EFTA Document EFTA01709902

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., %rill be delernit9491 by Me home sC1530I f NIS Eel ATM Wet' CENTRAL PeOCESSINCI tal Am Mb SOOT WAGE inns are Ilavieenes • Oa ANS IS Pans MON ROTOR liar haw a 4ega tar w▪ artaa ins NATO era Thee Nadi Cane Haas Came wee ass Send MRS, by I. SimMatas Otspos ke rata s. I I I I 3 21 21 23 2 25 2 3 itgrrl 32 ut NOTOWEVE NANO Wv biath 4. kiaddtde. Pura/ 4 Cain Shoe 4 rage r rota lawn tie CAM tack 45 Cam Oath 4 6 images fees 4 VISUAL OUICAIMNATION suer crui 3 I Inds Wpm 52 IebN Sa 53 Ilsadls istau 5.a tieseried Mw SS pr n eras II IlleleerS sti • evat Let er.4.1.• 37 err Ca Palate SI VMS.. MEMORY .1/4 0.• Cahn g Sawa Rese at ass Haan a2 lees Las as Nagl01I Is Sore ISM! "reeve lasemeatiadad NS de Ian 11§FIR dalleva *al U 7 31 area I annedered* _s Ueda 2t ECM LANCIIJAOS USTINING ▪ tassel Sri Omar 'Mr May $ 9 53 MIES SMARM 'aura a NI twa Car Ohms it' NS 101119.70 grri RPM it 3 PRIMMAINFOR INoplIS Pan Naga Ubila 'rpm Os Mae Ma Mary a1rWMTN Th Dllid= V T Ill Maas Fat kne it I 111 Ill It d IIS 121 122 77.411. AUMT0911 Illt RORY sr Soso Pr a Seri a 2 giros *sr I 3 'hags Oat I 4 55 ENVIRONMENTAL AWARENESS seen IatneS Mr Cep asap Fran Ora SreWle la Spirt bin I3 I 122 133 91402:1:) MATHOAAMCS LIEN. NWIBIA/1001 Maas One-0e Is lbws lank On 141 IU ISOM Oen Pada Ise Ileseee fele See ald WI Patellae* nagorwi owerag Main Maces SPECS. TOMES ran Oans Sr Yr of On Jon, $40•0•10 Sea slIXT niEgICEI 122 03 li II In K 6347 Oelisediell/IN Poo*/ Plakeled Paella Yellow IS Palled Giver3.40. Pe nod WhaVOII • Copy EFTA01709902 PISTR: /4S.. L Lv THE SCHOOL DISTRICT OF PALM BEACH COUNTY CI r lt.,:.‘cttt.t.'-'1' NEW RETURNING STUDENTS REGISTRATION '701 TOOL I NOR'. 504STOT 1002127 I a Hi" . 50^ 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 [tinted is IMOCIOCL PleiS0 core ocl it by catisfulh old IOW UOSSin9 OA toe incorrect .nformsoon and writing Ina owe:, 'thymus's's, above it TTOTTIT•Ral s situ LORI IM I= a; Rill PORI Al )." 01 UP I.1 blahs la MIRK /021/10m am., or e ROYAL PALM ESAC/1 FL 134'1 la //mom • .ii MOOT I Wu sl ern ..) 63 114.114 NOM ai 0) Ifs F 4 I It 1114 'n ' t 0 1 .u.sm .0.'" 0 10 %.<.:celstatig• 0 4.3/4e 106 .." /101/ /M4PC OH ....AK W ron s,.„„c FA wo„,.., PRATE P PR -. .s. III/ SAIL RIEP WEST PALM BEAM FL UR FLORIDA no ma on 11511X1PAPS 3 0 2 0410I•VATI 11/111NNT 0 0 .0111/16 I /01.0lif 1.110Ile 0 I PFT-O.001‘11 11/10110 0 5 ni.nuen IMMO OD ECU pm ORO 111A III/1101U1 YACT Alt SOO/ ant 0 .0 * III StRI011 111.141, PI 01/1101 PIKPIAT/ 0 TM 0 (100 1 NI MORO II sots a LOW um misers 0 ns Too : ne FAUWI it memo OR OMR*/ 111 11T1 mune S Paul sum mom 0 0/0 Res) S. rt. PAIIIIT II II 00110 PI LC* PAW )0X131114190 II PA01 MACK IPSO 0 41 (21.0 / Pe P.0141 -, is lot ~many sticsitti 01 IR PPTIO MAIO • ym, a TM Kama Ca aura port 0 ,,s 0 10 0 ... ittac, 0 a— 0 a.n.—• 0 wan,. 0 -nr..at ..a. El .. OP KM On 01111 IIIII 15•X41015 III PIISCPOr PURR PIACI • comma ( 5.0111141 AMU. ETIRM MOO PIPPO WM AA AMOR 1 RI 1111 PIPARAI MOO 040 MO IN MI /011101) El , cnna. 0 . i• ,,,,, n 0 0 .fla. 0 a IM -I •SAMillip 0 m 6///44,0 141/4 0 4 OsiMet//0 Out• (Sal 0 15144 too IITIMIRTIC• 0 lt /4/0•1411SIP/II Ckl0 CAM Hy, a la /14/14' A /4/14W4M1/1/ 0 in O N° OW 041137 PAW ad os TRANSFER INFORMATION. I/. %MI 01 .0.0(1. TRIR•114/Init IMP I II CIO II InflIKO HI 1011 C4 IAIT liolat/E1 :3, POP. IOU on its/ Poo/ SC/Ca AIT0100 It P•01 ROO/ MAO [21 API A111101/ FREE OR REDUCED PRICE LUNCH AND HEALTH INFORMATION: 21 KmI MC 031111 OM AP utymal 101 /RAI OR POMO Ingle 0 n, 0 No IAPPOCAION /S. PICIVANO WON MO RIIMM0011 1(11* 211 OUP 1011111161 ORM PIPPRISIO• IP la 0010 10 11 41171 RUM/ SP/1MM' 1041 1111: MAI 4.1 aiIR iPsynyusui pi 0 owns YES 0 II, 0 .0 IS KOOK 111044* • On 0141attufs PR MY none TO ..... /*An p im tops 10.515 •••••••• YES 0 I" Nri / 114/111 DOOM PEA/ 1014111115IS vA111 MOSS GRAM III NEW STUDENTS TO PALM BEACH COUNTY: HOME LANGUAGE SURVEY :1. GMT 1.411010.4 IS VOID III 'M. /KAM , t NI - PRAIA,/ On wail 1/44/0.1 IS Man IS 04 /Owl II 14 triOlor• OR 5414 01 taut 1.10 ns nu ;vac..., I: II I•apat4 SUMO I is • /01p41 oists 1501 11MIN MO • MAW On, 2 (KIS PI S11/314' .1.4 A ORS? 1•11001.4 01•111 11113/ 041/1117 On , [;11., r 301 141 511•241/ MOO 1.10011010 ..... A 1.41114444 COMM 111/0111Mair 0111 LIF4Y M EFTA01709903 OF« Pramil I". v°4;',,t+1, ''4(4)/ sav» tam PH nLLVron ofl« 5•4« •• 14 v••••nar .41M mår« h. 1.4.4 I øde ~4 .4. 145 Tart ter mer WIIIII- MICrPIPINTilln« corotn% Moveat mas n« 1003( On, G ,-;75C • ni Mint •IntOt '14 $010:41Wit• wo A '1.Sr MP MVA 00I: FAD.« Lyt Ortf.00 C.11 0 ,40 VIS flal INITFOrtelF4).4« gOt tOF LOM? agio YES ~e 110YA e. PALM ML ia FL 33411 ROYAL PAL11 1191/01 PL 33411 a rn >"R rna .110111.1-- a aner «non na — som! Ilt ~RF in,. Or [y-L.1 1311 rolakInD /Or^ A3 =n — e 0 =.77.7' C Ste—r, 0 g . ---- MI «Ann Iren. OF 50.1CnCr4 COIARI110 MPAANAU An ...........x. B 0 =,:r . C 0= D E; =:,;-r E Q.==2„. n« Lr..4 4IJA.Dort « Ant °on lost Gai.oar nr! Cnt00/0 0 r!! C «3 4«. p I ../...0. ta« , ERCENCY HEALTH AND SAFETY NYFOIMATION 1....n ørn! 10 li Frn un« FrIfnI.:1! nr ... %%roer s. Eli NtAFIT1/44 • rne fri NKS 0 NO 4 Øtt Imoic xYN1 meiAtosme n' ,t, trirts i 0 0 ns 0 PC MA Lat “PAISI ~PM MILAPAMAI Ei ns . 0 to 1441 APA ~Mfl ••001 MLATI01.94, o 'Rf El le ~I nen I. • 5.~ rta$00•00. V« 1.~. /Q CIWIACI IV« • CAS QF •11.0.1 Wc 441.000! W, •I runt 101.• IINSISOOF 10 C•Li 1.W a ris GNO Øla 0« 11.E.W.0 StRICIII Irr f CM ~mor lo ni. .,11., Ro .41- I I ISO r roa 0110 onnis ne« sin ault K AUN't oft la un PnliCIr 111104110•5 r441 X PIOL40 it Fanaf a. nemt Ia/ «NR MUR= IN 01TIER PALM IlEACH COUNTY 3090011k un sona nnicsi i efe6jW0öd n« non, 50 onwoo do4 o.44 n• pre• one NI I «An rin 111 II•ONVATI011 LIIIII n TIM a rtL•alt IV nr1 801 0 Yr 10.110{4 {/ 8 7 out Gummi 'I .ilq FOR OFFICE USE OMS: .11, SZnO11- MG 17191 h1.1 elos .t .u./11. 2002327/ ..1 MI 1110111 041.14‘1 EN 141 COB in Lo 1•111, tör11 E01 4/1 iii1., 41: 06/20/97 Bo. 1.: CO« 421D 1111:41 .0.IFOIAN .41Fr..L:r EN Db POOI lidi OR 14« Csue.prIr 01 IVI 1/FOIIN NO 504 Au «ritninel 01.01011 06.1101 nt! 01.11. ao‘tif +ni trnra0n1,04 On' 0 % G i t 3 4 t. .. 1/0 "-KAI o. a li" 1 i 3 1 O4 1 1 1 , 14:an Jr. idr z rsf 01.(n.11•Tilt. ffininIrnmo. an NIF an CrAn sainA0041. ittOoli• ..... CM-at el li. AICAPA V.C.ø./ .1.0.0.0. C m, ~filt" inFel OD 1114 Ortai CON/1710 Ir FISI« C415 *h !II) ... n EFTA01709904 / fICTUn 3 STUDENTS: o OR e S Cores a ro nes or SILOWS Nes wort. trate* Iro abblar reorer ran r• P• fael. ba to 171 BY 0.• OM Sty., germ: i • te a.. M on.. M ruocrer aceitaariON ........ t.,ass•Not Noe.. Pe cuty a madore ladete • a e . abet b, mnitentotw wo 8/22/94 wows L . I %anew , Lj yysig, no. • TOCO. NO 1751 ylia Dorn 50cox 1 one on 08/22/94 liz coo 421D ay* Inn 02 µ.M.. 31 ft •.:or A yy 208 re town ponceon. 50 KA F $10 V 10 , 0it a, a arson 1 VEST .u:.co tea PALM FL ma 2 IPLEtialknlet Wel trateDel gaga ROYAL PALM 3: AC 1, FL 33411 ...Lir . y'rro . il l......L 33411 mean CrarketOrarr NO al ark .. ro ......r WA( New N TANSI0NWCD. to: N ritsertrer stall 3 • et 0 EN EN US STUDENT INFORMATION (Panned. 0000 note taint-Hon In Ito appropiisby AN Wed take) '1, Ina"'`,.."'l mw Am ec, loan al PriallitanferrObi sr 1•44.1•0:94Is re.iiit re3 trim rr rywr ono ram re no rasa .n IC 'm torn le O= an On DUO. ' VW.'" ' a ' . " Qr." W v" " .“ — — — ...van°. re.. tr - ,, ry.. • nun El .." O I =•= O a Zr.v.,.,c OA =moan Dv, Pr. a • ..c ob OCT Or NM °O. ri a a Mit ' or rglibixho serol 0 • troilitsOon O • an re cerryoN 0 it Okrr C. not (OS 11- FreCCT MA, can. Os TVA an 001.1.... CO wont 03000 aniCT AC DSC, {ditty TIS trintot roy. OM O:OCOPAY I:Ai:inner FtOetS Murry Sena iil B i woe orlon envoys, on TV Fecipal Wary arra and Ow cos I a I my ciders souccion es peonsw n pal or rota by ederril save, ,µ..N Kull.. WIND MO r..!..CO1 V I I O ROM 01.01", ars Pace /iv Sell pognet allenel Alm Ore odes sena' CIS ptarO Wif Chid *mina kdratal 0 t mt. Dar reason,/ 3 a same aic.a• O. Haat., 3 cooraft, 0004 Omar*. D o ow eau •.....0..... ri...... n 5 kr* ...tan, 0.* CAM TRANSFER INFORMATON i• *PAW CV ICHX• nweletiveC WA r- rear. a•Lcomos • •ntOt O..A.S1 roo.a TO ,y.b. ,y LA, ,o..„ort my, y ry,,..........r K. FM Cart ronretO FREE OR REDUCED PRICE LUNCH AND HEALTH INFORMATION pHs.. Hu Hod St se appaess........ to Maw.. R....J...., i st.s, ..I. • r.........wi .... yr sn F..) C) nd (- 1 so ras rear.b• $farcerarO 150 nyrOicrbinvo . in. r................... br.............yory ..— b....err. tn... os......, . • y•••• a "" a ..) a Saul Roast p yyr rar......ar at eon... aryls roars Fern ..... Tars, .asses ....a sun O " a a l ' NEW STUDENTSTO PALM BEACH COUNTY: HONE LANUUAUE SURVEY (To be MIRO out by now Mara ONLY) Tc-i-,,,- --.44 • KT-is T. T.: w••••• ,.. Tn.-, .........,. • a l • • ...owns.. Ts, oar.-. T T•n•—• Ti IS in w vs.. r... ovum o rls ore V as fl yby... *sr 1.00., 0 „ s 0 se en turn anural ato‘ratyrr ore [ryas.. on..., cloCastritr Cris, FOR OFFICE USE ONLY ........aa pa one...run 0 0 CI .0 no Tiwomonwo. 0 0 pat rt.m.4.0'4v on. .....,,t fl aW. Slet .n..•. 0 001,INft unCciNia• C. M.00ONO Din 0 we COMO. s , 1 . • • • r • • r 0 ds 0 rs' . NY ' UM ENTATION CHECK LIST: (CHECK AND DATE WHEN RECOVED) on sauna OM saleaO 0 Yr , Plicarc} MI SCOMIXOLIOK1iY•roiro onind inn tr-i - EFTA01709905 ,,,ATA VERIFICATION FORM ..,--t-* NEW,RVURNING STUDENTS - tEREIGADON EORNELE. 'U HAAR XCE n t C, - TOTER PARENT WERS. AM Hem twe. EX Wwalono ew shaded Soontaw Row w ne ban, ta in aiat na ,,,,, , tti, w an n a , anka a 'ront Ww phew cetna m Re STLOENT INTORVATION• NEER "nM0'aeA' 0°mY Mow LITR W mare lwom G RN 3RENN ty your wean Debet Kata J/lo/G3 5:1 DATA ENTRY COMMIE° BY . O ?sowio O Rev-wg SfArt Caw _ł_ i _ WÓJT. RI SECICENTGO---- 1761 . ENTRY CODE i E01 ENTRY DATE OB/23/93 SAC CODE I MADE LEWE 9.210 01 CALENOA TEACHER It) 01 103 OUR ORMICTCOSE SEY F red SIGGIDAIE I4 EtA-CSINIGICATEFFL/a 1 OF mani BEST PALM FL MRS Z iiiittGAL RWE ALSONIKIKr1AFi ifini fil RGYAL PALM BEACH FL 33411 ' e WJENG AODGESS M ill iMIERI L 33411 Wat MFW N NNWPWATCAGUTODAIRESWITSTSO6 N 3 WM CEDE . SCIWPONCASSESSIGNI A Y WWW GLGROE I WWW SOW, Waro ro N sO. U.S CITLEEN ' OKASCHOOL .US ENTRY DAll (USA) 0 EN Es CAD US STUDENT WORMY/ON Warwa *ow wrIN corectiens h the epseopdele wew lad Sos) ERST PISO KNORR AS itl% SALING AGGRESS OM, STATE N• • NEV STATE W ERCRIT SEGAL *WPM IC. RWE WIONEND. Na ° W." O RMALL NW I WEYWAk raw , ACE san ta NRF O ALAS(Wsuca O D XOEHISFAwC CA PCK WAGER O M HOPa O TE mhesessuac ORE Merl ASAGLIFOADal OYES ONO On EE Ilell RACICY WS( k WENT STAGS 00 MAUI RESEW O i US RISCOIT 1)" os 44 coustur 0 x ICONTIO 4. U 4 MOM CNN OR YEW cn rATE ASTO, CCC< o A. ReseaRywnot Sad r Firet ti D. .......6en man sin. tf EWES MVO Olt n E SaSYAS,0•0160•YerSaar. O B. ,....xpaiła ł 'rw!, Ftą a Sena rd Pe ott d ry REG Rake s en, sapa a wf Nona . Rowed o W w ROOF Nan anet n C. saho lie d a ...gmt d a F. sw anod» awAnweir torcie n lm cipay L n G. Pl•1611%• eol la anno Fenu...non RWPG ROPI CI N. PuNerRakie We Caritas treed G wasi o a I. Ewa 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 FREE OR REDUCED PRICE LUNCH: KlY. YOU f6OCI O/ an 11;0220110ra kent AIOJOKI NCO URM kopiatCs 4 modelem Ma NrOcaxe Fcar) CI IS Ow SCREEN/44 A/CASSIUS/EAT i gon pr imp% lor re, OC *tytym, worn irg inarnnt Sp Or reassert Nie NOS maybe wen SCSYCISSOY X 1.1 70S0 ar TES ONO %MV FLUORU PROGRAM I me worralsr bi reloada wsypo o to Sstsal Novls PIOSCIT MglINini Sili Olaf Porressew vid RW Galen CIES J NO FOREIGN STUDENT INFORMATION: This Illoenudien Is volLertery aru used solely lot th. pumom ol ableinItsd Pewni MI6% diem onln Krowo scum IOC" NEW STUDENTS TO PALMREAOF CORRY ONLY: US WREN OYES Owo NO. CITIZEN OYW Ib ODWIANI IITUDINIVALLIWRIF SCRLISICIOIOMI I 2 3 4 5 6 $ stormsiammin Hat 5Allom Iłom (OzabsommaidelimarolndOming1M61 ' LAMUJCIE SPOCEN oCiget M PmixrolGulavan • s wsuw ero hr Dat OSIO WW\ ' 1WseaabAMse.aPlNa.MEHANN *.Ndste San •••*•••• w. 1wywer tOY, tie (VW, FOR OFFICE USE ONLY: LITW cOo€ mln ads Lc CON )0 Cit MINSPORTMOI OYFS ONE WRIMATIOM Cyder/On WIS o... Woe GM 121456719T A I Z WIX <ADOM TOCHEA %O OISE CATEGORY CIELN O • 2 34 S S DOCUMENTATION CHECKLIST: (Check wee ANN ody aro notheet) I son o skr •sonotore Crf FINSFAAK Otul PFO0FCF 0010:11 M WHAT °SWIPE NAS MC MOM kale flaPY GATT LVSIJ YJIIM teul UNNA/64 IS SPOIN NINE POR rest smar? OAS OC OYES at LIAS o.o yr MORT LARUM( STUDEMTUNOWOJSRODOUNOMOr . E \ EFTA01709906 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. "eAr S DAT! a - ll - ifd MAIM I rA Er :MYl K dlo)/ woo ataiess 0 dint • PATE m WY Foyer ,°alm 80) F1 3.341/ ST ATE 1W .4 Arne. SEE L141.1 Ma JIMENCAM:ACIA1 urea( noon n ii emit n ew wan ' ' al AMMO 1 1 YR SAIL IS 1N STUDENT A SINGLE PARENT? LIntat AMC WES .4 ygr. j ,,,, WRIFICAISOM IIIIIIIIIIIIR PLACE MINIM ill/ Palm Roach F MRS nu A o z ONE COOS Ott.T. d A iefe meeswas Nec R ItywN Ef CA oat j 0 An m to Psi Rory Since a 6 MO Wm Si alert Twine Flcr.-. As ce bros. sag as NMI ty Mises mesa a roe* w stem mem o a E Afi" oan in ier n hi Fall al l re he NN el Any *lift team le mops • RAP 0 0 SIMI amerce mesa 0 we n asde by Semi abide 0 H ea WRNS MS CRAW m imMi .. CI C IWNI NO a adellitan N [bole 0 Ns ] F An a Thiltccli ARgubtal sake ye** ste/ 0 I Enrol E/CRY CODE ENTRY DATE. OUT DER. JAM Ursa CATEGORY: Due I:Imo • M r:: o I 2 3 4 1 6 RESICMT STATUS Us Out ace Q L art CFCCWIT at MIIIIIINT 0 3. MOWN it us IASIVIT 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 EFTA01709907 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‘` EFTA01709908 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/Una= K 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 EFTA01709909 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 h 116 •93 Art AM ~Mc Om balty • OmMem - RUI PIM ▪ OSS amen = arre • Mamma ge Ir Ok I carenn 1111113 Vl plp ■ egel er b en tern doe PIMS VIPOIlt ■ ra ren ene ~ar 32-4 1101C4řa{, 11: tres rre irtie n nam tree Vrhal 48 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 -155~~15~1~ 440 540 440 560 _Le_ a_ s - Lia. S- en ri J • " E r/ r. St u .4 33 B Í n • R A h -en _AL A__./ A. -96-11-48. 44 _ • J r• JI_a_41_1 aa Lm _o_c_ (As _DL N C el m __S_A 6_13. a Via easaixedramothi n do sabel roman eoned raat .„, al ~oma" - r • takeestlim Vco erend p meshe(s). VA meed nam* n queM04(c) inc $00 C 00660. ..trAr*, 9~11 ~ia --Z- 04--•--44; I- -..4--e-ana ▪ . • 1-e -s« A C af /842 cS 0 .4 Cc< n,, C B rn Ap _.L4 D C m Aa ..-11 a st ra c., !! A ing _P e .4 re Geo 0 C E rn Ara- _Jr. a t/ h COO- _.18 E C n aa m tm_ 19A6 n Ad__ geadjaelbe 4_4 _a_Mth_ e heem Crietappe ▪ 0 C m Om • ClI nAla • 116hGee 11 6ChAle $Idkntit0and Ponem« 1 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 MM -Mala MEM ME 450 540 kfeltnelin 98.991 re bi braam eam. 3 ar n are 38 ar2 frt Nti Geo en AM' • Artr 11 Artn en me h Geo h Ar, answered cornet/in DI 40 nath gutntat and MMO 22 prots a ta e='/ cirnonrs st ri ti mam, rpetorn 2 0 . 11 bad gutsten *camera! 1 queatm(t). Vee ~wed nceenctl, ia mients; al kl 4 ro tu). 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 EFTA01709910 Ila COURSE PERFORMANCE Past 430 FINNIE-P21 (continued). Total [repeated 3 times] Corr/Att Percent Enroll IPM Current Course Time ExerCises Correct Level [repeated 3 times] 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 EFTA01709911 6 5 97 7:52am COURSE PERFORMANCE Page 430 FINNIE-P21 (continued) ' Total [repeated 3 times] Corr/Att Percent Enroll IPM . Current Course Time Exercises Correct Level [repeated 3 times] 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 EFTA01709912 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 [repeated 3 times] 36 N/A WE . 2:37 25/38 66 -- -- EFTA01709913 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 [repeated 3 times] 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 EFTA01709914 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 EFTA01709915 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 READING COMPREHENSION 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 Dear Parent/Guardian: 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 EFTA01709916 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 READING COMPREHENSION 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 Dear Parent/Guardian: 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. EFTA01709917 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 READING COMPREHENSION 79 ...man MATH CONCEPTS & APPLICATIONS 39 et. • TOTAL LANGUAGE LANGUAGE MECHANICS LANGUAGE EXPRESSION MAWSW MACCOUt IUMS 1-tr. name= 51.5 PIAMMU U.9 FUUNTUE REHM IDOWIU Dear Parent/Guardian: 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 EFTA01709918 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 READING COMPREHENSION 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 Dear Parent/Guardian: 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 EFTA01709919 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 EFTA01709920 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 From To To From [repeated 3 times] To To TO Change course code From To Reason for change: Micrcalculated Grade Average 0 Student Completed Wm* K Other (.AMM Wow) APPROVAL SIGNATURES (two of three required) sort / sort 01112U00 DAM rumor MWCWA • DESIGNEE sr MTh OP MLA Mittintrit4r01 cunt DATA PROCESSOR CONFIRMATION P3500797 (REV. smaocii) CRIONAL -Cuaularwe Folder 51,44, RAM OF DATA IY eqpy • Orice 4- ia,-61 EFTA01709921 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 OCAll CONCOCT Lith From From )14 inn From To [repeated 3 times] From [repeated 3 times] To [repeated 3 times] Change course code From To Reason for change: 0 Recalculated Grade Avenge K Student Completed Work K Other (noon bekoN 0424.4.4.4... to/ iaab-twit- gh-at- APPROVAL SIGNATURES (two of throe required) -3 ...Stri CATE =Noun OravverA/L • CESGNIE ScnATting v ArcA 0.0“:4971fArCa CUM DATA PROCESSOR CONFIRMATION P08O 0797 (REV. 9/122001) SIOWTIRE Of OITA PlbrrcESSOR ORIGINAL - Cumuatve Folder Copy -Oda Re NYE EFTA01709922 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 [repeated 3 times] Data Runtime: 0413/1,2003 0145293 EFTA01709923 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 ME EV at Z ° MSC Ar" • C-1 oven^ vsks& CHANGE DOCUMENTATION GPADINO POEN WW3E WM CONDUCT yvi oppAE. Oft;ollicsys ro w F To MCI To Z From j ih.3 WIS 0.9 To From To Firm 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 EFTA01709924 Page: 1 Document Name: untitled 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 EFTA01709925 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 [repeated 3 times] Interpretation 24 22 24 Critical Analysis 10 9 10 Strategies 10 6 10 Mathematics Problem Solving 50 . 38 50 Measurement 5 [repeated 3 times] 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 [repeated 3 times] 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 EFTA01709926 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 EFTA01709927 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. EFTA01709928 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 EFTA01709929 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 three- dimensional 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 EFTA01709930 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 : EFTA01709931 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 [repeated 3 times] Interpretation 27 26 27 Critical Analysis 7 [repeated 3 times] 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 [repeated 3 times] 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 EFTA01709932 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 EFTA01709933 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 EFTA01709934 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. EFTA01709935 lilt bUIltJUL. IJI5 I ttIL• I UP 41$ ' 163N 5 I UUCP.' I 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 NPs A NAM CO ALSO XNOWN AS 12/ LOCAL AWNLESS (4) MAILING ADDRESS a m € e . I Pairil ' exteh TL 3sL I ithit, h Nit am. 14 ill IIAI( Kona itIV 11411 1V St (6) ST firs SOCIAL SECURITY NO. I.Ja (OPTIONAL (6) HOME PHONE NO. (71 SEX aitalt I MALE (1) RACE . 0 cofttARLICAVANDIZITC 0 A :ete:t7i:RISLANC CR , were NON•HISAMOC 0 B ittit-HISPANIC 0 H HIPANIC 0 M MULTIRACIAL DATE OF BIRTH 1101 KCE RICH tx PI )ezi Palm eeoeh T1maim Be'etell (TAU MOM (I l) RESIDENT STATUS I 0. FOREIGN EXCHANGE STUDENT 2. OUT-OF-STATE RESIDENT I I. OUT-OF-COUNTY RESIDENT 3. IN-COUNTY RESIDENT (12) ENTRY DATE INTO USA Hsi .. FEDERAL IMPACT AID SURVEY Ii us.. U.10 A. THE STUDENT DYES alio . B. THE STUDENT • I Its 04o C. THE PARENT I TES i340 0. THE PARENT um B40 E. THE PARENT IF TES, RESIDES ON FEDERAL PROPERTT. RESIDES IN LOW RENT HOUSING. IS EMPLOYED ON FEDERAL PROPEATT LOCATED IN IS EMPLOYED ON LOW RENT 'MUSING LOCATED III IS IN THE UNIFORMED SERVICES Of THE UNITED IS THE PARENT ON ACTIVE NUTT? D ID 0 I AIR f ONCE 0 am! 0 COAST GUARD PALM BEACH COUNTY. PALM BEACH COUNTY. STATES. NO g MARINES 0 NATIONAL GUARD I NAVY ' 141 HAS I I THIS CHILD BEER ENROLLED IN ANY PRESCHOOL? . C. CHAPTER a 0. PRE4 DISABILITIES E. PRE•R EARLY INTERVENTION (PLEASE PLACE A CHICKMARK 1 yoM DY EACH PROGRAM WITH AN ASTERISK 1 * ) TM PROGRAM TOUR CHILD I H. HEADSTART I M. MIGRANT PRE-X 0 H. NON-SUBSIDIZED CHILD CARE ATTENDED. ALSO. INDICATE WAS IN THE LONGER II? 0 0. OTHER g S. SUBSIDIZED CHILD CARE LW 19 THE SMUT A SINGLE PARENT? TES gm 116) CURRENT ,1-A. GRADE LEVEE 0 M CITY OR LOCATION Reiff ) Pa Im 8eae_h OM DATE Of LAST ATTENDANCE le IV' (DO) GRADE LEVEL 121) LAST PUBLIC SCHOOL ATTENNE0 IN PALM BEACH COUNTY 4 1\ - • UM NATE ATTENDED A. ION %, (231 RAVE IOU FILLED GUT AN APPLICATION TOR FREE OR REDUCED LUNCH? (APPLICATION IS PROVIDED WIEN THIS REGISTRATION FORM) I TES 01110 1241 SUM SCRIUMISS: I GIVE PERMISSION FOR MT CHILD TO BE GIVEN HEALTH SCREENINGS. THESE TESTS' MAT BE GIVEN INDIVIDUALLY OR IN GROUPS. WEER I NO (261 SODIUM MUORIOt: • ur run vn PWNW An IN THE SODIUM FLUORIDE PROGRAM WM NO EFTA01709936 BACK TRICE or PALM BEACH COUNTY - NEW/RETURNING STUDENTS REGISTRATION DOI STUD [If 4(1 WEE WITH ICKES& I OOHS PARENTS 0 MOTHER 9 TAHITI. 0 SHARED CUSTODY . 7; OTHER • WI TRANSPORTED IV, Stviint 1.41 be I aaaaa Wild lillleee SSW by RWIR a *Wu thta yawl m• (32 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 0R g NO ORDER. MI FATHER/GUAROLAN DOES FATHER RAW CUSTODY? • YES oho ISO MOTHER/GUAROLTA: DOES Tina RAVE CUSTODY? . YES . NO -- ...pat s... WIT e-- Ili 1%/ 1/2 -3-- L 3.19; I Piiii rk -FE_ 33q r. (. 7. .14 1 PI P lil liii. . .. ...l eRoj(Y T CO TOM RAM OI SIQUIriNper igillina ll IIIi.c. OP ••••... RIM eil sega , MI HIGHEST LEVEE OF EDUCATION CORAL 1 P TONAL A0 sown IMIWn r;SP.00i D Clac, FIR r' ::(NRroG A TO I36) HIGHEST LEVEL OF EDUCATION COMPlETIO IOPTMNNAII AO angTilt."`""x E n som moo mom L Kamm. Pou C 0= = D 0 ' MK POST•STISISTAT E 0 Tri7 4.`,":00 --I D X r kwincr„A" E VII0IIIWICRIallt 137) LEGAL GUARDIAN OF AM DOES LEGAL GUARDIAN HAVE CUSTODY/ 0 yEs K NO TO WI ROW SUSS my sy •• t. NS, II J r 3 0tila '.. 4a 4 1301Witic0PW09 'fr et :1 reti.: e';'; :2 .C. ".• • 4 ... (.1:.•V, va EurvoNtse ISO PART h PERSONIS1 OTHER THAN PARENT AUTHORIZED TO PICK UP STUDENT. TM PASSWORD: POI IMPOIROT INKRP I ADDRESS Qh PHONE RELATIONSHIP ( al . tallES. 0 NO ( ADDRESS ef P.6 PROVE =tr17r1C1 RELATIONSHIP ce YES 203 NS) ADDRESS P rohE RELATIONSHIP U LO P 6 3i5-4¢r YES 0 NO • MI NAVE ADDRESS PHONE RELATIONSHIP O ' YES . 0 NO 1441 NAME ADDRESS PHONE RELATIONSHIP PI i—, YES 0 No No) PART II:IF SCHOOL PERSONNEL ARE UNABLE TO CONTACT YOU IN CASE OF ILLNESS OR NEciDENT, mix E EWE YOUR PERMISSION TO CALL YOUR . El YES . 0 No . DOCTOR OR EMERGENCY SERVICES (II U FOR TRANSPORT 10 THE HOSPITAL/ RLIIIII.N.Ita 1551 PHONE NUMSER MN HOSPITAL THRTERRRIA `{Palms Ides4- • ISO/ IF YOUR CHID FERS FROM ANY ILLNESS. *LEWES OR HAS AMY PHYSICAL LIMITATIONS THAT WE SHOULD BE AWARE OF. PLEASE LIST: . • - " 0 SjA 0 411511310 NVILL 1131110 33YRSTIV1 V 11.34S ATINIADIVI Icon mons in $log ON a atn !HMSO NVN1 N3N10 310119411 Anti Y ION DMUS IRA 1300 '1 on "A O 13WOR 341 NI OISII inEWN3 WEI V3B10 391MSNY1 N• El 1 /Mug nvnewn ot, • EIVII50114 1053 HIL 01111 AUNT 10 31V0 In/ tINSONIS NU AO EKON 3111 NI mimes SI 39flISNVI LYNN fa. 1Y1011rro ,o Ulna VII 19 ,11;1• Eqi NI N31041 SI loYONOT ORM (Ea AgiVEMS sovneNvtAINCSAINnoo H0VD8 INTid:Oral.N3GOSA EFTA01709937 RACE: W SE BIRTHDATE: BIRTHDATE: VagBed by Binh Ceniticate: 0 Yes 0 No II No. What Type Verification? BIRTHPLACE: CURR Name Street City SEX: RACIAL/ETHNIC GROUP: O White Not Hispanic 0 Black Not Hispanic 0 Hispanic 0 Arnettan I ncliaiThative Aaskan 0 AslanPadlia Islander Multi Racial STUDENT NUMBER: ADDRESS: (use pencil in this space uniii final ) PHONE NUMBER: (optional) NAME OF EARENT(S) OR LEGAL QUARDIAN OR OTHER RESPONSIBLE ADULT AT HOME: Date First Entered This District &hoot Grade: Schott Grade: Schad: Grade Schaal: Grade: Schcot Grad. Schad Year: IS • Shoat Year 19 • School Year: 19 • School Year. I9 • SchoolYeer. 19 • Days Present Days Meant Days Present Days Absent Days Present Days Absent: Days Present Days Ateent: Days Present Days Absent COPY OF REPORT CARD INCLUDED COPY OF REPORT CARD INCLUDED COPY OF REPORT CARD INCLUDED COPY OF REPORT CARD : INCLUDED COPY OF REPORT CARD INCLUDED INDICATE Administrative Placement (ADMP) Promote (P) Resin (R) Special Session (S$) INDICATE Mmiristrailve Piecemeal (ADMP) Promote (P) Raisin (R) Special Session (55j INDICATE MrenIstratiee Placement (ADMP) Promote (P1 Main (R) Special Session (SS) INDICATE AerninhaeW• Placement (ADMP) Promote (P) Retain (R) Special Session (SS) 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) Special Session (SS) INDICATE Admirisvellvo Placement (ADMP) Promote (P) Ratan (R) Special Session (SS) INDICATE Actrnineeative Placement (ADMP) Promote (P) Retain (R) Special Session (SS) INDICATE AdmInettelNe Placement (ADMP) Promote (P) Rash (R) Special Session (SS) INDICATE AcrnntsvatIm Placement (AIWA') Promo:9(P) Retain (R) Special Session (SS) PESO 0919 (REV. 312(1,97) EFTA01709938 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 EFTA01709939 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 EFTA01709940 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 SCHOOL ATTENDING STUDENT NO. (4040043 GRADE DATE OF BIRTH (52) NAME OF CHILD deg made, !am) SCHOOL ATTENDING 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 EFTA01709941 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 EFTA01709942 • 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 SCHOOL ATTENDING &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 SCHOOL ATTENDING 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 EFTA01709943 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) WEST PALM BEACH 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 EFTA01709944 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 EFTA01709945 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. EFTA01709946 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 EFTA01709947 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. EFTA01709948 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 EFTA01709949 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 EFTA01709950 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) WEST PALM BEACH 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 EFTA01709951 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 WEST PALM BEACH FL 33412 (47) CITY STATE VP COOE WEST PALM BEACH 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 EFTA01709952 tan GRAD: 0 - TE-Tr DATE 4/11/9 14E 8- 8 RICLUO mErnmortvAncm CTES/4 LEVEL 12 FORM A LANEE MADE 'OE 9- 8 PUPA NO CTBS/4 LEVEL 13 'II I IIIM 4)!IIII NAME CODE ARE 1 0— 8 NPLAO 4/ FORM A nn em/I N LEVEL 14 FORM A "" 05 nifun 4 " 11- 8 mmu.,0 mem/mona, CTBS/4 LEVEL 15 FORM B DE WI. 4/ Si m L12- 8 rum,0 INFORWJICH TBS/4 LEVEL 16 FORM A r.cORE TVE met-PER CITIMW aoPE SECAETYPE TEST RECORD INFORMATION Tral: KEAL) !WAIT TUTL -PTATIV.PIAIM — READ. COMP YOGA MATH L84 COMP ai 58 RrAu COMP C&A MAIM LA TaNG m LAMP ECH-EX CANA*PR ti...••••••• TON SCONE • /0. 413 ••• em••• gob. • TOTE -Com 'EWE KtAU Q3 69 „ertolP Q4 77 READ MATH V0€A READ Salta MATH ii" UIMP I i t :TOTE AIN ATH LAMB LAMO S ENCE STUD CI-. 79 Q4 39 Q2 .• aa,••• one " "neEAD..'0 'OIL (hp P • A'MATH Ote TOIL MATH C&A NATH] COMP 'TR ir SCORE W Q3 69 50 Q2 [ FLORIDA COMPREHENSIVE ASSESSMENT TEST ( FCAT SPRING 2003 SUNSHINE STATE STANDARDS STUDENT: GRADE: 10 DISTRICT: SID: Mr SCH001 I= DOB: READING: 362 PASSED MATH: 311 PASSED PBSD0280 01-9330 counc °run Au C11l VJC nuncons. ntomusg LullS 4,0 (a.,...44 1.1IngodrVii. Atekon 4. &Anus IV ;Ann E etintralim SCSMVTL tins tit Car Vac mincien. 'MAIM tin An to NLVJt avotEsinn. ...nu... ....L. IV 3A0n3S 1S0dX1 01 Olen 3A0M38 *IAISNOTV 3soax3 01 saw MOEN .3AIS3HOU ISOdx3 OL e3HI1 3A01130 isirstios3soax3 01 spin 3A0V133 '3AISIHOV 3SO4X3 01 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 VINII 3A0113ti '3AIS3H01/ INDIT3 01 emu 3A0M38 "AMMO( 3SOdx3 01 031111 3A0m38 '3AISINGV 1S0.03 01 031111 3A0r138 IIMS3IED; EFTA01709953 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 . [repeated 3 times] ? 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 /2- / information 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 EFTA01709954 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' EFTA01709955 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/WU= p 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 G/scl• Shoot lin": 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/2= 6OC 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 EFTA01709956 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 EFTA01709957 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 EFTA01709958 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. EFTA01709959 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 Date: 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: Date: 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: EFTA01709960 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 EFTA01709961 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 a0ernative 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. EFTA01709962 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: Date: 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: • Date: EFTA01709963 ..cute 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 EFTA01709964 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‘''"" EFTA01709965 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 EFTA01709966 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 EFTA01709967 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: EFTA01709968 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 EFTA01709969 PICTURE CARD School Tear Grad* Sc ho Year Sch.* Tear Crude First 7 Riddle / 993 - School' Tear (611W5- EFTA01709970 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) EFTA01709971 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 N/A -- N/A N/A -- EFTA01709972