUNTY 9.12 Academic Improvement Plan (AIP)
O READING O somas AissIffents O FCAT Mart/Rate
Ten
K Wrote Sobers O Oar
tocne• Phonemic Awanniss O miring O 13/UnaK Sinnentnogerdno
Phonics K SOASSynto Caregnthrou O comonvEicon Rooney
K HO Frequency Wads O Rale Vocab.dory fl Striae* Marra
O Word IANnix Tat Cornpronension K Cuisurng K s'••••..2
/blab
K
s
Outsc &Radom O Rittlek• Revd / Sea/ Instructional amity's o Terwary
Gr•AS O Canon Lining Gaps O Gad ReueledAbt•EDbm• o Tedmolon
O Ohm (see emceed) AssignmettAR•math• O Tr.
O Gatti O Orel,* Reairerants O chidSbAy Worn O Antabacnal Resdng
DO as
F
ET:
FLAT:
MAP:
PRIM:
O WRRING O Path Bean Woes O Pollan 0 Perbmance Asuttrnenb
0 RAT Da?xstcdPretece Tees 0 Dor/ostic Sateab K Omet (see tend)
Typos cl Writing K WoroSenrenre mug O Paragraph Ming
O CarOasbon Wrong Ammons Applicalion of
FLAT Writing Ibbric O row.
ikon' K Droawaton K Comentrors Carves/Non C] art em
K Evoiti-, • =mum Tubing Own; Saar Day O Altentareon Genre /Saturday
Insruc6oni I Alternatives K tompfly St/Craw O Caveat* taming Groge
K Duna RadnoWriing Croups O Tedookor O Other On teachod)
Assignmns Minify* O 'me O Ourtey O Pada Rem anent O Chad SW( Relents
K martacoiLorogoiNto : 11
RET:
ratios.
59
MATH:
74
READ: 362
MATH:
311
5.0
ATP: ft-U W-LZ M-1F S-FL
LLP:
504:
O MATHEMATIC!) Ert<euxoa F4IFOIRCOO O Poreein Canoe
Agnomen' 0 RAT Dip ostotback• Tests O Nona& Sarno O cow No tenet)
Wrenn Sine. Concepts rd
=1
0 Geom.?
Mt
rinkrg n ant Rotabily
T
O Rada it Carol Area Spook Crawls Tutoring O Deng Scheel Dee
K AfmAioltroSehoo I I Sun*
K
MIMI WWI SWANS
Tosawy SRO Crows O Cowen Ian° Oman O Tendon o dew On Stand)
Atsignianaltionitts K The O On!
O Foam RefWalesre O OW Suds Rotas O Insinanar lAnierrelks
O
SCIENCE
GIA'ca Assessments
O
haseSsmeno T OFFICIAorreace Tests O Oarostc &erne O Ceet (see tech*
g
r ail'', et Mater ord atom O Processes tot Shape ne Fan
O Eat rd Spa 0 Pitons aLN O IR* thrg TNiNs Had RIM thee Entente
• Seto
CEntert Area moms
SON& Cacaos A-55 L t( re CI •rr.C - t ,,.t._ s it e tinertdr
8tonng
RAZ:
ou Do re S.md I SaArdo Ire flukes! Alternatim
T
Sim Groups erre Lena Goods O Gilled hoetindenntwc Grout
K Technakgr O Ore (see Ora) AnIrmont Alomolivo tea
O Gal O Produd Reaxerrents O ago Stith ROWE O tratuctona Nato;
Student program, will a monitored throughout tin school rem, wed student peeress eele be Estleoned on the report card.
C
5 ,FT.R.OJOI Rwoolared O Stamm Nam AO Next Schur" Yea'
O Spcoal Senecas / Placental O qua (se. altatheS K Sixassluly Rernadaled
O Regales Non' MP Nor SOS Year 0 Snail Sera I Pecirent
O Otte (see eftscheci)
O Deficiencies die to nonattendance OW to Attendance Specialist)
Paant/Guardlan COMMItmenUCoritribUtiOn Ova as That •0•Y
O Monitor Attendance I Tank** K Chock Homework O Encourage Rimdm3 at Home
Reinforce Skills O Mena Parent Conte/axes C Sign CiallyINO•dy Notes
O Mend Parent Curnculurnl Infornatith hieetngs
PEISI) '687 (REY. Br 2,2(03)
ORIGINAL • Cumutaes Fodor COPY. Teacher
COPY - ParankGuardian K Sicrossruer Flemedisted O Paquin.' Nik*A Nett Scheel
Year O Speoa Sereces/Platenwt Daher bee Oxen) O Sucoosduei aro •
Yew
0 Sod* Senates f•xtmen Doter (see anal)
XIAA nu OF rd
R
out arra cm/ -W:4 - art our
PROT7
Nart*:
Your Scores Percentiles
Mat
SAT
Ranges Con Von Expect?
Review Your Answers
Ak
r
test box bid< so sou trn see th* quetttont.
-
K"
tertuí - o bal u bon» • law m trim
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tres rre irtie n nam tree Vrhal
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Vear: 2002 Wade: 10 School Code:
Math
50
Sores erithil these mams can te cansidered erniar to pul:
MIr
90 20 80 20 niallillsa
PIM
41
52
46
54
teen Wener een 59% ar unnervern detk ve. acne. ro)no,
63% sr renenet
Mak
SAT IYwW 880 250
SAT
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440
540
440
560
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11
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35
40
School Copy Writing Skills
48
44
52
INMSC) Programs n•:94Cl2I T
80
Intens' Merit 1." ~
MI
Schelarship Corporation eng een. t..e. 59% er manmamt
5511 atm 200
SAT N: »Ilias Teat
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450
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11 Artn en me h Geo h Ar, answered cornet/in DI 40 nath gutntat and MMO 22 prots
a
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*camera! 1 queatm(t).
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10:•• 21 n tž c J fI e zi n e go Ata41 - an 11 e naPro
Ye ermeed certarať l a a a astag Mis daeddrti ad umn ie pint al 3 ai:Tonen:os
______33j 3s_mnftvparostirm al _a. hredevenons lat eend o naanan(O.
lou aantrad arAtnntý 21 QtelblIA0 Sad 'ai s pen(s)
Improve • U nindiďatandfni mala Haas In
MMg paap.
Your sr ., Rem the 'Maa passage Wertully end try tO de/MMO dič attnOrg oyardi ~sus
Pracht. Making castmclons herweel tli. main dea and nopartina detail*
Stro oeren* ra, 20.5d ■ DMIngulahIng conflIcting vinnen
How b inOraVe: Veen Maning, pratpao rhernne-,1 Ins man !dein and eend tenteen<
taal mark transtton rints. "sar, to undleltald ~trein et aanvielen and indun.rviitloi
Exped geur taan to Int:.Ja egunentelve wert:n2, thch es poineer tornmentarb,
meceophy. aW C/ tiCi3M.
beo gr:kom '9, 20, 34.
■ Reen/MINI <onmensen betwean Ideaa In a martelnat
Mee ie inert*: Lenin how coniecrno ral
(enen as naad., reentl end cAnrytketiOnli) estatnsh rop manonding name Omazal pna
er a lančantaa Sele derft," 2, 32 Skills -he sKds and are heel nn your
Indiblůnal performance on tm tra.
Pt
the suggesticrn to mooi in
toch mee ■ Vang basic concept. and .panclone In erlthritotic ambten. zalving
Hoe tO Inren
Practici sc AN moderns intortneg tremen. eednel., ratio. reent, en2OnentS. square root' Ome voute aso andice lome° půot4ems maden) om am
men witgors. crime noemers, mades.
netslity, and neme Wen.
See questions a, IA 14, ■ dans; basic algebrak concept* and
°panelen@ to all problerns Hos to lepton Review almtem ruim. toen
•• .new !reine eigentb. 'anno *oeren.
and inept:a:tel, and COn0.01•19 ia0014IC 0.3, 051. ,0", •
Sec pannerk 4, 0. 0.
■ Making Ponne:dons neon* mathematkal teak,
Hei to lenfrOVIr PfaCt105 PODIO•n$ Pad regen) combi/eo +kril aCquired :n Otter natn
eturse2, SiAln N prObrem2 trp Na Cent> katen a annimele, retter. and decmetfy.
Set emmers e, a. It.
Beleg praam and da stem te Impreem team re ďeoneteaimence eerrenn teat arerning;,aus and conklirg 'n
'n teer warmg, <rooie wood!. Cerefulty and
CO,VIOrt 'hem te tell Men?, rig.
500 poenen /, '2, 14.
UnderstandIng M. nructure el aantonen sikh abstract Idem
Mem te hierom Raad ~Paden.
te49*0245.
*no boen tAat deal vin neyecto such as potrtio.aconomm. rrstoey, or pinano;ny.
Se* erstrom 7..0, 1/.
Selection Index 146' Percent'.
so
- we ...imenť.
roll ~Wen
Be ~Kan re no of rag vena mant ad Aam a aa MC tas die &karn hMamalMlltRanaRC
wiel dart Ika its 1• 010416 taNnatS Ger mese) eiN elMo ľi ...n re be./n
Madam m4 mies yeg St ~0 ree. noran11 tO enter ~K's 2004 veert
Zee We, ~In ~oe te ever, dam am ~V
en
/nar er ema - No slat Coby Reateronionte )dort n ~ti du pratte en mor ante« Met rolt tag Mei ar
Kt
Mama Iq, Mae M mt11.1 Me n cdest
IVO) Ms b ro etba ram 50'
ES cartia
aa
'ron meren ~na: e :een NO meel and intense ▪ 411~ rn :043.1.4. -use tata .h• narmuses men n
"Ne 0.1rilyear nurrr.r year)of raas a Ineke, 12 ter een
NMSC ontorens Your Educalional Plans Gade Wenst
A
lage Mar Oven mennen Greet Eairentarr streel barlaar iriaimaxa Ome a siii~
Darai sedinan.:
mw
art emmer. Manna te och chlIdna 1n er~* anaMaeMtllrlgelra.
tennis ons a taadaĎon In ~all art& lubjetta leem a van.yw onelhe4S fe/
***** wend,. hot arde", ei/Miers1,4<ndlyead ,reoloat.oFit. 444 an aflaat...el
,• een<* Pm reines reien' ret nennti eA meng Aeleežaled saut.
ermirnty.
raren sennt neneriny, 42.!l/ 10 tnána• *rem eithuLaVn ameremended Men Scheel
Carnet Er.one 4, InCe494 nenennet 3. oen/ r.
ary I ~les 1, ro obry eeg. reen es 7. ene cone...
worg* I Other Kalers ta Cureer.
Cerneneneen• Pet rik eed ~at." Jun•Or ..,4•OinaitiOrt
Meen *eerde Prverwroov Sheneary Meekon. ed tree amesCaten
Careers' in* wernentary eatgaten mem Mans ree le team m enetary
Redes wen 4(4.44•,414 grodadio th.dy ean 1414 a• ..nats 4(5444 oen... noor.
wentonal neemt*. er Knee
PROT8
Ila COURSE PERFORMANCE Past 430 FINNIE-P21 (continued).
Total [repeated 3 times] Corr/Att Percent Enroll
IPM
Current Course Time ExerCises Correct Level Gain 4305
(Enroll- Date - 9/12/96)
MCS
4:12 312/385
81
0.01 3.99 - 4.01 0.02
RW
3:59 570/666
86
3.50.
4.72 4.89 0.17
RA
' 0/0
0
N/A
N/A
N/A
N/A
PROT9
6 5 97 7:52am
COURSE PERFORMANCE Page 430 FINNIE-P21 (continued)
Total Corr/Att Percent Enroll
IPM
. Current Course Time Exercises Correct Level Oain
4355' (Enroll Date - 9/12/96) 213/244
87
0.01 3.92 0:00
RW
2:32 362/416
87
3.50 4.72 4.72 0.00
RA
0/0
0
PROT10
6/7/96 6:28am
COURSE PERFORMANCE Page End of Year Report
Total
Total
Tot
Cor/At
Per
Enr
IPM
Curr
Tot
Crs. Time Exer Corr
Lel
Lel
Idyl Bess Gain 3504 (Enroll Date
14
70/1773
83
- 8/22/95) 2.80 3.20 3.79
37
0.59
MCS
21:04 1213/1640
74
2.50 2.75 3.55
74
0.80
FAB
8:34
N/A
36
N/A
WE .
2:37 25/38
66
PROT11
6/2/95 12:36pm
COURSE PERFORMANCE Page End of Year Report
Total
Total
Tot
Cor/At
Per
Enr
1PM
Curr
Tot
Crs. Time Exer Corr
Lvl
Sess Oain 2352 RM..
(Enroll Date - 8/29/94) 1043/1170
89
2.00 1.55 2.53
54
0.98
MCS
10:10 818/1087
75
1.99 2.05 2.41
54
0.36
PROT12
REPORT 11 lEMEITE:
STUUSNT KMFOKT
FOR:
SCHOOL:
TEST:
ELEM
CTBS/4 LEVEL 12 FORM A
CRAM:
02.
DATE Of TESTING::
VIDEO NOMA:
4/18/95
TESTS mammal
NAM
SMUT
o
AmVER mAGsE
S.
WM
mama
TOTAL READING
READING COMPREHENSION
Si
READING VOCABULARY
TOTAL MATHEMATICS
MATH CONCEPTS S APPLICATION
58
MATH COMPUTATION
UMTSOF
PEWMUM
2-0
PERCEMILE
OS-/O'
NMEWILE S1-TS
WKWUM
M.,
MKOMM
MEd
Dear Parent/Guardian:
This spring,.. was given the Compreh Tests of Basic Skills/Fourth
Edition (CTB . This report explains test results.
When compared with students across the nation, scores were in the high-average range on all tests taken.
Additional information about these tests can be Alin the back of this page. If you would like more information about test scores, please
contact our school.
Sincerely, Principal
PROT13
REPORT II
TEACENR:
CTBS/4 STUDENT REPORT
KA:
SOKOL:
ELEM
Ian
CTBS/4 LEVEL 13 FORM A
GRADE:
03
DATE OF TESTISG:
SIMENT
WAITER:
4/17/96
TESTS
IESCEMILE
MOKS
LOWE
SUM
AVERAGE
LOW
MIKES
MW
MOKET
70
==K=0...
MATH CONCEPTS & APPLICATIONS
69
TOTAL LANGUAGE
LANGUAGE MECHANICS
LANGUAGE EXPRESSION umas or
PMCOTRE mao
1-0
MIKEWILE
Al*
POCOMLE 51-75
PEACOMLE 74.1, mmamu This spring,S. was given the Compreh
Tests of Basic Skills/Fourth Edition (CTB This report explains test results.
When compared with students across the nation, scores were in the high-average range on all tests taken.
Additional information about these tests can be
n
the back of this page. If you would like more information about test scores, please contact our school.
Sincerely, Principal
PROT14
nowt.
TEA,MR:
FM:
SOMOL:
TEST:
ELEM
CTBS/4 LEVEL 14 FORM A
CRME2
04
DATE OF TESTING:
SMOLT MIA:
4/15/97
TESTS
MMIMILE
NAM
LOWST
SOME
AVERAGE
LM
ROM
MM
MUTT
TOTAL READING
77
READING VOCABULARY
TOTAL MATHEMATICS
MATH CONCEPTS & APPLICATION
45
MATH COMPUTATION
SCIENCE
SOCIAL STUDIES
RIMMIN
FMCMTILE
MAIM 1-25
IMEMMLE 2650
PMCVMU 51-75
IMCMIRE 7.-t,
MMEMILE
This spring,11. was given the ComprehmalysTests of Basic Skills/Fourth
Edition (CTB This report explains IIIIIII test results.
When compared with students acrosii iiation, scored in the highest range on Reading Comprehension.
scores were in the low-average range on Math Concepts & Application.
Additional information about these tests can be iin the back of this page. If you would like more information about test scores, please
contact our school.
Sincerely, Principal hskiii6YS4pitz.
PROT15
TEAOCER3
SCHOOL:
TEST:
ELEM
CTBS/4 LEVEL 15 FORM B Mitt
05
DATE OF SSSSS
STUDENT
MISER!
I
4/20/98
TESTS
MUMETKI
MAIDE
EMU
SCONERA
AVERAG
UM
MISE moi
MOT
79
...man
MATH CONCEPTS & APPLICATIONS
39
et.
TOTAL LANGUAGE
LANGUAGE MECHANICS
LANGUAGE EXPRESSION
MAWSW
MACCOUt
IUMS 1-tr.
name51.5
PIAMMU
U.9
FUUNTUE
REHM
IDOWIU This spring, s was given the Compreh Tests of Basic Skills/Fourth
Edition (CTB This report explains test results.
When compared with students acrosii i iation, scored in the highest range on Reading Comprehension.
scores were in the low- average range on Math Concepts & Applications.
Additional information about these tests can be n the back of this page. If you would like more information about test scores, please
contact our school.
Sincerely, Principal
PROT16
J&II4.0.4fla
a
rya..
HINER:
SOIOOL:
TEST:
CTBS/4 LEVEL 16 FORM A
TOO:
I
GRADE:
06
DATE of TESTING:
4/13/99
SWOP? MIER:
TESTS
EMMET
RAMS
WORST
SCORE
AVERAGE
LN
RANGES
MN
MI0IEST
TOTAL READING
69
name
READING VOCABULARY
TOTAL MATHEMATICS
MATH CONCEPTS r. APPLICATION
SQ
41..e••
MATH COMPUTATION uwms Of mmeNna mem 1-m.
POURITILE
EE-SC mann, fl-T!
PEICNTILE
TO-If
ME UMMA
This spring,A. was given the Compreh rests of Basic Skills/Fourth
Edition (CTB . This report explains test results.
When compared with students across the nation,
a
were in the high-average to low-average range on all tests a en.
Additional information about these tests can be the back of this page. If you would like more information about test scores, please
contact our school.
Sincerely, Principal ',O"64410
PROT17
SCHOOL BOARD OF PALM BEACH COUNTY Notice of Student with Special Characteristic
PLEASE PLACE THIS NOTICE IN THE STUDENTS CUMULATIVE RECORD •
"HUAI
Please chock Fl In pencil each of the Information Items below which are accurate for
this atudenL When changes occur please update by adding or erasing check marks as
appropriate. Please sign and date each time the information on this page Is changed.
El Psychological evaluation has been completed.
al Student is being processed for placement in en exceptional student program.
K
Student has been staffed for an exceptional student program but has not been officially placed.
K
Student has been placed in a full-time exceptional student program.
List
M
/Student has been place In a part-time exceptional student program.
List:
K
Student has been referred for attendance problems.
El Dispensing of medication during the school day has been authorized.
Ei Evidence regarding high risk medical condition is in fettle.
K
Student has been referred to the Community Mental Health Center.
K
Student has been referred to community agencies foiservice.
K
Migrant student
K
Other This pap* has bean updated
IT:
PISS NH
DATE 0/91 (006.
DT:
GATE
PROT18
THE SCHOOL DISTRICT OF PALM BEACH COUNTY Grade / Course Change Documentation rallIKM1
CENTRAL INFORMATION
CHANGE DOCUMENTATION
GRADING PERIOD
GRADE
EXAM
CONDUCT
1-1
From
To
r
From
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From
To
To
TO
Change course code
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Reason for change:
Micrcalculated Grade Average
0
Student Completed Wm* K Other (.AMM Wow)
APPROVAL SIGNATURES (two of three required) sort sort
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DAM rumor MWCWA • DESIGNEE sr MTh
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DATA PROCESSOR CONFIRMATION P3500797 (REV. smaocii)
CRIONAL -Cuaularwe Folder 51,44, RAM OF DATA IY eqpy • Orice
4- ia,-61
PROT19
THE SCHOOL DISTRICT OF PALM BEACH COUNTY Grade I Course Change Documentation
GENERAL INFORMATION srteemuste 4'.
Lrnto3LoJoeS Cern, Comae Oman.
I2cruazeomi
CHANGE DOCUMENTATION
GRADING PERIOD
GRADE
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Reason for change:
0 Recalculated Grade Avenge K Student Completed Work
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DATA PROCESSOR CONFIRMATION P08O 0797 (REV. 9/122001)
SIOWTIRE Of OITA PlbrrcESSOR
ORIGINAL - Cumuatve Folder Copy -Oda Re
NYE
PROT20
Spring 2003 Florida Comprehensive Assessment Test (FCAT) sw"Homter
NORM-REFERENCED TEST Sacoi Name anaNuinber.
GRADE 10 Student Report
er
rill D2MtEtifl.tEll
SO - PALM BEACH
This report shows your results from the FCAT National Norm-Referenced Test.
The FCAT Norm-Referenced Test measures your achievement on a test that was given t0 •
national sample of students. Your nomnteferenced scores kt Reeding Comprehension end in
Mathematics Problem Solving describe your performance in relation to the performance of
students throughout the nation. Your scores are shown below.
SUBJECT SCORES Scale Score National Percentile Rank
Stanine Reading Comprehension
712
59
5
Mathematics Problem Solving
717
74
6
The Scale Score woe's, your sorktroance on the 1 at and aliens or COmparisenS Iron year to year.
Reading Comprehenalen Scale Scorn range horn 577 to 817.
mathematics Scala Scores ranee bin 568 to 883.
TM Ns/Sonia Percentile Rank and Stanine indcate your relative Montana In ecovarivon to the national referent*
group. National Pertenble Realm rang. from I to N. Sargon range lion 110 9.
RSV:block one test again, your National Percentile Rank night be stgMN Noise or Icwer than staled nere.
However. you, National Percentile Rank wood probably tan "reign a tartan range.
Foe Regant. Cotner...en...Um. your National Percentile Rank should be between 44 and 74.
For itanetnatich your Notional Foramina Rank 'naiad be barmen 64 and 82.
CONTENT SCORES Number of Questions on Test Number of
Correct Responses Number of Questions Attempted Reading Comprehension
51
40
St
Irilia/ UncYxsrandirg
a
8
8
interpretation
22
19
22
CrItcal Analysis
9
5
9
Stralealto
12
8
12
48
Mathematics Problem Solving
48
28
Problem SWAM
6
2
6
nifseca
6
5
6
Dashikis
6
.5
6
Probability
5
2
5
Function*
5
3
5
Geornetry-Syntherle
7
2
7
Cecrnetry-Algtbreic
4
3
4
TrigenonCray
3
1
3
Cescate maul
3
2
3
Precaleutur
3
Data Runtime: 0413/1,2003 0145293
PROT21
5..
)
b(k\ THE SCHOOL DISTRICT OF PAW BEACH COUNTY 4 Grade and/or Course Change
.......p Documentation 0 High School 0 Middle School
0 Elementary School
COWNI.Be.
SOUOt MAC9O1 SOI
COMM THIN High School
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From j ih.3
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0.9
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From
To
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From
To
To
Change course code From
To
Reason for change
CI Recalculated Grade Average
WAStu:lent Completed Work
CI Other (explain below)
APPROVAL SIGNATURES (two of three required)
AGWAROW Oe /AEA Ad.:NISTA' TOR
DATE
PESO 0797 (REV. sibtacciq
DATA PROCESSOR CONFIRMATION I confirm that the gradokourse change has been implemented.
SCALIIVAF Or OATAMOCT
ORIGINAL - Cumulative Fades Copy - Nice rile
PROT22
PANEL:
A13. ACADEMIC HISTORY
YEAR: 05
STDT:
MIiiiilAugust 16, 2004 10:19 am
SCHL: Ill, GR: 12 ST: A
A
CREDIT
CREDIT FIN H P --TAKEN--- C SY T COURSE
SA CODES ATTP EARN GRD FLGS C S SCHL DS GR
130
99 3 1302000 M/J BAND 1 R 0 1691 SO 06 00 3 1302010 M/J BAND 2
H
H 0 1691 50 07 01 3 1302030 M/J BAND 4
A
H
H01691 50 08 02 1 1302300 BAND I
PF F .50 .50 A
JE
R 0 2331 50 09 02 1 1302500 JAll ENS I
PF F .50 .50 A
HJE H 0 2331 50 09 02 2 1302300 BAND I
PF F .50 .50 A
JE
R 0 2331 50 09 02 2 1302500 JAZZ ENS I
PF F .50 .50 A
HJE H 0 2331 50 09 03 1 1302310 BAND II
PF F .50 .50 B
JE
R _ 2331 50 10 03 2 1302310 BAND II
PF F .50 .50 B
JE
R
2331 50 10 04 1 1302340 RAND V
PF F .50 .50 A
HLE H : 2331 50 11 04 1 1302510 JAll ENS II
PF F .50 .50 A
HJE H 2331 50 11
ATTP: 21.00 EARN: 21.00 POINTS: 52.00 GPA: 2.4762 EXCLUDE RANK: N
PF1-HELP 3-EXIT 5-REFRESH 7-BKWD 8-FWD 9-NXIP PAGE 12-ESCAPE
PAGE FULL...00NTINUE. ota-s - t pc ,,,-0-AřreAtir
Date: 8/16/2004 Time: 10:20:16 AM
TERML: DQ32
PROT23
Florida Comprehensive Assessment Test
FLORIDA COMPREHENSIVE ASSESSMENT TEST (FCAT) 2000
NORM-REFERENCED TEST Student Report Grade 07
This report shows your results from the FCAT National Norm-Referenced Test.
Sr
S d
r
chool Name and Number
e
t
MI 0=CNumber 50 - PALM BEACH
The FCAT Norm-Referenced Test measures your achievement on a test that was given to a national sample of students. Your norm-referenced scores in
Reading Comprehension and in Mathematics Problem Solving describe your performance in relation to the performance of students throughout the nation.
Your scores are shown below.
SUBJECT SCORES Scale Score National Percentile Rank
Stanine Reading Comprehension
720
88
7
Mathematics Problem Solving
704
85
7
The Scale Score expresses your performance and allows comparisons from year to year.
Reading Comprehension Scale Scores range from 490 to 819. Mathematics Problem Solving
Scale Scores range from 513 to 829.
The National Percentile Rank and Stanine indicate your relative standing In comparison to the
national reference group. National Percentile Ranks range from 1 to 99. Stanifies range from 1 to
9.
If you took the test again, your National Percentile Rank might be slightly higher or lower than
stated here. However, your National Percentile Rank would probably tall within a certain range.
For Reading Comprehension, your National Percentile Rank should be between 77 and 94. For
Mathematics Problem Solving, your National Percentile Rank should be between 77 and 92.
CONTENT SCORES Number of Points Possible Number of Points
Earned Number of Questions Attempted Reading Comprehension
54
47
54
Initial Understanding
10
Interpretation
24
22
24
Critical Analysis
10
9
10
Strategies
10
6
10
Mathematics Problem Solving 50 .
38
50
Measurement
5
Estimation
6
4
6
Problem Solving
5
4
5
Number Relationships
6
5
6
Number Systems
4
3
4
Patterns & Functions
3
2
3
Algebra
4
Statistics
5
4
5
Probability
3
1
3
Geometry
9
6
9
The content tested Is described on the back of this report. Each question was worth 1 point
Run Data 08/21/2O00 0141721
PROT24
Grades 5, 6, 7, and 8
The FCAT NRT Reading Comprehension Test assesses the following objectives:
Milla/ Understanding - Demonstrate the ability to comprehend explicitly
stated relationships in a variety of reading selections.
Interpretation - Demonstrate the ability to form an interpretation of a variety
of reading selections based on explicit and implicit information in the
selections.
Critica! Analysis - Demonstrate the ability to synthesize and evaluate
explicit and implicit information in a variety of reading selections.
Strategies - Demonstrate the ability to recognize and apply text factors and
reading strategies in a variety of reading selections.
The aboye objectives are measured within the following contexts:
Recreational - material typically read for enjoyment.
Textual - material typically found in grade-appropriate textbooks and other
sources of information.
Funcional - material typically encountered in everyday life situations.
The FCAT NRT Mathematics Problem Solving Test assesses the following objectives:
Measurement - Demonstrate an understanding of the principies of measurement.
Estimation - Determine the reasonableness of results and apply estimation
in problem solving.
Problem Solving Strategies - Demonstrate an understanding of the process
of solving conventional and non-routine problems.
Number and Number Relationships - Represent and use numbers in equivalent forms in real-world and mathematical problems, and demonstrate
number sense for whole numbers, fractions, decimais, and integers.
Number Systems and Number Thectry - Demonstrate an understanding of relationships among arithmetic operations and apply concepts of number
theory such as primes, factors, and multiples in real-world and mathematical
problems.
Palferns and Functions - identify numerical and geometric patterns and
functions and use them to solve problems.
Algebra - Demonstrate the ability to evaluate expressions and solve linear
equations.
Statistics - Demonstrate an understanding of the relationships in data sets.
Proliability- Demonstrate an understanding of the laws goveming chance.
Geometry - Demonstrate an understanding of geometric principies.
Grados 5, 6, 7, y 8
La Prueba de Comprensión de Lectura FCAT NRT evalúa los siguientes objetivos:
Entendimiento - Demostrar su habilidad para comprender explícitamente el contenido y la relación entre si dentro de una variedad de
selecciones de lectura.
Interpretación - Demostrar su capacidad interpretativa dentro de una variedad de selecciones de lectura, basándose en información explícita e
impilcita en dichas selecciones.
Análisis crítico - Demostrar la habilidad para sintetizar y evaluar información explícita e implícita en una variedad de selecciones de lectura.
Estrategias - Demostrar habilidad para reconocer y aplicar el contenido del
texto y estrategias utilizadas en una variedad de selecciones de lectura.
Los objetivos anteriores se evalúan en los contextos siguientes:
Recreativo - material utilizado para entretenimiento.
Textual - material utilizado en libros de texto del grado apropiado y en
otras medios informativo.
Funcional - material utilizado eh la vida diaria.
La Prueba para Resolver Problemas de Matemáticas
FCAT NRT evalúa los siguientes objetivos:
Medidas - Demostrar sus conocimientos de los principios de medir.
Estimación - Deteminar cuán razonables son los resultados y aplicar la
estimación en la solución de problemas.
Estrategias para resolver problemas - Demostrar comprensión del proceso de resolver problemas convencionales y fuera de lo común.
Números y relaciones entre números - Representar y usar números en formas equivalentes en problemas de matemática y de la vida diaria, y
demostrar sentido para las fracciones, los decimales y los números enteros,
positivos y negativos.
Sistemas y teoría de los números - Demostrar conocimiento numérico de las relaciones entre las operaciones de aritmética y aplicar conceptos de la
teoria de los números tales como números primos, factores y múltiplos en
problemas de matemática y de la vida diaria.
Pautas y funciones - identificar funciones y pautas numéricas y usarlas
para resolver problemas.
Aletas - Demostrar la capacidad para evaluar expresiones algebraicas y
resolver ecuaciones lineales.
Estadistica - Demostrar conocimiento en procesamiento de data.
Probabilidad - Demostrar conocimiento de las leyes que gobiernan el azar.
Geometría - Demostrar conocimiento de los principios de geometria.
So urce: Stanford Achlevemenl Test SeM1es, rüeb Echtion, Cerrad= of Metniettatal Objectives
Noldr PilnInd wth nottnIAAkto Itu Marero/1 Felotailanal Lia•••••••••••
4000
PROT25
EVALUACION DE SECRITURA DE LA FLORIDA
PRIMAVERA DE 1997
REPORTE ESTUDIANTIL
INFORMES DE LOS ESTUDIANTES DE 4' GRADO Descripción de las Notas de Redacción
6.0:
la redacción se concentra en el tema, está lógicamente organizada e incluye un
amplio desarrollo de las ideas o ejemplos fundamentales. Demuestra un dominio maduro del
idioma, incluyendo precisión en la elección de términos. Las oraciones varían en su estructura.
La puntuación, uso de mayúsculas y ortografia son generalmente conectas.
5.5:
La redacción recibió un S por parte de un lector y un 6 por parte del otro lector.
5.0:
La redacción se concentra en el tema y tiene un desarrollo adecuado de las ideas o
ejemplos fundamentales. Tiene una estructura organizada, aunque haya algunos lapsos. La
elección de términos es adecuada. Las oraciones varían en su estructura. La puntuación, uso
de mayúsculas y ortografia son generalmente conectas.
4.5:
La redacción recibió un 4 por parte de un lector y un 5 por parte del otro lector.
4.0:
La redacción se concentra en el tema, aunque puede contener información ajena al
mismo. És evidente una estructura organizada, aunque puede haber algunos lapsos. Algunas
ideas fundamentales contienen datos específicos y detalles, pero otras no están desarrolladas.
La elección de términos es adecuada. Las oraciones varían algo en su estructura, aunque la
mayoría son simples. La puntuación, uso de mayúsculas y ortografia son generalmente
conectas.
3.5:
La redacción recibió un 3 por parte de un lector y un 4 por parte del otro lector.
3.0:
La redacción se concentra generalmente en el tema, aunque condene información
ajena al mismo. Se intentó una estructura organizada, aunque puede haber algunos lapsos.
Algunas de las ideas o ejemplos fundamentales pueden no estar desarrollados. La elección de
términos es adecuada. Las oraciones varían algo en su estructura, aunque la mayoría son
simples. La puntuación y la ortografía son a veces incorrectas pero las palabras más
comunmente usadas están escritas correctamente.
2.5:
La redacción recibió un 2 por parte de un lector y un 3 por parte del otro lector.
2.0:
La redacción está apenas relacionada con el tema u ofrece poca información
relevante, así como pocas ideas o ejemplos fundamentales. Hay poca evidencia de una
estructura organizada. La elección de términos puede ser limitada o inmadura. Las oraciones
se limitan a construcciones simples. Pueden encontrarse errores frecuentes de puntuación, uso
de mayúsculas y ortografia.
1.5:
la redacción recibió un 1 por parte de un lector y un 1 por parte del otro lector.
1.0:
la redacción considera mínimamente el tema porque no hay o hay muy poco
desarrollo de las ideas o ejemplos fundamentales. No hay evidencia de una estructura
organizada. Las ideas aparecen enumeradas en listas y la elección de términos es limitada o
inmadura. Puede aparecer información no relacionada con el tema. Los errores frecuentes de
puntuación, uso de mayúsculas y ortografia pueden Impedir una comunicación efectiva.
U:
La redacción no tiene relación con el tema asignado, no puede leerse o no obtuvo
respuesta.
Estimados padres o tutores:
La prueba escrita por su niño(a) en enero como parte del Programa de
Evaluación de Redacción de Florida, fue leida independientemente por dos
personas capacitadas para evaluarla. Cada lector Juzgó la prueba en relación
a un conjunto de normas y la calificó con una nota general. La nota final de
su niño(a) es el promedio de las notas otorgadas por los dos lectores.
Esta nota de redacción le ayudará a usted, a su niño(a) y a los maestros a
comprender cómo se desempeñó su niño(a) en esta prueba de redacción realizada en todo el estado. Una descripción de cada una de las notas
posibles aparece en el lado izquierdo del Informe.
Los estudiantes dispusieron de 45 minutos para leer el tema asignado, planificar lo que iban a escribir y escribir sus respuestas. Las condiciones
bajo las cuales los estudiantes redactan otras pruebas en clase o en el hogar
pueden ser diferentes a las empleadas en esta prueba; por lo tanto, la
redacción puede ser diferente. Ustedes y los maestros deben considerar la
nota de esta prueba junto con todas las otras redacciones del estudiante, al
planear actividades para continuar desarrollando las habilidades de redacción del estudiante.
PROT26
1997 Florida Writing Assessment
STUDENT REPORT Grade 4
TYPE OF WRITING TESTED: WRITING TO TELL A STORY Student Name: r
Student I.D. No.:
School:
District:
PALM BEACH COUNTY
SCORE: 3.5 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 writing focuses 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 are 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.
U: The writing is unrelated to the assigned topic or cannot 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 happened when they traveled on a wagon pulled by horses.
RUN DATE 04/19/97
SO-1781-00O3074M
PROT27
Mathematics Content Tested Área de contenido del examen de Matemáticas
PCAT Mathematics Is an assessment of the Sunshine Sude
Standards In mathematics. PCAT Mathematics assesses content
from the following aseas:
Number Sense, Concepts and Operations
• identifying operations (+, x, +) and effects of operations
• determinIng estimates • knowing how numbers are represented and used
Measurement • recognizing measurements and units of measurement
• comparing, contrasting, and converting measurements
Geometry and Spatlal Sense
• describlng, drawing, identlfying, and analyzing two- and threedimensional shapes
• visualizing and IllustratIng changes in shapes • using coordinate geometry
Algebralc Thinking
• describing, analyzing, and generalizing patterns, relatIonshIps, and functlons
• using expressions, equations, inequalities, graphs, and formulas
Data Anaiyzing and Probabillty • analyzing, organizing, and interprefing data
• identifying patterns and making predictions, Inferences, and vaild concluslons
• using probability and statistics
CAT omprebensive Assessment Test
El examen de Matemáticas PCAT es el examen que evalúa las normas educativas de Matemáticas del estado de la Florida (Sunshine &ate
Standards). Este examen evalúa las habilidades siguientes:
Compresión numérica, conceptos y operaciones
• Identificación de operaciones (+, a, x, +) y efectos de operaciones
• estimación de resultados • uso y representación de números
Medidas • reconocimiento de medidas y de unidades de medidas
• comparación y conversión de medidas Geometria y noción espacial
• descripción, dibujo, identificación y análisis de figuras de dos y tres
dimensiones • visualización e ilustración de cambios en figuras
• uso de geometría coordinada Razonamiento algebraico
• descripción, análisis y generalización de patrones, relaciones y funciones
• uso de expresiones, ecuaciones, desigualdades, gráficas y fórmulas
Análisis de datos y probabilidad • análisis, organización e Interpretación de datos
• identificación de patrones y elaboración de predicciones, inferencias y
conclusiones válidas • uso de probabilidad y estadística
Mensaje a los padres de familia:
La Prueba de Evaluación Comprensiva de la Florida: Florida Comprehensivo Assessment Test (I7CM) es un examen
nuevo diseñado para los estudiantes del estado de la Florida. El examen PCAT mide las normas educativas (Sunshine
Suite Standards) de matemáticas y de lectura. Dichas normas, que fueron adoptadas en 1996, tienen expectativas altas
de los estudiantes del estado y se aplican a todos los estudiantes ya sea que vayan a trabajar o que sigan con
estudios universitarios después de la escuela secundarla. Las normas educativas representan lo que los estudiantes
deben saber y pueden hacer en su avance académico. Las normas educativas establecen la base para un sistema
que define una mayor responsabilidad para las escuelas de la Florida.
El examen PCAT fue administrado por primera vez en enero de 1998 en las escuelas del estado de la Florida. Los
resultados del examen de 1998 determinarán la base para el futuro logro de las normas educativas del estado de la
Florida en las áreas de lectura y matemáticas. Los resultados del PCAT' son un reflejo general de estas nuevas normas
educativas y sus altas expectativas. Los resultados del PCAT no se usarán en 1998 para decidir en qué grado se
colocará el estudiante pero sí será uno de los factores que se considerarán en el futuro.
CTB
McGraw-Hill
PROT28
FCAT 1998 Individual. Profile Report
ID Number Grade 5
CAT
CommeOensive Assessment Test
31
um or:
PALM EIVACti Run bate: 4/30/90 r it' i CM McGraw-Hill
• 2 •. • en. a% •••• el .A• e7/44••••• • it%Pe'ree .
Total Score
The Total Score indicates the student's level of achievement on FCAT Mathematics.
The Total Score that a student could achieve ranges from 100 to 500.
Total Score
-
The Total Mathematics Score of 290 Indicates that scored in the middle third of grade 5 students who took FCAT Mathematics in 1998.
Subscores
The Subscores indicate the student's level of achievement on separate content areas
of FCAT Mathematics. Each Subscore represents the percentage of content in that
area that the student responded to successfully.
0
25
50
75
Mathematics Number Sense
51%
Measurement
28%
Geometry
51%
Algebraic Thinking 39% Data Analysis
54%
The Sunshine State Standards content tested by FCAT Mathematics is described on the back of this report.
10D
Message to Parents:
The Florida Comprehensive Assessment Test (FCAT) is a new achievement test for Florida students. FCAT
measures the Sunshine State Standards for reading and mathematics. Adopted In 1996, the Sunshine State Standards
are challenging expectations for Florida students. They apply to all students whether they plan to enter the world of
work or go on to further education after high school. The Standards signify what students should know and be able
to do as they progress through school. The Sunshine State Standards are the foundation for a strong accountability
system for Florida's schools.
FCAT was administered for the first time in Florida schools in January 1998. The 1998 test scores will set the
baseline for future achievement of the Sunshine State Standards in reading and mathematics. FCAT scores are an
overall indicator of achievement of these challenging new standards. FCAT results will not be used in making
decisions concerning the promotion of students in 1998 but will be one consideration in promoting students in future
years.
PM'
• I
S.•••:31S• . 13.3
PROT29
FLORIDA COMPREHENSIVE ASSESSMENT TEST (FCAT) 2001 Student Name
FEAT lorido Comprehensive Assessment Test
NORM-REFERENCED TEST Student Report Grade 08
This report shows your results from the FCAT National Norm-Referenced Test.
*co ame and Number Mime
an
um r 50 - PALM BEACH
The FCAT Norm-Referenced Test measures your achievement on a test that was given to a national sample of students. Your norm-referenced scores in
Reading Comprehension and in Mathematics Problem Solving describe your performance in relation to the performance of students throughout the nation.
Your scores are shown below.
SUBJECT SCORES Scale Score National Percentile Rank
Stanine Reading Comprehension
759
97
9
Mathematics Problem Solving
667
46
5
The Scale Score expresses your performance and allows comparisons from year to year.
Reading Comprehension Scale Scores range from 510 to 820. Mathematics Problem Solving
Scale Scores range from 527 to 836.
The National Percentile Rank and Stanine indicate your relative standing in comparison to the
national reference group. National Percentile Ranks range from 1 to 99. Stanines range from
1 to 9.
If you took the test again, your National Percentile Rank might be slightly higher or lower than
stated here. However, your National Percentile Rank would probably fall within a certain range
For Reading Comprehension, your National Percentile Rank should be between 91 and 99. For
Mathematics Problem Solving, your National Percentile Rank should be between 38 and 57.
CONTENT SCORES Number of Points Possible Number of Points
Earned Number of Questions Attempted Reading Comprehension
54
51
54
Initial Understanding
8
Interpretation
27
26
27
Critical Analysis
7
Strategies
12
10
12
Mathematics Problem Solving
52
25
42
Measurement
5
3
5
Estimation
5
1
1
Problem Sdving
6
0
0
Number Relationships
6
4
6
Number Systems
4
Patterns & Functions
3
1
3
Algebra
6
3
6
Statistics
4
3
4
Probability
4
2
4
Geometry
9
4
9
Each question was worth 1 point.
Run Date: 04/26/2001 0181621
PROT30
FEAT lorido Comprehensive Assessment Test
FLORIDA COMPREHENSIVE ASSESSMENT TEST (FCAT) 2001
SUNSHINE STATE STANDARDS Student Report Grade 08
This report shows your results from the FCAT Sunshine State Standards Test.
Student Number Number .itlame nd Number 60 - 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. On the FCAT, you can
attain one of five possible achievement levels. The table below shows the scale score ranges for each Student Achievement Level.
FCAT Student Achievement Levels Scale Score Ranges
Reading Mathematics
LEVEL 5:
LEVEL 4:
Student Achievement Level Descriptions
Performance at this level Indicates that the student has success with the most challenging content of the Sunshine State Standards. A Level 5
student answers most of the test questions correctty, including the most challenging questions.
Performance at this level Indicates that the student has success with the challenging content of the Sunshine State Standards. A Level 4 student
answers most of the questions correctly but may have only some success with questions that reflect the most challenging content
Level 5:
394-500 371-500
LEVEL 3: Performance at this level Indicates that the student has partial success with the challenging content of the Sunshine State Standards, but
Level 4:
350-393
347-370 performance Is Inconsistent A Level 3 student answers many of the questions correctly but Is generally less successful with questions that are
Level 3:
310-349 310-346 most challenging.
Level 2:
271-309 280-309
LEVEL 2: Performance at this level indicates that the student has limited success with the challenging content of the Sunshine State Standards.
Level 1:
100-270 100-279
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 Scale Score
State Comparison:
Thirds Lowest Middle Highest Reading
4
383
I
Mathematics
1
279
1
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 354 and 412. For mathematics, your scale score should
be between 266 and 292.
The check marks (1 ) show If you scored In the lowest, middle, or highest third of grade 08
Fiends students who took this test.
CONTENT SCORES Number of Points Possible Number of
Points Earned State Comparison:
Thirds Reading Lowest Middle Highest Words/Phrases
5
5
1
Main Idea/Purpose
19
17
I
Comparlsons
9
9
1
Reference/Research
8
6
I
Mathematics Number Sense
10
4
1
Measurement
10
4
1
Geometry
6
2
Algebraic Thinking
10
4
1
Data Analysis
8
1
1
The Content chart shows the number of points possible and the number of points earned
for each category. Each question on this portion of the test was worth one point. The
results on your performance items will be reported separately.
Run Date: 04126/2001 0178747
PROT31
FCAT WRITING
STUDENT REPORT 2001 Grade 8
WRITING TO EXPLAIN Studcnt Name:
Student I.D. No.:
School:
District:
PALM BEACH
SCORE: 4.° How Papers Are Scored
The student responses arc scored by trained readers using the holistic method to evaluate
a piece of writing for its overall quality. The readers consider four elements: focus,
organization, support, 'and conventions. In this type of scoring, readers make a judgment
about the entire response and do not focus on any one aspect of the writing.
Focus refers to how clearly the paper presents and maintains a clear main idea,
theme, or unifying point. Papers representing the higher end of the point scale
demonstrate a consistent awareness of the topic and do not contain extraneous
information.
Organization refers to the structure or plan of development (beginning, middle,
and end) and whether the points are logically related to one another. Organization
also refers to (I) the use of transitional devices to relate the supporting ideas to the
main idea, theme, or unifying point and (2) the evidence of a connection between
sentences. Papers representing the higher end of the point scale use transitions to
signal the plan or text structure and end with summary or concluding statements.
Support refers to the quality of the details used to explain, clarify, or define. The
quality of the support depends on word choice, specificity, depth, and
thoroughness. Papers representing the higher end of the point scale provide
examples and illustrations in which the relationship between the supporting ideas
and the topic is clear.
Conventions refers to punctuation, capitalization, spelling, and variation in
sentence structure used in the paper. The conventions are basic writing skills
included in Florida's Sunshine State Standards. Papers representing the higher end
of the point scale follow, with few exceptions, the conventions of punctuation,
capitalization, and spelling and use a variety of sentence structures to present
ideas.
Dear Student:
The paper you wrote in February as part of the FCAT 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 score is the average of the two readers' scores.
This writing score will help you, your parents or guardians, and your teachers understand how well you performed on this statewide writing
test. A description of how papers are scored is printed on the left side of this report. A description of each possible score is printed
on the back of this report.
Remember, you were given 45 minutes to read the assigned topic, plan what to write, and then write your response. The conditions
under which you write 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 your teachers should consider the score on this test along with all of your other writing when planning activities to
continue developing your writing skills.
DESCRIPTION OF THE TOPIC:
You were asked to explain why one thing is special to you.
RUN DATE 04/18/01 50-1691
PROT32
Description of Grade 4 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 arg generally correct.
5.5: The writing was given a 5 by one reader and a 6 by the other reader.
5.0: The writing focuses 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 are
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.
35: 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 I 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.
U: The writing is unrelated to the assigned topic or cannot be read.
Description of Grade 8 Writing Scores
6.0: The writing focuses on the topic, is logically organized, and includes substantial 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 writing focuses on the topic with ample 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 are
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 I 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 pattem 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.
U: The writing is unrelated to the assigned topic or cannot be read.
Description of Grade 10 Writing Scores
6.0: The writing focuses on the topic, Is logically organized, and includes substantial development of supporting ideas or examples. It demonstrates a mature command of language with
freshness of expression. Sentences vary in structure. There are few, if any, usage, punctuation, or spelling errors.
5.5: The writing was given a 5 by one reader and a 6 by the other reader.
5.0: 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. Sentences vary in structure. Usage, punctuation, and spelling are
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 loosely related information. An organizational pattern is apparent.
. Some of the supporting ideas contain specifics and details, but others do not. Word choice is adequate. Sentences vary in structure. Usage, punctuation, and spelling are generally
correct.
35: 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 loosely related information. An organizational pattern
is demonstrated. Development of the supporting ideas may be uneven. Word choice is adequate. There is some variation in
sentence structure. Usage, punctuation, and spelling arc generally correct.
2.5: The writing was given a 2 by one reader and a 3 by the other reader.
2.0: The writing addresses the topic, though it may lose focus by including extraneous infonnation. An organizational pattern is
demonstrated. Development of the supporting ideas may be nonspecific. Word choice may be limited. Frequent errors may
occur in sentence construction, usage, punctuation, and spelling.
1.5: The writing was given a I by one reader and a 2 by the other reader.
1.0: The writing addresses the topic, though it may lose focus by including extraneous and loosely related ideas. The organizational
pattern is weak. Ideas arc presented through lists and limited or inappropriate word choice. Frequent errors may occur in sentence
construction, usage, punctuation, and spelling.
U: The writing is unrelated to the assigned topic or cannot be read.
PROT33
lilt bUIltJUL. IJI5 I ttIL• I UP
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NUIVIISCFE:
1.4) )4 At,',," %sto,,I9NEW/RETURNING
CAft
PALM BEACH COUNTY
STUDENTS • REGISTRATION
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 of typed information. If the information
printed is incorrect please correct it by carefully and lightly crossing out the Incorrect information and
writing the correct Information above it.
tti
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3. IN-COUNTY RESIDENT
(12) ENTRY DATE INTO USA
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FEDERAL IMPACT AID SURVEY
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A. THE STUDENT
DYES alio .
B. THE STUDENT I Its 04o
C. THE PARENT
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RESIDES IN LOW RENT HOUSING.
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IS EMPLOYED ON LOW RENT 'MUSING LOCATED III
IS IN THE UNIFORMED SERVICES Of THE UNITED
IS THE PARENT ON ACTIVE NUTT?
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THIS CHILD BEER ENROLLED IN ANY PRESCHOOL?
C. CHAPTER a
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E. PRE•R EARLY INTERVENTION (PLEASE PLACE A CHICKMARK 1 yoM DY EACH PROGRAM
WITH AN ASTERISK 1 * ) TM PROGRAM TOUR CHILD
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UM NATE ATTENDED
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(231 RAVE IOU FILLED GUT AN APPLICATION TOR FREE OR REDUCED LUNCH?
(APPLICATION IS PROVIDED WIEN THIS REGISTRATION FORM)
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01110 1241 SUM SCRIUMISS:
I GIVE PERMISSION FOR MT CHILD TO BE GIVEN HEALTH SCREENINGS.
THESE TESTS' MAT BE GIVEN INDIVIDUALLY OR IN GROUPS.
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(261 SODIUM MUORIOt:
ur run vn PWNW An IN THE SODIUM FLUORIDE PROGRAM
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PROT34
BACK
TRICE or PALM BEACH COUNTY - NEW/RETURNING STUDENTS REGISTRATION
DOI STUD
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THERE A COURT ORDER SARUM EITHER PARENT WILE MOVUNC
CONTACTING THE STUDENT 'DURING THE SCHOOL DAY?
YES
M YES, PLEASE PROVIDE THE SCHOOL IRA A COPY OF THE COURT
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NO
ORDER.
MI FATHER/GUAROLAN
DOES FATHER RAW CUSTODY?
• YES oho
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DOES Tina RAVE CUSTODY?
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No) PART II:IF SCHOOL PERSONNEL ARE UNABLE TO CONTACT YOU IN CASE OF ILLNESS OR NEciDENT, mix
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DOCTOR OR EMERGENCY SERVICES (II U FOR TRANSPORT 10 THE HOSPITAL/
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PROT35
RACE: W SE
BIRTHDATE:
BIRTHDATE:
VagBed by Binh Ceniticate:
0 Yes 0 No
II No. What Type Verification?
BIRTHPLACE:
CURR Name Street City
SEX:
RACIAL/ETHNIC GROUP:
O White Not Hispanic 0 Black Not Hispanic 0 Hispanic
0 Arnettan I ncliaiThative Aaskan 0 AslanPadlia Islander
Multi Racial
STUDENT NUMBER:
ADDRESS: (use pencil in this space uniii final )
PHONE NUMBER: (optional)
NAME OF EARENT(S) OR LEGAL QUARDIAN OR OTHER RESPONSIBLE ADULT AT HOME:
Date First Entered This District &hoot Grade:
Schott Grade:
Schad:
Grade Schaal:
Grade:
Schcot Grad.
Schad Year: IS Shoat Year 19 School Year: 19 School Year. I9
SchoolYeer. 19 Days Present Days Meant Days Present
Days Absent Days Present Days Absent:
Days Present Days Ateent:
Days Present Days Absent
COPY OF
REPORT CARD
INCLUDED
COPY OF
REPORT CARD
INCLUDED
COPY OF
REPORT CARD
INCLUDED
COPY OF
REPORT CARD : INCLUDED
COPY OF
REPORT CARD
INCLUDED
INDICATE Administrative Placement (ADMP) Promote (P)
Resin (R) Special Session (S$)
INDICATE Mmiristrailve Piecemeal (ADMP) Promote (P)
Raisin (R) Special Session (55j
INDICATE MrenIstratiee Promote (P1 Main (R) Special Session (SS)
INDICATE AerninhaeW• Promote (P) Retain (R)
INDICATE AcksinisteiNe Placement (ADM') Promote (P)
Retain (R) Special Session (55) School:
Grade:
50100t Grade:
Scholl:
Omer
SCOW:
Glade:
Shoot Grans' School Year 19 Deeds Year 19
-
School Year. 19 School Year:19 School Year IS Days Present
Days Absent Days Present.
Days ATAent Days Prewar:
Days Absent Deis Resent Days Absent Days Present Days Absent:
COPY OF
REPORT CARD
INCLUDED
COPY OF
REPORT CARD
INCLUDED
COPY OF
REPORT CARD
INCLUDED
COPY OF
REPORT CARD
INCLUDED
COPY OF
REPORT CARD
INCLUDED
INDICATE AcIminiabetive PlaCemenl (ADMP) Pron/cte (P)
Rat" (R)
INDICATE Admirisvellvo Promote (P) Ratan (R)
INDICATE Actrnineeative Promote (P) Retain (R)
INDICATE AdmInettelNe Promote (P) Rash (R)
INDICATE AcrnntsvatIm Placement (AIWA') Promo:9(P)
Retain (R)
PESO 0919 (REV. 312(1,97)
PROT36
For Secondary Cumulative Grades: SEE STUDENT RECORD SCREENS
GENERAL QUERIES
A01
Student Name (District)
A02
Student Name (School)
BASIC RECORD
A03
A04
A05
A06
A07
A08
Demographics General Assignments Contact Information
Health Information Assignment History Local Data Elements
COURSES
ATTENDANCE
A15
Daily Summary
A16
Period Summary
A17
Absence Detail
Al8
Absences (Class Hours)
A19
Letter Preview (PRD ATD)
TESTING
A20
Test Score Query
A21
Test Score
A2A
Test Score Errors
A22
Standard Mastery
A09
A10
Course Requests Current Schedule
MISCELLANEOUS
A23
Special Programs Al 1 Interactive Scheduler
A24
Discipline
Al2
Current Grades
A25
Fees and Fines
A13
Academic History
A26
RecognitiorVAchievement
A14
Graduation Status
A27
Letter History
SPECIAL CHARACTERISTIC CARD
STUDENT
Place a red dot or red check in any area to denote that this student has additional information available
ESE
ESOL
504
DOP
HEALTH
MIGRANT
OTHER
0
See ESE Confidential Fotdor
A23
See ESOL Folder A23. A03 See 504 Confidential Folder
A23
See DOP Folder
A23
See Health Flakier
A06
See Migrant
A23
PROT37
THE SCHOOL DISTRICT OF PALM BEACH COUNTY (SDPBC) New and Returning Student Registration
NEW STUDENTS: Complete all non-shaded areas on both sides of the form.
RETURNING STUDENTS: Review both sides. If the pre-printed information is incorrect, correct the information by carefully and lightly
crossing out the incorrect Information and writing the correct Information above it.
(1) SIUUENT NUMUtH
(2) SAC CODE.
1068
DISTRIBUTION:
(3) STUDENTS LEGAL NAME oast frst Inkldle)
(4) ALSO KNOWN AS
(5) LOCAL ADDRESS NounRad (reel 0•444)
OA 4O (nib) moo aro rose)
ROYAL PALM BEACH FL 33411
(6) MAIM ADDRESS (ken no. a /toot name) (RP( no) (020
(aMS) (zip coda)
(7) SCC1AL SECURITY NO. NON)Q0 (8) HOME TELEPI4ONE NO. Q)) SEX
F
(10) RACE/ETHNIC ORIGIN
W
O1-American Indian/Alaskan Native O B:BlicK Non-Hispanic
O H-Hispanic O A-Asian/Pacific Islander O W-White, Non-Hispanic O M-Multiracial on DATE OF ERRTH
(MLIaflnYYY)
(12) PLACE OF WITH (aty. 5104 comity)
WEST PALM BEACH
FL
US
FLORIDA
(13) RESIDENT STATUS
3
O 0. Foreign Exchange Student O 1. Out-ol-county Resident
O 2. Out-of-state Resident O a In-county Resident
(14) LISA ENTRY DATE (IAMtCONYTY) (I5) FEDERAL IMPACT SURVEY
YES NO O O A. The student resides on federal property.
O O B. The student resides in low rent housing.
O O C. The parent is employed on federal property located In P.B. County.
O O D. The parent is employed on low rent housing located In P.B. County.
O O E. The parent Is in the uniformed services of the United States.
O O If E. is YES, is the parent on active duty?
Check service below:
0 Air Force O Army O Coast Guard O Marines
0
National Guard O Navy
(16) PRESCHOOL ENROLLMENT INFORMATION
Place en X by each program attended. Also, indicate with an asterisk (*) the program your chid was in the longest.
D N. Non-subsidized Child Care O M. Migrant Pre-K O D. Pre-K Disabilities
O H. Headstart O I. Pre-K Early Intervention O C. Chapter I
❑O S. Subsidized Child Care O O. Other 07) IS THE STUDENT A
NE) CURRENT GRADE LEVEL
SEIGLE PARENT? No
09
O YES O NO
LTSVOSINFORMAlla,
V
(IS) NAME OF SCHOOL TRANSFERRING FROM
(20) CITY OR LOCATION
(21) LAST ArrEiroANCE DATE
(22) LAST GRADE LEVEL
(23) LAST PUSUC SCHOOL ATTENDED IN PALM BEACHCOUNTY
(24) DATE ATTENDED IN PBC
MW4PAggN14041a0AVAlticiN
FREE OR REDUCED
(25) Students will receive non-invasive heath screenings pursuant to Florida Statute 381.0056(7)(d). Non-invasive
include hearing, height, These tests
be
indwidualhi
PRICE LUNCH screenings may vision, scoliosis, and weight.
may gNen
or
in groups. Parents or guardians, however, have the right to request an exemption in writing. If you DO NOT
want your chid to receive the screenings, mite the words 'Do not screen" here:
(27) Have you filed out an application for free and
(This exempthon MY cover all types of screenings)
(261 I give permission for my child to participate in the sodium fkoride prog rain to prevent tooth decay. O YES .
10
(permission is mid through 6th grade)
YES ii, reduced lunch?
O YES O NO (Application Is provided' with this form):
tomilsovpa• A4MilaEoScii:PQVAn.
.ear.
ataraRattv.c
(26) HOME LANGUAGE SURVEY
YES NO O 1. Is a language other than EngIsh used in the home?
' If YES, what language?
O
O
2. Does the student have a first language other than English?
If YES, what language?
O O 3. Dces the student most frequently speak a language other than English?
If YES, what lanoyepat.: ' -
Qin 4. What language is spoken in the home by the parent or guardian?
(30) 5. What language is the student's first language?
(31) What Is the date of entry into an ESOL program?
(32) STUDENT UVES WITH. (check one) El Mother O Father O Both Parents
O Other
(33) EINCL018I taEs FOR ENTRY INTO PEG SCHOOL DISTRICT
YES NO O O 1. Has the student ever been expelled from school?
O O 2. Has the student ever had an arrest resulting in a charge?
O
3. Has the student ever had any juvenile Justice actions?
00CUSTOOY STATUS OF STUDENT Knecic Aly , O Mother O Father O Shared Custody
O Other
(35) Is there a court order barring either parent from removing or contacting the student during the school day?
O YE$ O NO If YES, provide the school with a copy of the court order.
STDT
RUN DATE: 08/07/01
PBSD 0636 (REV. 5/29/2001)
page 1 of 2
PROT38
THE SCHOOL DISTRICT OF PALM BEACH COUNTY - NEW AND RETURNING STUDENT REGISTRATION
(Y) FATHER OR LEGAL GUARDIAN (rest Madre mad MI0
a
l
PU: Y
(37) MOTHER OR LEGAL GUARDIAN dad made Med. 1630
PU: 'V
ADDRESS (sINwrimienber, steel twee *mimed number)
ADDRESS (strool number, stoat name, Warned Medea
CITY
STATE
ZIP CODE
ROYAL PALM BEACH ' FL 33411
CITY
STATE
ZIP CODE
ROYAL PALM BEACH
FL 33411
OCCUPATION
OCCUPATION
PLACE OF ELIOLDHAENT
PLACE OF EMPLOYMENT
HOME TELEPHONE
BUSNESS TELEPHONE
CELUPAGER NUMBER
HOME TELEPHONE
BUSINESSTELEPHONE
CELUPAGER NUMBER
EMAIL ADDRESS 0:9544190
EMAIL ADDRESS NON*
INIKSENOWArfitg4 0 100Es C9SIQN Person(s) other than parent authorized to pick up student
(38) PASSWORD (llra 10 characters)
(39) NAME Hest melee MAW ma)
(41) NAME (FEN middle SW 44
ADDRESS (street number. abed name, Apedmonf number)
ADDRESS 01rot: number. seed mime, amtamed nungaa
CITY
STATE
ZIP CODE
CITY
STATE
ZIP CODE
TELEPHONE
RELATIONSHIP
OTHER
(40) AUTHORIZED FOR
EMERGENCY PICKUP O YES O NO •If 1ELEPHONE
RELAZONSHP
OTHER (4Z AUTHORIZED FOR
EMERGENCY PCICUP O YES O NO V
(43) If school personnel are unable to contact you In case of illness or accident.
may we have your permission to call your doctor or emergency services (911 for transport to the hospital?
O YES• O NO
(44) MEDCAL INFORMATION gist audenTs ruin . emcees, medications. or oMee physbel
Menne hamar, haat emEdkam)
(45) PANAY PHYSICIAN
(48)PHYSCIAN PHONE
(48) Does your child currently have health insurance? O YES O NO
If YES, indicate:
(47) HOSPITAL PREFERENCE O Medicaid O Private O Healthy Kldsfiad Care
O Interested In receiving information worsompospwnwcoamosotrama-g4stgoostitsomot5k
4-1
WIN/WEOF CIA D (rest mW4. WO
SCHOOL ATTENDING
STUDENT NO. (opt,o 1 .; ) I GRADE
DATE 0? 9IRTH
Pl
i
11
(SO) NAME OF 0 11.0 (Mg middle, MN)
SC
STUDENT NC). (cptcoa3
GRADE
DATE OF hi kl H (SI) NAME OF CHILD ((kg made M10
STUDENT NO. (4040043
GRADE
DATE OF BIRTH
(52) NAME OF CHILD deg made, !am)
STUDENT NO. (aprons,)
GRADE
DATE OF GIRTH
PARENT/GUARDIAN SIGNATURE
I verify that the information given is true and accurate to the best of
my knowledge.
g
b
IPIIIIIIIHIS
L
S
A TURE OF PARENT/GUAR/YAM
DATE 4E0. .$tiEt.I0aftCOTNM:
Niro.
(54)S
i
55)Uwb
S
59 WTRY E01".
0687 2701 csej on IN
09
(59K.A.
01
(60) TEACHER MO. '61)REISSIGN COVE (62 TRANSPORTATION
O PSC els s O Palm Tian (63( BM VEIN.
1 2 3 4 5
(61) INS
A
O Parent/Student Trars. O Walk O Bike 6 7 8 9 7
BZ
(65) DOOMENTA110:1 CHECKLIST (thetk and tble 41/4 4 rtteNS)
O Immunizahons (date) O BIrth Records Veil. (de e)
Soc. Sec. No. (date) O Physical Exams (date)
(65) DATA ENTRY COMPLETED BY
DATE
PBSD 0636 (REV. 4'6/20015/2912001)
page 2 of 2
PROT39
ilm••• 'Mr INN r. Score Re tacl.
port Plus
'Preliminary SAT/National Merit Scholarship Qualifying Twit .
Get the Most Out of Your Score Report!
INSIDE: the results of the PSAT/NMSCIT. you took in October
Your Scores is Review Your Answers
Use this report together with your test book to review your answers.
■ Improve Your Skills
The areas for improvement listed in each section are unique to you;
they are based on your performance on the test.
OUTSIDE: more information about • Test Scores
• ritiSC Scholarship Programs in Planning for College and Careers
PROT40
• no • • %no • Ate r ineats smewn quAsun r T - Pecrir Amu Kt I MINIMS STUDENT REGISTRATION
(36) FATHER OR LEGAL GUARDIAN 0144 MUMMY( MO
PU: Y
(37) MOTHER OR LEGAL GUARDIAN OR mMdlo *WM bsQ
PU: Y
ADDRESS (Oval numb:4 Moot Immo, opmintoM ewes**)
ADDRESS M.Yeei number a boot name. end/ non( numbs)
CRY
STATE
DP CODE
ROYAL PALM BEACH
FL
33411
CITY
STATE
ZIP CODE
ROYAL PALM BEACH
FL 33411
OCCUPATION
OCCUPATION
PLACE OF EMPLOYMENT
PLACE OF EMPLOYMENT
DOME TELEPHONE
BUSR4ES3 TELEPHONE
CELUPAGER NUMBER
HOME TELEPHONE
BUSINESS TELEPHONE
CELLaPAGER ((LIMBER
EMAIL ADDRESS (opticaaQ
EMAIL AGGRESS 006oniN
AMERG,ENDY<HEALTHAND SAFETY,INFORMATION,, Person(s) other than parent authorized to pick up student
(38) PASSWORD (Unit 10 characters) pm NAME fest middle In KM les0
MN NAME (MA mickNoinfiaf I a sQ
ADDRESS (sin* MS, steel imam apalmene nombef)
ADDRESS Nisei number. nee( name. Anil:nerd nomtv0
CITY
STATE
VP CODE
CITY
STATE
ZP CODE
TELEPHONE
RELATIONSHIP
OTHER
(40) AUTHOECCED FOR
EMERGENCY PICKUP 0 YES 0 NO Y
TB.EF140hE
RELATIONSHIP
OTHER
(42) AUTHORIZED FOR 0 YES 0 NO V
(43) If school personnel we unable to contact you in case of limes cc accident,
may we have your permission to cal your doctor ct emergency services (91 ) for transport to the hospital?
0 YES 0 NO
(44) AIECOCAL INFORMATION OAS sluctenrs Nnesses, MANNA bees,
Magic% Am 1 "cations. o- oils phySkANANAWAAM
(45) FAMA.Y PHYSICIAN
(46) PHYSICIAN PHONE
(48) Does your child currently have health insurance? MI YES 0 NO
If YES, indicate:
(47) HOSPITAL PREFERENCE 0 Medicaid 0 Private 0 Healthy Kids/kQd Care
0 Interested In receiving information
ASWALOA491.4:04iiit lit filierAlaffiblikr0S-1-101)1; .
(49) NAME CF CHILD (Mg mild*, t330 &cell 44 igh
STUDENT NO. (*100.0
GRADE
U.
DATE OF BIRTH
MN
ere) NAME CF CHILDKis( middle. MO
tc
*:iitc2t1/44
,0
1:a..6
G
STJOB4T NO. (*100.0
GRADE
DATE CF BIRTH (SI) NAME OF CHAA)(Cnt middle. Imo
SCHOOL AlTENDWG
MOST NO. OptionaQ
GRADE
DATE OF 8RTH
(52) NAME CF CHILD pest middle, lasts
STUDENT NO. (opeons0
GRADE
DATE OF BIRTH
PARENT/GUARDIAN SIGNATURE
FOR OFEIGMAE"ONLY.'
I verify that the information given is true and accurate to the best of
kJ.
BB SIICENT NO.
us
6) ENTRY CD
EO1 t 57) WRY DATE O8/14/O1 03) GR IV
O9
PK CAL
01
my knowledge.
(60FTEACNER NO. (61)REASSIGMCCCE
(67)TRANSPORTATION 0 PSC Bust
0
Palm Tian (aBEM VERF.
1 2 3 4 6 1 0SI) ISS
A
0 Parent/Sludent Trans. 0 Walk III Elks 6 7 8 9 T
BZ
PSI DOCIALEITATION CHECKLIST(P.4 Yd Po ALP Ncei.e8
0
Immunizations (date)
0
Birth Records Verif. (date) '0 Soc. Sec. No. (date)
0 Physical Exams (date) i t eillSk( 771RE OF PARENT•GUAROMN
DATE
PP DATA EMMY COMPLETED BY
DATE P88O O636 (REV. 4/6/2OO16(29/2OO1)
page 2 of 2
PROT41
i stam1)) New and Returning Student Registration
(_,
IIIt bcl-IVUL LAU I KIL: I tar PALM btAL:11 QUUN I Y (SUF'UC)
NEW STUDENTS: Complete all non-shaded areas on both sides of the form.
RETURNING STUDENTS: Review both sides. If the pre-printed information is incorrect, correct the Information by carefully and lightly
S. air 001 crossing out the Incorrect Information and writing the correct Information above it.
1088
DISTRIBUTION:
(3) STUDENTS LEGAL NAME (lest trig middb)
I
(4 ALSO KNOWHAS
(5) LOCAL ADDRESS (house no. St nee name) (apt no)
0 11)0 (stale) (zip code)
ROYAL PALM BEACH FL 33411
(6) MAILING ADDRESS (house no it steel name)
OW no) 91110 (stab)
PIP code)
(r) SOCIAL $EGURITY HD WOO* (8) NOME TELEPHONE NO.
ll
(0) SEX
r
(10) RACE/B- 04NC ORIGIN
W
O I-American Indian/Alaskan Native O Warrick, Nor.-Hispanic
O H-Hispanic O A-AsiarUPacific Islander O W-White, Non-Hispanic
O M-Multiacial
(1) DATE Cf 011114 itAINDONYYY)
(12) PLACE CC MTN rag so* county)
FL
US
FLORIDA
(13) RESIDENT STARS
3
CI O. Foreign Exchange Student O 1. Out-of-county Resident
O 2. Out-of-state Resident O 3. In-county Resident
(14) USA ENTRY DATE (01/DantYYY)
(15) FEDERAL IMPACT SURVEY
YES NO
O
O
A. The student resides on federal property.
O
B. The student resides in low rent housing.
0
C. The parent is employed on federal property located in P.B. County.
O
O
D. The parent is employed on low rent housing located In P.B. County.
O
O
E. The parent is in the uniformed services of the United Slates.
O
O
If E. is YES, is the parent on active duty?
Check service below:
0
Air Force O Army II Coast Guard MI Marines O National Guard O New
(1131 PRESCHOOL ENROLLMENT INFORMATION
Place an X by each prcgram attended. Also, Indicate yeah an asterisk (') the program your chid was in the longest.
O N. Non-subsidized Child Care O M. Migrant Pre-K O D. Pre-K Disabilities
O H. Headstart O I. Pre-K Early Intervention O C. Chapter 1
O S. Subsidized Child Care O 0. Other 07) (SYNE STUDENT A
SIN3LE PARENT? No O YES O NO 08) CURRENT GRADE LEVEL
09
asIVII:O.KatiartgrifektOfriarCal4 rdWill
' A tact;:vi:
(19) NAME OF SCHOOL TRANSFERRING FROM
(20) CITY OR LOCATON (2 I ) LAST ATTENDANCE DATE
(22) LAST GRADE LEVEL
(23) LAST PUBLIC SCHOOL ATTENDED IN PALM BEACH COUNTY
(24) DATE ATTENDED IN PBC VcgtificcBgENRWNEPRAMICAtin
?I'I
mi
/es* qEE OR REDUCED
DICE. LUNCH
(25) Students will receive non-invasive health screenings pursuant to Florida Statute 381.0056(7)(d). Non-invasive
screenings may include vision, hearing, scoliosis, height, and weight. These tests may be given individually or
in groups. Parents or guardians, however, have the right to request an exemption in writing. If you DO NOT
want your child to receive the screenings, write the words to not screen' herhere:
application (2?) Have you filed cut :::-.
for free and reduced lunch?
O YES O NO.
(Application is provided • with this form (This exemption MI cover 0 types of screenings)
(26) I give permission for my child to participate in the sod= fluoride prograin to prevent tooth dimy. O YES L
'NO
(pemttssion is valid through 6th grade)
YES
Al
EACH coliNtie Yr '1.:
1 -,
(93) HOME LANGUAGE SURVEY
YES NO
O
0
1. Is a language other than English used in the home?
If YES, what language?
• O 2. Does the student have a first language other than English?
If YES, what language?
O O 3. Does the student most frequently speak a language other than English?
If YES, what langtitig1;;
(2c) 4.
4. What language is spoken in the home by the parent or guardian?
poi 5. What language is the student's first language?
(31) What is the date of entry Into an ESOL program?
(32) STUDENT LIVES %1111. &Saone) O Mother O Father O Both Parents
O Other
(33) DISCLOSURES FOR ENTRY INTO PBC SCHOOL DISTRICT
YES NO
O •
1. Has the student ever been expelled from school?
O O 2. Has the student ever had an arrest resulting in a charge?
O
O
3. Has the student ever had any jwentle justice actions?
(94) CUSTODY SIMS OF STUCENT (check oi6):.
Mother D Father • Shared Custody O Other
(35) Is I here a court order barring either parent from removing or contacting the student during the school day?
O YES O NO
II YES, provide the school with a copy of the court order.
PBSD 0636 (REV. 5/29/2001)
STDT
RUN DATE: 08/07/01 page1012
PROT42
Spring 2003 Florida Comprehensive Assessment Test (FCAT)
SUNSHINE STATE STANDARDS Grade 10 Student Report 50-PALM BEACH
The Florida Department of rem that student has the ability to learn and succeed. The purposeof the FCAT Is to ensurethat
Florida's public schools are providing the best uca on possible, and preparing students to succeed in the competitive 21st Century job market.
Working with teachers, the State has developed a measurement system that allows you to track a student's academic achievement from year to
year and determine if a year's worth of learning has occurred In a year's time. This system also allows you to compare a student's score to a
score that represents 'grade lever achievement. If a students score is above the 'grade level' score, then they are performing at a level above
thrOr current grade. If a is below, they are In need of improvement. Using the 'Content Scores,' you are able to Identify any specific academic
skills needing improvement.
Below you will find your 2003 FCAT Reading and Mathematics scores as well as your scores from previous years. The chart on the right side of
the page shows your score compared to the score that represents "grade level achievement.
Congratulations! You have passed the Reading test and your score is above grade level. You have answered most of the questions
C11 FCAT correctly.
2003 Reading Content Scores Content Areas Points Points
Possible Earned Words/Phrases
9
7
Main Idea/Purpose
14
11
Comparisons
13
12
ReferencelResearch
16
13
Year 2001 2002 2003 Grade Tested
8
9
10
Achievement Level
4
2
4
FCAT Score' 2233
1961 2262
FCAT Score 2000 tS00 Reading Grade 3 Grads 4 Credo 6
Grade 6 Grads 7 Grade 8 Grade 9 Gracie t0
11+
• Your Score
CI On Grade Level
Congratulations! You have passed the Mathematics test; however, your achievement needs improving. Talk to your teacher or guidance
counsebr about classes you should take to better prepare you for college or a career.
2003 Mathematics Content Scores Content Areas Points
Points Earned Number Sense
11
6
Measurement
10
2
Geometry
14
5
Algebraic Thinking
14
6
Data Analysis
11
7
Year 2001 2002 2003 Grade Tested
8
9
10
Achievement Level
1
3
2
FCAT Score • 1732 1998 1934
FCAT Score 3000
23
2000
10
Mathematics Oracle One. 4 • Oracle 5 • Grade I Oruro 7 • Grade
• Your Score O On Grade Level
These scores show your achievement on the day you were tested. If you had taken this test numerous times, it Is likely that all of your scores would
have been within a certain range. Your 2003 FCAT Reading scores probably would have been between 2170 and 2354.
Your 2003 FCAT Mathematics scores probably would have been between 1893 and 1976.
NT= Not Tested
NR =Not Reported
NA= Data Not Available Data Run Date: 05/09/2003 0164772
PROT43
FCAT Reports Separate reports are produced for the Sunshine State
Standards tests in FCAT Reading and Mathematics,
Science, and Writing. A separate report is also printed for the norm-referenced tests in Reading and
Mathematics.
FCAT Norm-Referenced Test (NRT) Report The FCAT
NRT report shows reading and mathematits scores on a Florida version of the SAT9 (published by Harcourt
Educational Measurement).
Student scores are compared to a national "norm" group, where a percentile
rank store of 50 is average.
Sunshine State Standards (SSS) Reports The FCAT
SSS Reading, Mathematics, and Science reports show test scores from Florida's tests of academic standards.
These reports contain subject scores and content scores.
Subject scores describe the overall achievement, and content scores give the number of
points earned in specific skilt areas. Success on the
Reading and Mathematics tests can be best understood by using the achievement levels where a 3 or higher is
on or above grade level.
Achievement Levels Five categories of achievement describe the success students have with the content
tested on the FCAT Reading and Mathematics. Level 5 is the highest and Level 1 is the lowest. Since science
achievement levels have not been determined, science scores are ranked as to whether they fall in the lowest,
middle, or highest third of statewide student performance.
5 This student has success with the most challenging content of the Sunshine State Standards. A student scoring in Level
5 answers most of the test questions correctly, including the most challenging questions.
4 This student has success with the challenging content of the
Sunshine State Standards. A student scoring in Level 4 answers most of the test questions correctly, but may have
only sonve success with questions that reflect the most challenging content.
3 This student has partial success with the challenging content of the Sunshine State Standards, but performance
is inconsistent. A student scoring in Level 3 answers meny of the test questions correctly, but is generally less
successful with questions that are the most challenging.
2 This student has limited success with the challenging content of the Sunshine State Standards.
1 This student has little success with the challenging content of the Sunshine State Standards.
FCAT Certificates
Students who earn Level 5 scores or whose science scale scores are greater than 400 receive
Certificates of Achievement. For writing, certificates are given
to all students with scores of 5.5 or 6 and to fourth graders with scores of 5, 5.5, and 6. Certificates are not awarded based on
the FCAT Norm-Referenced Test scores.
Informes FCAT (Spanlsh)
Se preparan informes separados para los exåmenes del FCAT de lectura y matemäticas, ciencias y redacción según las
normas estatales Sunshine State Standards.
También se imprime otro informe por separado para los exåmenes de lectura
y matemåticas de acuerdo a las normas de aplicación nacional.
Informe sobre el FCAT cefildo a normas de aplicación naclonel (NRT)
El informe del FCAT NRT presenta los resultados de lectura y matemäticas en una versión del estado
de Florida del SAT9 (publicada por Harcourt Educational
Measurement). Los resultados obtenidos por los estudiantes se comparan con el grupo modelo o "norma-, en el que la cladficación es de un 50% del promedio.
Informes segån las normas estatales Sunshine State
Standards (SSS) Los Informes según las normas estatales
SSS del FCAT presentan las calificaciones de los exåmenes de lectura, matemåticas y ciencias de las normas académicas de
Florida. Estos inlormes contienen calificaciones por materias y calificaciones por contenido. Las calificaciones por materia
proporcionan un resumen general del rendimiento y las calificaciones por contenido que proveen el numero de puntos
obtenidos en åreas de habilidades especificas. El éxito de los exåmenes de lectura y matemåticas puede entenderse mejor utilizando los nlveles de rendimiento en los que una calificación
de 3 o superior estå al nivel del grado o por encima.
Niveles de rendimiento El éxito que un estudiante ha logrado en el contenido examinado en el FCAT de lectura y matemåticas
se describe por medio de tinto categorfas. El nivel 5 es el mås alto y el nivel 1 es el mås bajo. Como los niveles de rendimiento
en ciencias no se han determinado, las callficaclones de ciencias se clasifican con respecto a si entran dentro del tertio
inferior, medio o superior del rendimiento estudiantil a nivel estatal.
5 Este estudiante tiene éxito con el contenido mås difícil de las normas Sunshine State Standards. Un estudiante del Nivel 5 responde a la mayorfa de las preguntas del examen
correctamente, incluyendo las preguntas mås dificiles.
4 Este estudiante tiene éxito con el contenido difícil de las normas Sunshine State Standards. Un estudiante del Nivel 4 responde a la mayorfa de las preguntas correctamente, pero
es.posible que solo tenga cierto éxito con las preguntan que reflejan el contenido mås diffcil.
3 Este estudiante tiene un éxito parcial con el contenido diffcil de las formas Sunshine State Standards, pero su rendimlento es inconsistente. Un estudiante del Nivel 3 responde muchas
de las preguntas del examen correctamente, pero por lo general tiene menos éxito con las preguntas que son mås
dificiles.
2 Este estudiante tiene éxito limitado con el contenido difícil de las normas Sunshine State Standards.
1 Este estudiante tiene poco éxito con el contenido dificil de las normas Sunshine State Standards.
Certificados del FCAT Los estudiantes que se claslflquen en el Nivel 5 o cuyos resultados de ciencias sean superiores a 400,
reciben Certificados de rendimiento.
En redacción, los certificados se otorgan a lodos los estudlantes que han obtenido
calificaciones de 5.5 y 6, y a los estudiantes de cuarto grado que han obtenido 5, 5.5 y 6. Los certificados no se otorgan basados
en los resultados del FCAT ceilido a normas de aplicación nacional.
Rapò FCAT (Haitian Creole)
Yo prepare rapò apa pou egzamen lekti ak matematik, syans ak redaksyon FCAT bay swivan prensip Sunshine State
Standards yo. Yo ekri yon rapb apa tou pou lekti ak matematik pou "modet egzamen ofisyél FCAT itilize pou fé evalyasyon" an.
Rapò egzamen ofisyél FCAT itilize pou fé evalyasyon
(NRT) Rapb FCAT NRT a montre nbt lekti ak matematik nan vésyon Florida genyen pou SAT9 la (Se Harcourt Educational
Measurement ki pibiliye h.) Yo konpare nöt elev la ak yon gwoup nöt yo konsidere kbm "modél pou egzamen ofisyél" la,
kota swivan klasman pa pousantaj la, nbt mwayén nan se 50.
Rapò Sunshine State Standards (SSS) Rap() FCAT SSS pou kid, matematik ak syans lan montre nöt elev yo fò nan
egzamen Florida bay sou prensip akademik yo. Rap() sa yo gen nbt pou matyé ak nöt pou kontni ladan yo. Nbt pou matyé
yo dekri tout sa elev la reyalize anjeneral epi nöt pou kontni yo bay kantite pwen elev la fé nan yon matyé byen detémine. Ou ka konprann kisa elev la reyalize nan egzamen lekti ak
matematik la pi byen si w itilize yon nivo siksé kote 3 oswa plis se yon nöt ki nan nivo klas la oswa yon nöt ki pi wo pase nivo
klas la.
Nivo siksé elév yo Gen senk kategori siksé ki dekri nivo siksé elev yo pote nan kontni yo teste nan egzamen lekti ak
matematik FCAT la. Pi gwo nivo a se nivo 5 epi pi piti nivo a se nivo 1. Piske yo poko detéminen nivo siksé nan egzamenn syans lan, yo klase nöt pou syans lan swivan si II tonbe pi ba,
nan mitan oswa pi wo yon tyé péfömans elév toupatou nan eta
a.
5 Elév sa a gen siksé nan matyé kl te gen pi plis difikilte ladan yo nan egzamen Sunshine State Standards la. Yon elév ki nan syém Nivo reponn pifö kesyon egzamen yo
kbrékteman, elev la menm reponn kesyon kl gen pi plis difikilte ladan yo.
4 Elév sa a gen siksé nan matyé ki te gen difikilte ladan yo nan egzamen Sunshine State Standards la. Yon elev ki nan
4yern Nivo reponn pifb kesyon egzamen yo köréldeman, men II ka gen kök siksé sélman nan kesyon ki sanble yo gen
pi plis difikilte ladan yo.
3 Elev sa a gen enpe siksé nan matyé ki gen difikilte ladan yo nan egzamen Sunshine State Standards la, men péfémans
Ian pa rete estab. Yon elév ki nan 3545m Nivo reponn anpil nan kesyon egzamen yo körékteman, men anjeneral li gen
mwens siksé ak kesyon ki sanble yo gen pi plis difikilte ladan yo.
2 Elév sa a gen siksé limite nan matyé ki gen difikilte ladan yo nan egzamen Sunshine State Standards la.
1 Elév sa a gen yon ti siksé tou piti nan matyé ki gen difikilte ladan yo nan egzamen Sunshine State Standards la.
Sétifika FCAT Elév ki fé nöt syöm Nivo oswa elev ki fé gwo nöt ki pi plis pase 400 nan syans ap resevwa Sétifika pou
Siksé. Yo bay tout elev ki fé nöt 5.5 oswa 6 ak elév klas katriyém ki fé nöt 5, 5.5, ak 6 yon sétifika pou redaksyon. Yo
pa bay sétifika swivan nät elev fé nan egzamen ki baze sou
"modél egzamen ofisyél FCAT itilize pou fé evalyasyon" (NRT) an.
PROT44
Spring 2003 Florida Comprehensive Assessment Test (FCAT)
Sunshine State Standards Grade 10 Student Report Sludent
U/11 et School Name and Number
sr
am
50-PALM BEACH
The Florida Department of Education believes that every student has the ability to learn and succeed. The purpose of the FCAT
is to ensure that Florida's public schools are providing the best education possible, and preparing students to succeed in the
competitive 21st Century job market.
Working with teachers, the State has developed a measurement system that Includes reading, writing, mathematics, and science.
This report allows you to compare a student's score to other students in the state. Using the 'Content Scores; you are able to
Identify any specific academic skills needing improvement
Below you will find your 2003 FCAT Science scores. The chart on the right side of the page shows your score compared to the
average score this year.
Science Score Score.
State Comparison lowest Middle Highest
278
i
The Score is a number between 10.1 and 500.
500
460
400
360
300
250
203
150
100
Student's Score Slate Average Science Content Scores
Content Areas Points Possible Points Earned State Comparison
Lowest μiddle Highest Physical and Chemical
12
3
i
Earth and Space
13
5
i
We and Environmental
13
7
Scientific Thinking
13
7
i
• These scores show your achievement on the day you were tested. if you had taken this
test numerous times, It Is likely that all of your scores would nave been within a certain
range. Your 2003 FCAT SSS Science scores probably would have been between 261 and 295.
Data Run Date: 05/09/2003 0060359
PROT45
FCAT Reports 3eparate reports are produced for the Sunshine State
Standards tests in FCAT Reading and Mathematics,
Science, and Writing. A separate report is also printed or the norm-referenced tests in Reading and
dathematics.
:CAT Norm-Referenced Test (NRT) Report The FCAT klIRT report shows reading and mathematics scores on
Florida version of the SAT9 (published by Harcourt
Educational Measurement).
Student scores are
:ompared to a national "norm" group, where a percentile ank score of 50 is average.
3unshine State Standards (SSS) Reports The FCAT
3SS Reading, Mathematics, and Science reports show est scores from Florida's tests of academic standards.
(hese reports contain subject scores and content ;cores.
Subject scores describe the overall ichievement, and content scores give the number of
mints earned in specific skill areas. Success on the
Reading and Mathematics tests can be best understood using the achievement levels where a 3 or higher is
in or aboye grade level.
achievement Levels Five categories of achievement iescribe the success students have with the content
ested on the FCAT Reading and Mathematics. Level 5 s the highest and Level 1 is the lowest. Since science
whievement levels have not been determined, science
:cores are ranked as to whether they fall in the lowest, niddle, or highest third of statewide student
ierformance.
i This student has success with the most challenging content of the Sunshine State Standards. A student scoring in Level
5 answers most of the test questions correctly, including the most challenging questions.
This student has success with the challenging content of the
Sunshine State Standards. A student scoring in Level 4 answers most of the test questions correctly, but may have
only some success with questions that reflect the most challenging content.
1 This student has partial success with the challenging content of the Sunshine State Standards, but performance
is inconsistent. A student scoring In Level 3 answers many of the test questions correctly, but is generally less
successful with questions that are the most challenging.
! This student has limited success with the challenging content of the Sunshine State Standards.
This student has little success with the challenging content of the Sunshine State Standards.
:CAT Certificates
Students who earn Level 5 scores or vhose science scale scores are greater than 400 receive
Artificates of Achievement. For writing, certificates are given o all students with scores of 5.5 or 6 and to fourth graders with
:cores of 5, 5.5, and 6. Certificates are not awarded based on he FCAT Norm-Referenced Test scores.
Informes FCAT (SpanIsh)
Se preparan informes separados para los exámenes del FCAT de lectura y matemáticas, ciencias y redacción según las
normas estatales Sunshine State Standards.
También se imprime otro informe por separado para los exámenes de lectura
y matemáticas de acuerdo a las normas de aplicación nacional.
Informe sobre el FCAT ceñido a normas de aplicación nacional (NRT)
El informe del FCAT NRT presenta los resultados de lectura y matemáticas en una versión del estado
de Florida del SAT9 (publicada por Harcourt Educational
Measurement). Los resultados obtenidos por los estudiantes se comparan con el grupo modelo o "norma", en el que la clasificación es de un 50% del promedio.
Informes según las normas estatales Sunshine State
Standards (SSS) Los informes según las normas estatales
SSS del FCAT presentan las calificaciones de los exámenes de lectura, matemáticas y ciencias de las normas académicas de
Florida. Estos informes contienen calificaciones por materias y calificaciones por contenido. Las calificaciones por materia
proporcionan un resumen general del rendimiento y las calificaciones por contenido que proveen el número de puntos
obtenidos en áreas de habilidades específicas. El éxito de los exámenes de lectura y matemáticas puede entenderse mejor utilizando los niveles de rendimiento en los que una calificación
de 3 o superior está al nivel del grado o por encima.
Niveles de rendimiento El éxito que un estudiante ha logrado en el contenido examinado en el FCAT de lectura y matemáticas
se describe por medio de cinco categorías. El nivel 5 es el más alto y el nivel 1 es el más bajo. Como los niveles de rendimiento
en ciencias no se han determinado, las calificaciones de ciencias se clasifican con respecto a si entran dentro del tercio
inferior, medio o superior del rendimiento estudiantil a nivel estatal.
5 Este estudiante tiene éxito con el contenido más difícil de las normas Sunshine State Standards. Un estudiante del Nivel 5 responde a la mayoría de las preguntas del examen
correctamente, incluyendo las preguntas más difíciles.
4 Este estudiante tiene éxito con el contenido difícil de las normas Sunshine State Standards. Un estudiante del Nivel 4 responde a la mayoría de las preguntas correctamente, pero
es posible que sólo tenga cierto éxito con las preguntan que reflejan el contenido más difícil.
3 Este estudiante tiene un éxito parcial con el contenido difícil de las normas Sunshine State Standards, pero su rendimiento es inconsistente. Un estudiante del Nivel 3 responde muchas
de las preguntas del examen correctamente, pero por lo general tiene menos éxito con las preguntas que son más
difíciles.
2 Este estudiante tiene éxito limitado con el contenido difícil de las normas Sunshine State Standards.
1 Este estudiante tiene poco éxito con el contenido difícil de las normas Sunshine State Standards.
Certificados del FCAT Los estudiantes que se clasifiquen en el Nivel 5 o cuyos resultados de ciencias sean superiores a 400,
reciben Certificados de rendimiento.
En redacción, los certificados se otorgan a todos los estudiantes que han obtenido
calificaciones de 5.5 y 6, y a los estudiantes de cuarto grado que han obtenido 5, 5.5 y 6. Los certificados no se otorgan basados
en los resultados del FCAT ceñido a normas de aplicación nacional.
Rapó FCAT (Haitian Creole)
Yo prepare rapo apa pou egzamen lekti ak matematik, syans ak redaksyon FCAT bay swivan prensip Sunshine State
Standards yo. Yo ekri yon rapé apa tou pou lekti ak matematik pou "modöl egzamen ofisyél FCAT itilize pou fé evalyasyon" an.
Rapó egzamen ofisyél FCAT itilize pou fé evalyasyon
(NRT) Rapé FCAT NRT a montre nät lekti ak matematik nan vésyon Florida genyen pou SAT9 la (Se Harcourt Educational
Measurement ki pibiGye II.) Yo konpare nät elév la ak yon gwoup nät yo konsidere köm "modöl pou egzamen ofisyél" la,
kote swivan klasman pa pousantaj la, nät mwayén nan se 50.
Rapó Sunshine State Standards (SSS) Rapé FCAT SSS pou lekti, matematik ak syans lan montre nät elév yo få nan
egzamen Florida bay sou prensip akademik yo. Rapi, sa yo gen nät pou matyé ak nät pou kontni ladan yo. Nät pou matyé
yo dekri tout sa elév la reyalize anjeneral epi nät pou kontni yo bay kantite pwen elév la fé nan yon matyé byen detémine. Ou ka konprann kisa elév la reyalize nan egzamen lekti ak
matematik la pi byen si w itilize yon nivo siksé kote 3 oswa plis se yon nät ki nan nivo klas la oswa yon nät ki pi wo pase nivo
klas la.
Nivo siksé elév yo Gen senk kategori siksé ki dekri nivo siksé elév yo pote nan kontni yo teste nan egzamen lekti ak
matematik FCAT la. Pi gwo nivo a se nivo 5 epi pi piti nivo a se nivo 1. Piska yo poko detéminen nivo siksé nan egzamenn syans lan, yo klase nät pou syans lan swivan si li tonbe pi ba,
nan milan oswa pi wo yon tyé péförnans elév toupatou nan eta
a.
5 Elév sa a gen siksé nan matyé ki te gen pi plis difikilte ladan yo nan egzamen Sunshine State Standards la. Yon elév ki nan 5yém Nivo reponn pito kesyon egzamen yo
körékteman, elév la menm reponn kesyon ki gen pi plis difikilte ladan yo.
4 Elév sa a gen siksé nan matyé ki te gen difikilte ladan yo nan egzamen Sunshine State Standards la. Yon elév ki nan
4yém Nivo reponn pito kesyon egzamen yo körékteman, men II ka gen kök siksé sélman nan kesyon kl sanble yo gen
pi plis difikilte ladan yo.
3 Elév sa a gen enpe siksé nan matyé ki gen difikilte ladan yo nan egzamen Sunshine State Standards la, men påfomans lan pa rete estab. Yon elév Id nan 3yém Nivo reponn anpil
nan kesyon egzamen yo kärékteman, men anjeneral li gen mwens siksé ak kesyon kl sanble yo gen pi plis difikilte ladan
yo.
2 Elév sa a gen siksé limite nan matyé ki gen difikilte ladan yo nan egzamen Sunshine State Standards la.
1 Elév sa a gen yon ti siksé tou piti nan matyé ki gen difikilte ladan yo nan egzamen Sunshine State Standards la.
SétIfIka FCAT Elév ki fé nät 5yém Nivo oswa elév ki fé gwo nät ki pi plis pase 400 nan syans ap resevwa Såtifika pou
Siksé. Yo bay tout elév ki fé nät 5.5 oswa 6 ak elév klas katriyém ki fé nät 5, 5.5, ak 6 yon sétifika pou redaksyon. Yo
pa bay sétifika swivan nät elév fé nan egzamen ki baze sou
"modöl egzamen ofisyél FCAT itilize pou fé evalyasyon" (NRT) an.
PROT46
flails Comprehensive Assessment Test Spring 2003
FLORIDA COMPREHENSIVE ASSESSMENT TEST (FCAT)
READING SUNSHINE STATE STANDARDS PERFORMANCE TASKS
Student Report Grade 10
This report provides your results on the FCAT 2003 Reading performancetasks. Each performance task on FCAT requires you
to respond with either a short response or a longer, more detailed response. Short-response tasks are scored on a 2-point rubric and
extended-response tasks are scored on a 4-point rubric.
One of the short-response tasks Is shown below with a copy of your answer. The number 01 points you earned for your answer Is
shown in the box to the right.
This task required you to read a passage about an American zoologist's attempts to rehabilitate two young gorillas In Africa.
Describe how Coco and Pucker change as a result of their experience with Dian Fossey. Use details and Information from
the story to explain your answer.
FCAT 2003
READING PERFORMANCE TASKS Student Name Student Number
School Name School Number District Name District Number
2331
PALM BEACH
so
This Performance Task Response ing PerAll Read formance Task
Responses Points Possible
2
12
Points Earned
2
10
ulnae ttwiara d by 9".,, en dPSG V0-tit giVariti epti Mer3 west 1franito
ci.dfletd cuti:ri no itct...+.2" and ea,. rtett!ii.t 0255 Mr 5* Mt, •Tiderivat.' ChIstial ltrtz
Vt•eds ok95, fnatiCLieje
VC" carni.ha With fatid-e• ep eTum %yenta twis• • eAractedee tea en be
Trot. Gond.
stk.° :coot trio fry...wog e'Asti to be. se•recochored tart teln9
V41t tote t*"
OKA
IACITYLC.9
C'MittACk an.* eaten, Ctra uric (ter} til 6.1eAJC5 00- tiaserieed.•
Data Run Date: 05/07/2003 0063533 85320[379
PROT47
FCAT floti61Compescasiverlisosoini Tel Spring 2003
FLORIDA COMPREHENSIVE ASSESSMENT TEST (FCAT)
MATHEMATICS SUNSHINE STATE STANDARDS PERFORMANCE TASKS
Student Report Grade 10
This report provides your results on the FCAT 2003 Mathematics performancetasks. Each performance task on FCAT requires you
to respond with either a short response or a longer, more detailed response. Short-response tasks are scored on a 2-point rubric and
extendec-response tasks are scored on a 4-point rubric.
Onc of the short-response tasks Is shown below with a copy of your answer. The number of points you earned for your answer is
shown in the box to the right.
FCAT 2003
MATHEMATICS PERFORMANCE TASKS Student Name Student Number
School Name $chool Number District Name
PALM BEACH District Number
50
This Perfo*rnance I ask Response All Mathematics Performance Task
Responses Points Possible
2
16
Points Earned
0
6
The students in the senior class at Paradise Island High School have decided
to raise money by selling graphing calculators and geometry tool kits. They
have set aside $3,000 to purchase the items they need to sell They will spend
$75 for each calculator, and 520 for each tool kit. From past experience,
they know that twice as many students will buy the calculators as will buy the
tool kits.
The inequality and equation below can be wed to determine the number of each
item the senior class should have available to sell, where c is the number of
calculators and t is the number of tool kits.
75c + 20t 5 3,000 c - Zt
How many tool kits should the senior class purchase? Show your work
- Mt 42 t 7r e.'
g.
zottsS Number of tool kits t003 Data Run Date: 05/07/2003
0083534 854200805
PROT48
I.J,,ks)\ I tit SUMUU I WS I HIV I OF PALM BEACH COUNTY (SDPBC)
• 9 a New and Returning Student Registration
NEW STUDENTS: Complete a areas on both sides of the fomi except areas specified.
c!titbet•Late,/ RETURNING STUDENTS: Review both sides. If the pre-printed Information is incorrect, correct the information by carefully and
lightly crossing out the incorrect Information and wiling the correct information above it. Complete any areas that are blank.
vt)JfV
VWC
068K
LCVEL
DIST:
CHR:PRIETO
(4) mown. Lam NM,IE pay. int Indire)
Ill
(5) ALSO KNOWN AS Kg LOCAL ADDRESS MOON no. & T km' Ramo)
(apt no) robe Ohne/ Cry code)
WEST PALM BEACH FL 33412
(7) MAUIO CORMS (house no &semi =me) (apt. no)
WY)
Woke
OP code)
(0) SOCIAL SECURITY NO.PAPLOneg (I) HOME TELEPHONE NO. (10) S 1
F
(I1) RACErETNNIC ORIGIN 0 I-American Indian/Alaskan
0 A-Asian/Pacific Islander
W
Native 0 B-Black, Non-Hispanic 0 H-Hispanic 0 NI-Multiracial
• W-VVhite, Non-HiSpanic
(12) DATE OF BIRTH
M
TMARDCWYY (13t PLACE OF BIRTH (c4 stab. couphy)
FL
US
FLORIDA (It) RESIDENT STATUS
0 0. Foreign Exchange3 Student 0 1. Out-of-county Resident
2. Out-of-state Resident
0
0 3.ln-county Resident
(15) USA ENTRY DATE
RALVDDATTY) ('0) FEDERAL IMPACT SURVEY
YES NO
0
0
A. The student resides on federal property.
0
0
B. The student resides in low rent housing.
D 0
C. The parent Is employed on federal property located in PB County.
0
0
D. The parent is employed on low rent housing located In PB County.
0
0
E. The parent Is in the uniformed services of the United States.
0
0
If E. Is YES, Is the parent on active duty? Check service below:
l: Air Force 0 Army 0 Coast Guard 0 Marines 0 National Guard 0 Navy
Indxate with an are longest.
Prekindergarten Prekindergarten Parent Program Applicable
(17) PRESCHOOL ENROLLMENT INFORMATION Place an X by each program attended. Also.
asterisk (*) the program your chid was In 0 C. Tale I Prekindergarten 0 M. Migrant
III D. Pre-K Disabilities 0 N. None • F. Fee for Services
0 P. Private
II H. Head Start 0 T. Teenage 9 L. Readiness Program
0 Z. Not (IS) Is the student a single parent? N • YES 0 NO
TRANSFER STUDENT Only students transferring from another school complete this section
(19) NAME OF SCHOOL TRANSFERRING FROM
(20) cm /STATE I COUNTY
COUNTRY
(21) LAST ATTENDANCE DATE
(22) LAST GRADE LEVEL
(23) Have you ever been enrolled in a Palm Beach County School?
If yes, what school?
0 YES • NO
(24) DATE ATTENDED N PBC
All now and returning students compete the remaining form including page 2
12
NBR:1SS STDT
CRS:1503350
SEC:00
BLDG:02 RM:GYM 08 11
4
Qs) Students will receive non-invasive health screenings pursuant to Florida Statute § 381.0056(7)(d). Non-Invasive screenings may include
vision, hearing, scohosis, height, and weight. These tests may be given individually or in groups. Parents or guardians, however, have the
right to request an exemption In writing. If you DO NOT want your child to receive the screenings, write the words "Do not screen" here:
(This exemption wit cover ail types of screenings)
CAD I give permission for my child to participate In the sodium fluoride program to prevent tooth decay.
El YES 0 NO (Pemassion Is va,d through grade 6)
YES pn Does your child currently have health insurance? I2
'Y ES 0 NO, If YES, indicate: 0 Medicaid 0 Healthy KidsnOd Care 216rivate
0 Interested in receiving information
(a) HOME LANGUAGE SURVEY (chccA WI *Nappy) O A language other than English is used in the home.
What language?
O The student has a first language other than English.
What language?
O The student most frequently speaks a language other than English.
What language?
am DISCLOSURES FOR ENTRY INTO PBC SCHOOL DISMICT (check at Met WOW
0 The student has been expelled from school.
0 The student has had juvenile Justice actions taken against him/her.
DI The student has wrested resulting in a charge.
(30) STUDENT LIVES WITH: (chock ro D Mother 0 Father oth Parents 0 Foster 0 Group Home
0 Other '
(31) CUSTODY STATUS OF S7111:Off (check one) 0 Mother K Father
0 Shared Custody 0 Other
IMPORTANT INFORMATION - MUST BE COMPLETED tra Is there a court order barring either parent from removing or contacting the student during the school day?
0 Yes f3 No If YES, provide the school with a copy of the court order.
PBSD 0638 (Rev. 03/17/2004)
page 1 of 2
PROT49
YANCEY / Lela/AL Ut)4411UUMNI IIVFVKNIMI lull
(33) FADER OR LEGAL GUARDIAN (Du mivele /Mist hul)
(34) DATE OF BIRTH
(44) MOTHER OR LEGAL GUARDIAN (rat middle iniial. hug
(45) DATE OF BIRTH
(35) ADDRESS (40,444 number. sent 0Famrdid number)
(413)A0ORE8S (steel number, street epereneni number)
(36) CITY
STATE
ZIP CCCE
FL
33412
(47) CITY
STATE
VP COOE
FL 33412
(37) OCCUPATION
(39) PLACE OF EMPLOYMENT
(38) HIGHEST
ED. LEVEL
h
.._l
(48) OCCUPATION (SO) PLACE OF EI/PLOY/ ENT
(49) HIGHEST
ED. LEVEL eatlele
(40) HOME TELEPHONE
(41) BUS:NESS TELEPHONE
(42) CELL/PAGER NUMBER (61) HOME TELEPHONE ) BUSINESS TELEPHONE
(53) CELL/PAGER NUMBER
(43) EMAIL ADDRESS (op:email (ie) EY 3IL ADDRESS (405440
EMERGENCY HEALTH AND SAFETY INFORMATION
Provide name(s) of person(s), other than parent, allowed to pick up student.
ms) PASSWORD (limit 10 chamfers)
(56) NAME MS middle MU( MN)
(82) NAME (8-34 middle int* leap
(57) ADDRESS (skeet mimeo,. Meek Apar:PION homer)
(63) ADDRESS (Owl reenieN One( neelmeel eumee) Cbenc."
STATE
ZIP CCYTE RoNet Pe• %re% Calse.c.)^%
FL
3-3(4%1
(84) CITY 2c..Ni n( c) -m %Cr%
STATE
ZIP COLE
HL
33412
(59) RELATIONSHIP
OTHER (801TELEPHONE
(51) CELUPAGER NUMEER (65) RELATKiNSRP
OTHER
(66) TELEPHONE
(67)CELL/PAGER NUMBER
(68) STUDENTS ALLERGIES (cheek a the/ apple end Weary)
ID None 0 Animals 0 Birds
0 Reptiles 0 Amphibians 0 Plants 0 Food 0-Other Specify St/AC ( %) Be , I 4-01-0"94--
(89) LIST STUDENT'S ILLNESS. BEHAVIOR ISSUES. MECCC,ATIONS CR PHYSCAL UllTATIONS
(70) FAMLY PHYSICIAN
(71) PHYSICIAN PHONE
NAMES OF PARENT'S/LEGAL GUARDIAN'S OTHER CHILDREN (7Z NAME OF CHILD MU meddle Ina( 4440
(73) SCHOOL ATTENDING
(74) STUDENT NO. Optiyme (75) GRACE (76) DATE OF GRIN
(77) NAME OF CHILD Firs( middle M$ IMO
(78) SCHOOL ATIEM:ING
(79) STUDENT NO. fopfiene0 (80) GRADE (81) DATE OF MTH
(I3D NAME OF 041.0 MA middle IS MM
(63) 80.100L AT-FENCING
(84) STUDENT NO. (opeonel) (85) GRADE (88) DATE OF EOM
INFORMATION VERIFICATION
I verify that the information given is true and accurate to the best of my
knovAedge.
TURE OF PARENT/LEGAL GUARDIAN
DATE
PARENT/GUARDIAN CONSENT
I understand and agree that all educational records of my child may be shared with the District's
health care partners and other governmental and social agencies jointly seeing the child or having
a legitimate interest in the records, as needed to provide and evaluate health services and
government/social services to students. I also understand and agree that my chide medcal
records or other medical Information that I provide to the school, and treatment records or other
medical records created by health care personnel at the school wit be shared with school officials
who have a legitimate educational purpose for accessing such medical records and information.
FOR OFFICE USE ONLY
COS
US
CAL
SI. Bin/ Code E01 Si. ENry Dale 08/11/04
ESOL Entry Date
PBSD 0636 (REV. 03/17/2004) Teacher Na.
Reassign. Code FirthFVerification 1
DC
fl
Z e)
TURE OF PARENT/ LEGAL GUARDIAN
DATE Documentati hecldist Transportation 0 Immunizations
0 Birth Records Verification 0 Social Scarily Number
0 Physical Exams
CI Address Verification O PBC Buse 0 Patn Iran 0 ParonVStudent Transportation o Walk 0 Bice
page 2 of 2
PROT50
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FLORIDA COMPREHENSIVE ASSESSMENT TEST ( FCAT
SPRING 2003 SUNSHINE STATE STANDARDS
STUDENT:
GRADE:
10
DISTRICT:
SID: Mr
SCH001 IDOB:
READING: 362 PASSED
MATH: 311 PASSED
PBSD0280 01-9330 counc °run Au C11l VJC nuncons.
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43N11 3A01438 43ATS3ROV
MOVE LIVER
TO EXPOSE ADHESIVE. REMOVE LINER
TO EXPOSE ADHESIVE. REMOVE LINER
TO EXPOSE ADHESIVE, REMOVE LINER
TO EXPOSE ADHESIVE. REMOVE LINER (0 EXPOSE ADHESIVE. REROVE OOP
10
3A0D3B .3AISIKat 350.03 01 001 MOWN, ITAIS3HOV 330.03 01
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031111 3A0m38 '3AISINGV 1S0.03 01 031111 3A0r138 IIMS3IED;
PROT51
ear
:17
THE SCHOOL DISTRICT OF PALM BEACH COUNTY
ELEMENTARY REPORT CARD School Principal
MARKING CODES - ACADEMIC SUBJECTS
GRADES 1 and 2 E - ExceIent S - Satisfactory V - Very Satisfactory
N • Needs Improvement
GRADES 3-5 A • Outstanding (94% • 103%) B - Above Avenge (65% - 93%)
C • Away° (75% • 64%) • Below Avenge (65% - 74%)
F
raiTeg (0% - 64%) I • Incomplete
ACADEMIC SUBJECTS l marking Peeled tat
ZS NI 46 Vt+AA Nft.i.Ns...113Ziits Iri, prof , 4.1'L nips., m.prom ft,,N1
M ssi.d.tm rat Composition
INCLEMX9 IrsIVIMEI Lan.ua.e Spew mtaralit tiandwriting/Peoman '•
MIAMIll Social Studies PitlItElln Science/Health
IIIMEILI • Grades not given this nine weeks
FINE ARTS REPORT guide° Period
IA
avi
341 46
An
.'3' .5 .1 a Music :3 i., 3 .3 Physical Education
3
v
a
Marking Period
/b
Id as
2sd
Ltonamonce =inductee Ockale 0003 gfrel a
In
PARENTIGUARDIANNEACHER
CONFERENCE I PIM 07611 (lee. 7114) Gekbantalet Pirkat
4*
Grade
Jr
Year 1997-19 qg
SOCIAL DEVELOPMENT/CLASSROOM STUDY HABITS Please work on the area(s) that have a cited( (4.
Madams Period
to
2n4 ad
Oar
Overal effort Works cooperatively Works independentty
Completes classwork on time Completes homework on time
Follows classroom rules and routines Uses time wisely
Follows directions Accepts responsbitity for own actions
Comes to class prepared with materials
ALTERNATE ASSESSMENTS Indicate those used with a check (I).
Markin Ported let as as se Skills Chec/Rat(s) Pertfolie it I/
Audio Cassette Recording Wee Recording Compute Program
Standardized Test(s) ObservationsWitten Comments Other
ATTENDANCE
Regular attendance and punduenty are essential fasually educator.
Marking Period
2.
2. i
3.
4a
Days Present .
Vol
.2. sit 0 44,44 -V O Days Agent Days Tardy
0
0 v/ ti /2information Included
V
PLACEMENT • Grade (0 Special Session
• g speed session program a retard. grade Placernald be determined by ea home sollow.
Plnki2nd Ported etneryl3rd Period Onionleth Potted www/Ontoe Cery
PROT52
THE SCHOOL DISTRICT OF PALM BEACH COUNTY 1997-1998 END-O -
D INSERT for GRADES 1-5 Grace
Dear Parent(s)/Guardian(s),
In a continuing effort to keep you Informed, this report card insert Is being provided to notify you of your child's
progress toward meeting the school district's desired levels of performance in reading, writing, and
mathematics. Your child's end-of-year performance level In reading, writing, and mathematics is Identified
below.
READING
VVRITING (COMPOSITION)
MATHEMATICS 2 7AI or above grade level & At or above grade level la ...At or above grade level -
K Below grade level*
ID Below grade lever K Below grade level*
'If Below grade level has been indicated for reading, writing, and/or mathematics, you will bi asked to
participate in the development of a plan to improve your child's academic performance. This plan will be .
developed at the beginning of the 1998-1999 school year.
Sincerely,
PBSO 1674 (NEW 5/15/98) White/Cumulalive. Folder Yellow/Report Card'
PROT53
STUDENT NA
UPI
SEX
A LALJETHNIC GROUP O Hispania
F. I O 8Whita, Not Hiiperik . Not Hispanic
O Anietken lerSon/Netivti Alaskan O Asian/Peptic Wilder
ADDRESS:Tine pencil In this space. until final.)
PHONE NUMBER: (cptionet)
SIRIHDATt Votified by Binh CeniTicate:
Yee
IS Not, what Type Venlicati
r
il
iMilliMill -
NAME OF PARENT'S) OR LEGAL GUARDIAN OR QTHER RESPONSIBLE /ADULT AT HOME
p
G
OA
-
ii"‹.
GU
-
Nom
Snet
CRY , P.
ezi
Data Pat Enured Ibb Mulct Withdrawal Date . Mithdraval Doe
Withdiewal Data 3 laspa-,
FLORIDA _PERMANENT RECORD CARD
CATEGORY A - Education Records
GRADES K-6
0.4( on.
siimaziGnet Gros
G. , • Seidel Yen: 19- 4-19 Schaal Year; 191_3 -191_t
ESN Yam 19
.19
Schell Yew: 19
.19
IlehmiYesr 1$ SI9
V?
Days Print" DaVe
'3
on, nns VersArisatt 1'4T - ac.
i
Dans net
t,
Eerie Days Present / go Nye Amen:
0
i
Twits Sublaci isatita Mast Seekci learnt Mast
k
Iloblait home
Mak
1
Ern
'I
5
of
IA
tAMILIAM in)) u
I
HAND lltlO
T. Lt.
iiniameineic;
HAAJosvainkry yffoWpTI
HANDSING
A
SOOAL T dadtAL ADAMS
SOCIAL STUOite
MIMATOWS
COM, AlinlIFIZ
SCIENCE and a/At 11.1
SCIEME and "Ar TW tr,,Nrc.f rd v "'laic "4 I' A FS AW: • ^ '
6
9O1AvICHI CODE at RAGE
IL
-1cti4AviOn <001
AVrAMW
IIIIMMACA CON
MARAnE
'T
MANOR CODE
AKAAGE
Q.,
1
MIHAVOR CODE
AIMANIF 'MAW*:
Ir4t3W Promote Pt ,i) Hcricait =API Mame:
Prow* In flown ail Sown4t St/WUp Roldin CIO s,...-.,.., scniiil X551
Samna.. School IS Summar 'VT**, Ratan IR) Swann Schott 1
P
Promote?) Stnoot &nett ii.....
I
GISH
5
I
Goat
I
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Sd.cct I ChS* Sans? Veen 19.33-49S - Eden )Men 19 _.19
-
Selma Ye?: 19 - .11 - Scheel fl an 19_.19_ lame Then 19 - 49 -
Days Pisani:
Dm Abend J.73
7
aim Present DeveMeent Dm Present Dm Advent Dan Present
Days Atom:
Deis Peasant Dove Absent:
Sobliet Teacher Mark 9(.140 Twine *Awl.
Maths,
Men
Sag(.
'NOON Mart &Men Tatar
Ma
MATIOMAMS
MA/MFMATICS 2.4ATIOMATeM
MATHFMAMA RtADONO
sv
AAANIZANCS
AIA0049 A 010,143
MADIA*
ANCUAGe r.fraismte um:smut t ANOVA%
LANGUAGit
WALING
WU et()
SP/WM)
APPI INA %ration ttANDWRHPIG /ANON/TORO
HANOWRINNO
HANDY441TING )(ANDY/26OC tet STUDIES
AERMA SRAM
SOCIAL SWORS //COAL DTIN/ti 5OOA
s
SOCNCt one
NIACIN
A
SCIENCE at d
IKALTH S CIEACC and
WALT).
SC IENCE and
MM.TH
SOUK( nd
a
HEN-111
ODWAO*COOE
AVFRAGE `-' eciavion cep( litHeveTWIGODC
AIMS 1304AVIOACOM
AVERAGE
BEHAVOR COOt
AVEPAGE _AVTRAGE
IMIkete:
Fonda (PI amen Pi)
e
SiAnnin acme ISEI ind,rate:
Proroio (P/ Retain IR:
SATiymi Svice1 WI
YYNNIN PromosPI /Man pia Surname StheolISS) hda lt
Promo* lel Ameia IL Swami STAppiONS) Proem l% Ndlealt:
Ratan ITU Sunkmee strewn, PliDot32 01-9340
PROT54
Verification of Receipt (NOTE: This is not the application for the scholarship.)
I verify that I have received and read the initial eligibility requirements
of the Florida Bright Futures Scholarship Program for the year 2004.
Please return to your high school guidance counselor
PROT55
lirEALIFIT Sante
PLR Name
ENT HEALTH EXAMINATIONS rufivt
Dn
a
Race
Sea
Andra..
Name ol Parent or Quatelon
SchOci
SW?,
5
5 3/ CV Weiiihl -)* ebod Presuxe &dna
A. HEALTH EXAMINATION
(I) NeemaleN: AlmortnaleA
N
A
COMMENT: Abnormal Findirps. by number
I. Appearance 2 Sloh/Noso 1Hoxl/Scogo &Eon
S. Veal Actin ilit s. LI
0. Can
7. Polledy Addy ft EU
B. Maas / Ibmal
9. MOOR Teem bald Guns
10. Chu( / LUMS 1 I.Ideorl 12.AbOnso
i
n..
e
13. Gefiab and Anus
14. Masculo-Slablal
IS.Meterd0{kal 16;Meelmes
17. Emallanal /Weep's' Bentryke Prob )
IS. Hendee° lanyticeli
OMR (Speedy) .
IR Acihity Resbiotione (Reedy)
20. Abet CealananCeet physical/ backed 2 lislotraion
'If
22.0ther
B.
HEALTH HISTORY tursan Isms loam apMH0 (Mach nun** i adOEceol abig teddibDRF-NS CLINIC
C.
LABORATOR Hemp:Rein/limb 'read
NAME:
TITLE:
ADDRESS:
(Please Pant) On 304 (Me (RPOI:48 Haan Fern 1040 .%cn an be anal
Senn Hunter. £7440Od1bO11 Noe dole
MOM
- 4 tuiUsonse &psaltery,
Date
PROT56
FLORIDA CERTIFICATION OF IMMUNIZATION
Legal Mahoney: FLORIDA STATUTES man, a. 10D-3.088, F.A.C. and s. TOM-12, PSC.
LAST NAME
FIRST
MI
DOB
M0MANIt
k
3.
Child's SDI (optional) Directions:
•-. Enter all appropriate doses and dates below.'
Sign midden appropriate certificate (A-1 A-2;B, or C) on reverse side of form.
If the child is presenting for the lth grade requateeni6PALWinlItyarneviously filed a Certificate of Immunization (680A
or 6.80A-1) with their current Florida sch i?fillilial'eteas liellifastrioni Tete Pan A-2 on the reverse side of this
form.
.c.r . . Vi s. t...61- !We: ,4j ^Nr.
For additional information: See -millA o
et
atibtang•Cltilif Facilities for information and ....,.--s 0- dr/ •,.
Instructions on form cotnpktio944"d hi . Iliettact.f:011id..", d annually and are available
from the local county health EP ifi ." 3.:
' :rm.....
'Dr '
STATE IMMUNIZATION IDle
VACCINE -•• DTaP/DTP' is DT' Polio'
RIB°
MMR (Combined)' (Separate)a Hepatitis B9 rl•-•
I
The state immunization MN is an identifier supplieby.the li stVatelmmunnation `registry (optional).
2
DTP 5 doses required. If the fourth primary dos-c taalinistemd ofirar the fourth birthday a fifth dose
is not required. DTaP is an acceptable alternative for one or more doses of DTP. •
. s . DT (pediatric) is aacqxable if Patustis vaccine is medically contraindicated. (Complete Part C for Paten's
contraindication.)
".•
2
Td (Adult) Vaccine is recommr.nded for children 7 years of age or older.
a
S
Polio 4 doses required. 'If the third close is administered on or after the fourth birthday, a fourth dose is not
4..
required. WV is an acceptable alteMative for one or more doses'of OW. Polio vaccine is not required for children 18
Ia.
years of age or older.
4
Nib is required for child are and preschool entry arid attendance only.
4- 7
1st dose valid if given on or after.' st birthday. Second dose (measles) valid If given at least 1 mouth:Ulm 1st dose.
A second dose of measles (preferably MMR) is required fot students inrades IC-4 in the 1997-98School year, and •
7th grade entry and attendance affective whist& 1997/08 school year. In each subsequent year thereafter, the next
highest grades are included
s
Includes single measles vaccine (0), single mumps vaccine (H) or single rubella vaccine (I).
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.
PROT57
LAST NAME
FIRST
MI
DOB (4O/DAPin)
Certificate of Immunization for K-12 Excluding 7th Grade Requirements
PART A-1 (Immunizations ale complete for school entry and attendance grades kinderganen through 12 with the exception of
the 7th grade requirement) DOE Code I
I have reviewed !ht .:words available, and to the best of my knowledge, the above named child has teen adequately immuni;e'd ogatut
diphtheria, moms, pristine:, Polio. %Virg.
r.
hepatitis B kindergarten
fo
school attendance as doewhaVellefIhr Physlitan.or Clinic Name:
Physician or Pintor:tamp) Authodzied Signature:
Add
5--
Certificate of of Immunization Supplement for 7tli Grade Reqairement
PART A-2 (Immunizations am complete for students who enter or attend the lih grade after the beginning of the 1991/98
r.• school year. Each subsequent year thereafter, the next highest grade will be included in the requirement.) DOE Code
I have reviewed the records available, and so the best of my knowledge, the above named child Ms received the following immuninarions
required for entryand anerdance in 7th grade electric. wish the ;PPM school year: tetania-diphtheria booster, hepatitis B vaccine sent,
and second dose (sneaks vaccine a,donmentedon the reverse ride of this font (bared areas).
Physician or Clink Name:
Physician or Print or cramp)
Authorized Signature:
Address:
Temporary Medical Exemption
PART B (Foe preschool children, children in day care and school childitn who are incomplete for immunizations in Pan A=l'
of A-2.) Invalid without expiration date. DOE Code 2
1C0116* that the above named child har received the immunisations documented en she men* side of this form and has commenced a schedule to
complete the required intmunizanionn Additional immunisations are not enedical6, tndkated at this time.
Physician or awe Name:
(Print or swap)
torn b` 1.47
OLEPinitiOnOt
..,a rfsgv Physician or Address:
Authorized Signature:
Date Pennanent Medical Exemption
:it PART C For medically contraindicated immunizations, list each vaccine and state valid clinical reasoning or evidence for
examptioo: DoE Ccdp 3
I her*, that the pluaiced condition of this child Is such that immurazation(s) as indicated in Pan C &bowie medically contraindicated.
Pieta or Clinic Name:
"tint or stamp) Address:
VIM II 54. 0.4,1/4".1:te °Lied (Swat Oat: 31000)0004)
Physician Signature:
Dare:
PROT58
ERS
DEPARTMENT OF HEALTH 8 REHASIUTATIVE SERVICES
STATE OF FLORIDA
DENT HEALTH EXAMINATIONS Dale Sloctent's Full Name
Race Address Name cl Fares a Guaratan
A. HEALTH EXAMINATION
WI NormaInn; Abnormal-.A
N
A
COMMENT: Abnormal Findings, by number I.Appearance
2. SI:In/Noso
V
3. toead/Sasso
4. Ems
S. Vaal Acuity 8 LI
(A
el EMS
7. Augpxy Acuity (R a LI
8. Noe / Throw 0.14Mh. Tee and Gonna
10. Own / Lungs
11. /Marl
12. AtdCanen
13. Gmbh V.:1 Mu /NCI le. Muscb-3keletal 1 PI(/ 1814eusoloakal
Lr-sethanninhs-yi in. Mennen
17. Ern:Paul / Mental/ Behataa Web I .....-taiEsMec
I 8 . Hanc:010. Physical/ other (Specayl ,,,.
19. Acihdy Resaricikm (S - y)
20. Abuse. subsaance/ "Peal / emit:Drug
21. Nuoinan
22. Ona
B. • HEALTH HISTORY (Scrips 1:1655CAD INuesey ~lain)
%tight
Blood Premise (attach narrallna M addincoal space netted/
C.
LABORATORY las Inclecated) Hemcglabin/Namt Lean
NAME,
TITLE:
ADDRESS:
(Please Pant)
FOWL
MRS- /I ion 3040, Mar 9 (Stock Weber: 5744.000.3040-2)
Mod JO SPI *Ostlers) ---4110ato
PROT59
FLORIDA CERTIFICATION OF IMMUNIZATION
Legal Authority: FLORIDA STATUTES 23L037., a. 20D4.088, F.A.C. and s. 10M-12, P.A.C.
LAST NAME
PARENT OR GUARDIAN
FIRST
MI
DOB
MOIDNYR Child's SS* (optional)
STATE BOILINIZATION IN Directions:
Enter an 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 the7th grade requireaftWOBrarriFFlina rnmiously filed a Certificate of Immunization (680A
or 680A-1) with their current Florida schp61,Fdtreiliaid aias lizoaa tete Part A-2 on the reverse side of this form.
41.4. 5:.,..."rt"'" For additional information: Seesjinratunritso.
1.40 §.
7n5") Facilities for information and
from the local county healthelioa ion ructions on form co:aplenty ad im Ermaligif
'annu ally and are available
a.
VACCINE
DTaP/DTP'
DT'
Td'
Polies'
MMR (Combined)' (Separate)' Hepatitis 219
t
The state irrummization IDN is an identifier su .die statrommunizatiolficgistry (optional).
2
DTP 5 doses required. If the fourth primary doseTtahlinisteredear the fourth birthday a Mb dose
is not required. DTaP is an acceptable aoernative for one or more doses of DTP.
3
DT (pediatric) is acceptable if Perrussis vaccine is medically contraindicated. (Complete Part C for Pcnussis
contraindication.)
Td (Adult) Vaccine is recommended for children 7 years of age or older.
s
Polo 4 doses required if the third dose Is administered on or after the fourth birthday, a fourth dose is not
required. BV is an acceptable altemative'for one or mare doses of OPV. Polio vaccine is not required for children IS
years of age or older.
Hib is required for child care and preschool catty and attendance only.
7
1st dose valid if given on or after 1st birthday. Second dose (measles) valid if given at least 1 morthafter Ice dose
A second dose of measles (preferably MMR) ii required for students in grades. E-4 in the 1997-98 school year, and
7th grade entry and attendance effective with the 1997/98 same; year. In each subsequent year thereafter, the next
highest grades are included.
s
Includes single measles vaccine (0), single mumps vaccine (H) or single rubella vaccine (I).
9
Hepatitis B vaccine writs 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 schcol year. In each subsequent year 'hereafter, the next
highest grades are included.
PROT60
LAST NAME
FIRST
MI
DOB (idoAwn)
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
I haw mined the records mailable, and to the ben of my knowledge. the above named child has been adequately immunised ageing
diphtheria. karat MMUS'S. poll.
4
hepatitis B brae lindergartin elective with the 99:
I ear or school attendance and Physician or Clinic Na •
Physiciso or (Print or stamp) Authorised Stgaitutt:.
Certificate of Immunization Supplement for 7th Grade Requirement
PART A-2 (Immunizations arc complete for snide= 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 needs available, and to the best of my knowledge. the above named child has received the following Mottwasatiom
required for may and attmdeutee in 7th grade effienve with the 1997/941 school year: tetansu-chpbtheria boaster. htpantls B vaccine snits
and second dove of measles marinas documented on the mane side tithes form (bored arrae).
Physklan or Clinic Name:
(Print or stamp) Address:
Physidan or Authorized Signature:
Date 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
I (trek that the *bowers:ma child has methsd the immunisations dontatented co the mane side of this form and has commenced a satiate to
complete the required immunizations. Additional inrmanbsolions an not medically indicated at this tine.
Physicist's or Clinic MOM:
(Print or stamp) Address:
'Exisiritakita rt t arT1
COS dap nitia rrili Physician or
Authorised Shalom:
Permanent Medical Exemption
PART C For medically contraindicated immunizations, list each vaccine and stare valid clinical reasoning or evidence for
exemption: DOE Code 3
I cestift that the physical condition of this child Lt nth that immenitatiomNat indicated in Pan C above is medically caltraindicated.
Physician or Clinic Name:
(flint or stamp) Address:
D44 610, 1196. dada= la (4Omo (SIM Maher 574.11O:MX1106)
Physician Signature:
PROT61
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Po '.Jof lenyb coCded ea twenty. U. Cren ea 'dn..= em mule ea Pe *dada!
canFearet wi6 es Metals by be lelieemlet tuectu ceety reletitelleteeba Walla. is Cds Pee. Lretelep Ikeideliceaud
rue
%rem tetement Yull coetene extp•ence abet mike-oat Heide :wets peeteeiey le ueurigy *posit had revue. le • rya'
*puttee% ce eye Indleid.ereorthberalip. rake:mud petered otell leg Wily,. Ois estate= to *Soria emplarce. Thinbemi.m
pee.su owe any ccalleCeg ',miens., in gape. 475 ued ti ten exemé et V. >lake Stuatee
Noeek/uteetres Oa ester. soya/Abu me* yeas ot deaexe et• Trantes >eke a Ite aphelia a A. eon •14 retehosatievey oats tio'e• perrlokt•
contsbera eXa Lcese letoetentruy. Fiedta eL0 te••1 lual eeem(7)1ayseeistn ace:m.4 «reel rell et prriceeteLvere Weed ?tile le verean
elead..x•eytha probe weicbeetionfael is/laded:4 addreat wiwa•So kited en be node& Fame tep:ne each° r deb, mitre toter& of 0. tees
oteulestre et
83.40(7)(•). Fetid» esztas. Peettean reed tees eel tor seen ResideS den ceptho were •he Wee
S. Dybiplaljeurystrœpese II Indeed ineable le Mint portiere et de Yuceata m
Lit of in coneesereetset teno. beaus ue oçosit, sent,
PC•leasks.m fa unr diet team balked 'La nabolliel• fet Wee is .1•Ilelr pewee. quid Oak .tkot Ps tax meat temedee aka
le bleed end Ceecllet.luedwpcelenUe•
Ittelket. Tke knells:ice 4••• el A< la eta na be •••••••••1. U tented or. ea. ter wiener dean. p•neke RnIS•at
et hue«. feu • puled N A4ry po)4.), ekr At fee illy (lee Weeks. abet liseted et Leilint ray atrial Si. kw by Keen • wimet noCrte to el. Mee. yel
..5 nenke F•i0 6t Rakka eel be Weldsd le fell
PROT62
7 A9- AnRI•MtIT
ADDRESt:
Litid8 DATE 71119
RSOINNotb.
MONTILLY P.BtYf
PIORATWO MET
ADVAXCE
SECURITY
TBR FEB MEP Of dun nee
DRI6:itT (tun (00.
00
3:
3 (000.00 s 510.0(~l
FIPSWINTKAMEO'R
NAMIS OP OT1011
"Illt bokt« Pam bona/ pool PatIttp)milly klm nood taibod faUn speontot Po:6n Pcabol Pm. 1 b tb Pitt p pubs benen P.r.:M.1<i)
Leallad•ad pybo solifla colt Inobbig. Ibbom b Mo lbo op Readni..2 PabliotputfobOtbd ornotto 6tble fes Log Fopbotten blond:P. U1014
EXECUSION OF Te LEAS.. SOU AOCNOWLEIXIITIIAT YOU IIAS9 WAD AND AOLIS TO ALLOFIr. ITOVISIORC. It pa pot:cd ly Out PoOnct(s) on,
dus Waad os P Pot lep Des'.
ItSSIDINT SIONATURII:
S
DY IECECtIllh011US LEASE ACREERGYIT. ISSIDENTA0Qt0WIED016 RECTIPT OP TM ECII.Oblt.St (I) N.euvudwpf
ot
hbo Astonnen, ud (2) dep byt tod ruil beo Idy. bM dan Pabot ottnieu.
I. frofflabfrout: lbedkol 1.444 P4114.al du Itpboo bt
om
ktOpEnt.
ittoPore Poon kali lo ban *pik lo truicts 8 W bteal calibwo pownske atno tb tot ot in. lam Tam pl O 6t ontbood co of roupbent
lobtrytt e poot POP pront. Ilo bou P Wodan ~b b ntob Puby bt nib imams •• LAndoti tuy taiga Roildtal ba
nbjen all robnins ot bi Up otudt ut.plaSk tod tosticont PI e oost,' b cpb kun.
2. 'Plm:
lordlet 'Pct ta Eindig • batelybdianct m ortolonOwEdb O.).by afb. cumil. beo Istrord i,J4
ce614 bs kb loc b do Poot ot teut (lb%) pro bb d plu butaboutot. Ray tr• ka da. banoadtt obell b• o4.4~
). sare.mir lba tretur. ua1 Inboaplobbly by /PUP pl Rodattonbutabfab fiauly tot toidnal ?pop MI.
tput bet
0.• lu».1 rumlus 010 k otoniod by ro non Pa bob lobbf kpatetd Pm. To Timp boy en k *P Ix Pp,. ~al
: n bunoprt pep«.. Al el
Oit didos et Rou:dat (<aeg' tooi mynnuit) tic Po dut 6.dou o!uy u.J al oictousto of to Plal"401. Pailrul hal/. poot, employee». eit r4 botweg ttd
Whi L1) V.OLVIOS ot bc Pm d Pb lab ot byernotonn Sobiudo.bloloresiatin et P no. a *blaast Acboopolor eultotialtey Loadbudiebotouealubobou
ot bin LP* Agg Kaait kadi bo 6666 by Rodibot.
4. to...mits r. Atlant, attO
•,)
• I / 044:ent ..1.•1 &Cm« te 4.341.w4tb• Swaigy D•roel uil .4~5 cut leliegoi Sen ?MI ka tab. peetaka IS* halm baan elatitydpanad
bratIpoo tas Pl b kl[ ae lotion4 bnp:
I 1 Op:Pol:a • bouw 1 1 kiept beu bus l l op:pp bobby popi Plut
Ooit un• tot •:4«e). 8ltead4a loaxet lobby op.:. bb PTI ~In 25%
py
Ida" tb d s'• 6 2" &P's!, " duandsb 3% P it Its. 1 1 Oxim'a 4.9. wi Pct kolt. PI
brOl rer.44 Pilt, blb Oa oxn deuk of Ito man. Tot WI nalln Instm to ptt aball P tote 015% pu
b)
Toot tobtin dtobeimuy trAbe nrsa by,cq u bist le rol Ines debba yon lailftl po dorps« of bob omkip b LP Poe pl boon:~ optut son plot: domp b to pabbn prol by bb ot bot lat:P*
Tbc fidooks b Sint 1.2.49(7)Pla tul be beplad to yorrid• b rob
PX6) Opa te opeof dubt rebus P ~bobo n be hm.0 ladonbhall bun (444n (I b dan io nam odd hecenty &pa breve
rd" Mum. U obabbi uunhel, tob voldutt b tint Ue Tyedbut ordla wikt by ~GIER pil n bb &Piano iropop &P dun cp. u Oe
linideain lui bon ~Etui oOttu. !be roep ~I pull • anno« l itabluebuly 0< Inkod. lotto: 'Tb b • onk* ot my Poolm b
pm' • In &Pp b be ~pl cl :pen ps «baby depodb tbc b ....
0 La ent b yoa u.gdtdlT. 53.4fily. flodt•
Siatuub lbo nebben bond !int you ma /Won toni:20PP dedotecolranyou ~win br:44.PP Illitto(lbbp
bt not you teak* bb ptict. ot 1 MI to ottodanl b PIP ny dab, bon po buebby &buit Ton obEcion Put be mol b Plkeet tOttat.Y.
bat b gbi M nodin
Quibb u 15-6y ptrbd. to falla bb enba b loopst:41n po tu• at, ambt
(b) Lbh.aAe &btw ebbe., bu inpalm ot ibt Lablyn't Pm.« On, Pooit Paar:~
Nina (Lbatunbtostabi of be lyeand• nota. d iwnimp Inpust • dils.bo Indom! ruy Ode &don tv pap n tb PP un tmlN. bijna ob& Sneb b Itt Ibidon Mbb
(92)dito •ttit Mani. ot WRatT b bnp. • dan fa duopa.
p
.:..w .tt• fraliPite*. artla. ;A uwnd ~p.e.: Mak<c• ta'''""
PROT63
a.
NAMES
BIRTHS
DATE OP
PLACE di EBRTHe
CERTIPICA44 NUHBER:
DATE PILEDt
HOTHER'E.HAIDEN NAME:
FATHER'S. NAMES
OFFICE of VITAL STATISTICS
CERTIFICATION OF BIRTH
SEX: FEMALE
PALM BEACH COUNTY, FLORIDA
DATE ISSUED:
This is to cattily that this is a true abstract of the official record tiled with this office
OUVEa H. 000404. MPH.
Sim* FlepliVar
WARNING:
.4527r,c
PROT64
NIS
FLORIDA CERTIFICATE OF IMMUNIZATION (HRS 680 - PART A)
(FREW Stalutry 232032)
0 HAVE COMPLETED ALL REQUIRED IMMUNIZATIONS FOR SCHOOL ATTENDANCE
PARENT OR GUARIYA/I
MOOR POT A CF MIL 10B1 IS USED QV IF TEE C
.MO MS ABEND ALL PEP WO fintIZAIONS LISTE3 IFUR If MT. SEE LEITISF
OFF - $ MILS 1E1ORIO
F TIE MIRTH PRIMARY DOSE OF OW IS ADIANISTE,ROH cia.i itttmekomni eLY;
DT (PEDATRIC) VACCINE IS AOCEPTABIS F PERTUSSIS VAgyfilnEciefil
Tga
TO (ADULT) YACCTIE (A SEFPES OF 3005E5) IS 146EVADLE:AND:RECOWIEgliDAFIc '
7 YEARSOF nto OWl) 1 DOSES IIEPODO F TIE 1HRD FRWARY DOSE CF TOP! IS
POLO VAW'CE IS WITTED FROM TIE
GENSLES. ans. MO 1001114 - I DON REICUELI /AMR COSIGNED - 1 DOSE AT 12 MONLIS
MEASLES SD/GLE - 103.5E AT 12 MOITHS
MUM'S SNGLE - 1005E AT 12 MONTHS OF AGE OR
RUBELLA SINGLE - 1 DOSE AT 12 MONTHS CG AGE OR OLDER
MD
DA
ALL APPFMEIMINE)ggeSARIMUS 01CLUDING I3WITHDATE MUST BE ENTERER MD THE cartecoxesoci) BELOW BY A PHYSICIAN CR AUTHORIZED
DEAMBAWAL1W-KONCIMPlifiaTtg.,c4JP TO ATTEND SCHOOL
H. JOHN RICHMOND, M.D.
I HAVE REVIEWEENTLTEHVONDS AVAILABLE. MID TO THE BEST OF MY KNOWLE
OPHTHE • POLIO, MEASLES, MUMPS, AND RUBELLA ASR
D.
BLVD.
610
DA
YR
MO
DA
YR
UWE (PLEASE MIT)
EQUATELY IMMUNIZED AGAINST
YR
DATE
PROT65
DOCTOR
RTH
CHLUS NAME
DA
YR
PAP
OR GARMAN
IF THE CHILD HAS NOT RECEIVED DIE REQUIRED DOSES USTED IN PART A, PLEASE COMPLETE PART B OR PART C, AS APPROPRIATE, AND SIGN AND DATE.
I CERTIFY
IMMUNIZATIONS.
TEMPORARY MEDICAL EXEMPTION (HAS 680 - PART B)
FOR PRESCHOOL CHILDREN AND FOR SCHOOL CHILDREN WITHOUT All. IMMUNIZATIONS REQUIRED IN PART A
THAT THE ABOVE NM/ED CHILD HAS RECEIVED THE IMMUNIZATK)NS LISTED BELOV/ AND HAS COMMENCED A SCHEDULE TO COMPLETE THE
ADDITIONAL IMMUNIZATIONS ARE NOT MEDICALLY INDICATED AT TIC TIME.
REQUIRED
TYPE VICORE (tb /DAM)
DTP
DT
14
PDW
MUMPS
PAYS/INI OR AUDIONZED SIGNATURE
CATS I CERTIFY
CUNICAL
PERMANENT MEDICAL EXEMPTION (FIRS 680 - PART C)
THAT THE PHYSICAL CONDITION, OF THIS CHLD IS SUCH THAT IMMUNIZATION(S) IS MEDICALLY CONTRAINDICATED. UST VACCINE(S) AND STATE VAUD
REASONING OR EVIDENCE FOR EXEMPTION FOR EACH VACCINE.
Has Nem 55O..
PHYSOMS SIGNATURE --- ons $dI epr Hba or agtesseseirM
r-
•Itt elisrilaai r " -C-7--- 1.!, r,<• ' I "- -'' -: I.- -'T r
' -".r
-
I ^. In:
PROT66
STATE OF FLORIDA
DEFAFRWIENT OF HEALTH & REHABILIIATIVE SERVICES
NT HEALTH EXAMINATIONS Dale 0-9-q/ Slutlenre Fun Name
Meese Skladate Nairn of Parent or GosePen
r
Sol
A. HEALTH EXAMINATION tnNomlihrt Abnormal-A N
A
COMMENT: Abnonnal Finings, by number
I. MINIMS
ti
2. Skil/ Nese v i
3. Reed/See
4.1
41Eyes 21la
V
7.
aA
r
e
Rd Li &Noce/
L.,
9.14cuat Teeth and Cans ,../
10. Chesil / Leo 11.14esel '../
12. Placlamea cei i3.Garilati ore/ Prue
si
le. literstib-SbIlelal i../
IS. treatiblazil
L./
It Aiertaese
../
1 T.Ernalicoal WSW
ci
ElahaVOC Pf00 I it HOIIMCa9. "IOU alba (Soedly)
a
it.. MP At/ Restricts** (SPOON)
20. Musa subsume/ Physical I famtonid
9
21. Walla
22. Olher
B.
HEALTH HISTORY (Se locumusses murex muum asahl h /,
WW2
Blood Pilaw*
5
C.
LABORATORY les intrine Herrocktirdlaarialocit
Lea
Tile
CL:HIC
NAME:
TITE.
ADORE (Please Fora 3040, mumFS aPAb1824S1ed I II 8n1)
(Stock Iliater: 5744-CatkatMa31)2.9.617
PROT67
PICTURE
CARD School Tear Grad* Sc ho Year Sch.* Tear Crude
First
7
Riddle / 993 - School' Tear (611W5-
PROT68
Name
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
CUMULATIVE SCHOOL HEALTH RECORD (This tone Is not Intended for physician's use)
Race VI
Sex
F .
Schoo Address Fathers Name
Date of Birth I .?
'<Moe: Name Place of Sim WPaN FT-) Birth Recorded:
Ye*
No 0 Immunization Certification:
YesX
NO D Special Immunization Programs
A NARRATIVE NOTE IS REQUIRED FOR REFERRAL AND OUTCOME ENTRIES
Screening and Assessment Grades
K-3
K
1
2
3
E.
5 -a
P.O
-
1
i
co
c
11
A
w
g
1
Z
g
1 8
-.: 0
m
w
g
1 -
I
O
i 5-'
ea
,x
.1.; .
1
.2,3 Vision lafilte
"7
1
-41
Hearing
d7
3- V' -4V
-r"
-If
Height. Weight &ar.p&ing
04
l'
tis. ,,,.., 45 rt .it,, /f' VO" 1.0.-55%., idea"a 414"
SD as lies- 4114
t
i 2
Nutrition Dental Health Mental Health Communicable Disease
Records Review
-
Physical Assessment Other Other Spsciai Health Prcetems - See
Narrative_ Screening and Assessment Grades
4-8
4
5
6
7
8
Screening
Date 7 t 0
0
cc
Outcome I . .
0 7.
92 0
T. $
P.
8
2
gi
0 0
8
i
A 0
cc
- 8
Screening
Date
ROI.(MI 9E 8
8
F
E e c r•
P. 0
(8
a
Outcome Vision Ans/flz i d qv
P
Hearing
/ 0
Heig Gra ht, phing Weight
8
CO7 91,1140thri410 um.
41' t o rr
47
Novato Dental Health Mental Health Commerical:lie Disease
Records Review Physical Assessment Scetloels Other
Other
HRS-H Form 3041, MAY 80 (Replaces previous editions and MCH 304)
PROT69
LEVEL & COURSE PERFORMANCE School End of Year Report
Total Course Time
Total Corr/Att Exercises
Total Percent Correct Enroll Level
1PM
Level Current Level Gain 1231 pp III., (Enroll Date - 9/24/97) Class 120 GENCO-607
1493/1837
81
4.50 5.61 6.15 0.54
MCS
7:32 557/851
65
4.49 4.51 4.77 0.26
RA
WRT
0:00
0/0
0
N/A
[repeated 4 times]
PROT70
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AS12Flight #
OS11Flight #
SQ41GPS
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(4040043Phone
1732 1998Phone
2912001Phone
3500797Phone
381.0056Phone
4200805Phone
607
1493Phone
687 2701Phone
9544190SWIFT/BIC
CALENDAATail #
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