N O I T A C U D E D E Z I L A U D I V I D N I d u l c n I ) ( : r a e Y l o o h c S M A R G O R P : n o i s s e S Y S E s e . . ) d e d u l c n i e r a s e c i v r e s Y S E f i ) ( k c e h c e s a e l P ( H T N I E C N A M R O F R E P F O Y R A M M U S M A R G O R P L A N O I T A C U D E T N E R R U C E l l o f e h t t c e l f e r d l u o h s e c n a m r o f r e p f o s l e v e L ( e c r u o s e h t g n i t s i l s a l l e w s a , s m e t i g n i w o e d u t s e h t w o h ) 1 : n o i t a m r o f n i e h t f o n i s s e r g o r p d n a t n e m e v l o v n i s t c e f f a y t i l i b a s i d s ’ t n r c s e d d e l i a t e d a ) 2 ; m u l u c i r r u c l a r e n e g e h t t n e r r u c s ’ t n e d u t s e h t f o n o i t p i e h t f o s t l u s e r ) 3 ; h t a m d n a g n i d a e r n i e c n a m r o f r e p v e t n e c e r t s o m r o l a i t i n i ) 4 ; t n e d u t s e h t f o n o i t a u l a s n r e c n o c ) 5 ; t n e d u t s e h t f o s h t g n e r t s e h t e e h t g n i c n a h n e r o f n a i d r a u g / t n e r a p e h t f o n o i t p i r c s e d a ) 6 ; t n e d u t s e h t f o n o i t a c u d r o / d n a , r o i v a h e b , l a i c o s s ’ t n e d u t s e h t f o t w o h t c e l f e r , n e r d l i h c l o o h c s e r p r o F : E T O N . s l l i k s l a n o i t o m e v i t c a e t a i r p o r p p a n i n o i t a p i c i t r a p s t c e f f a y t i l i b a s i d s ’ d l i h c e h ) . s e i t i E C N A M R O F R E P F O ) S ( L E V E L T N E S E R P F O Y R A M M U S . W - 1 N O I T A M R O F N I G N I Y F I T N E D I : e t a D y t i l i b i g i l E l a i t i n I : t c i r t s i D : l o o h c S : e m a N s ’ t n e d u t S : r e d n e G : e c a R : e d a r G : r e b m u N D I S I S M / r e b m u N y t i r u c e S l a i c o S : e t a D y t i l b i g i l E t n e r r u C : r e b m u N e n o h P : h t r i B f o e t a D : y r o g e t a C y t i l i b i g i l E : s s e r d d A : e m a N s ’ r e h t a F : e m a N s ’ r e h t o M : P E I l a i t i n I f o e t a D : P E I l a u n n A f o e t a D Revised July 20, 2009 Page 1 of
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W-2
Revised July 20, 2009 Page of
METHOD(S) OF MEASUREMENT 1. Written Observation 2. Written Performance 3. Oral Performance 4. Criterion-Referenced Test 5. Time Sample 6. Demonstration/Performance 7. Other (Specify)
REPORT OF PROGRESS 1. Not applicable during this grading period 2. No progress made 3. Little progress made 4. Progress made; Objective not yet met 5. Objective met
PROGRESS TOWARD ANNUAL GOAL 1. Anticipate meeting goal 2. Do not anticipate meeting goal (note
reason) 3. Goal met (indicate date)
REASON FOR NOT MEETING GOAL 1. More time needed 2. Excessive absences/tardies 3. Assignments not completed 4. Need to review/revise IEP 5. Other (Specify)
EXPLANATION OF CODING SYSTEM
PHYSICAL LO
BEGINNING/ENDING DATES OF SERVICES: FREQUENCY: PROGRESS TOWARD ANNUAL GOAL:
CATION OF SERVICES: REASON(S) FOR NOT MEETING GOAL: Beginning: Ending:
* Check if objective is a transition activity. (student ages 14-20) W-3a Revised July 20, 2009
SPECIAL EDUCATION SERVICE GOAL
REPORT OF PROGRESS BENCHMARK/ SHORT-TERM INSTRUCTIONAL OBJECTIVE(S)
SPECIAL EDUCATION SERVICE GOAL Student Name: Grade: Subject Area: MEASURABLE ANNUAL GOAL(S)
EXPLANATION OF CODING SYSTEM
METHOD(S) OF MEASUREMENT 1. Written Observation 2. Written Performance 3. Oral Performance 4. Criterion-Referenced Test 5. Time Sample 6. Demonstration/Performance 7. Other (Specify)
REPORT OF PROGRESS 1. Not applicable during this grading period 2. No progress made 3. Little progress made 4. Progress made; Objective not yet met 5. Objective met
PROGRESS TOWARD ANNUAL GOAL 1. Anticipate meeting goal 2. Do not anticipate meeting goal (note
reason) 3. Goal met (indicate date)
REASON FOR NOT MEETING GOAL 1. More time needed 2. Excessive absences/tardies 3. Assignments not completed 4. Need to review/revise IEP 5. Other (Specify)
PHYSICAL LO
BEGINNING/ENDING DATES OF SERVICES: FREQUENCY: PROGRESS TOWARD ANNUAL GOAL:
CATION OF SERVICES: REASON(S) FOR NOT MEETING GOAL: Beginning: Ending:
REPORT OF PROGRESS BENCHMARK/ SHORT-TERM INSTRUCTIONAL OBJECTIVE(S)
T.A. * METHOD(S) 1st 2nd 3rd 4th 5th 6 th
* Check if objective is a transition activity. (student ages 14-20) W-3a Revised July 20, 2009 Page of
Revised July 20, 2009
EXPLANATION OF CODING SYSTEMMETHOD(S) OF MEASUREMENT PROGRESS TOWARD ANNUAL GOAL REASON FOR NOT MEETING ANNUALGOAL
1. Written Observation 1. Anticipate meeting goal 1. More time needed2. Written Performance 2. Excessive absences/tardies
* Check if goal is a transition activity. (students ages 14 – 20)
W –
3b
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6. Demonstration/Performance 3. Goal met (Indicate date) 7. Other (Specify)
3. Oral Performance 2. Do not anticipate meeting goal (Notereason)
3. Assignments not completed4. Criterion-Referenced Test 4. Need to review/revise IEP5. Time Sample 5. Other (Specify)
SPECIAL EDUCATION SERVICE GOAL (NON SCD)Student’s Name:Goal
#MEASURABLE ANNUAL GOALS: Method(s) of
MeasurementArea(s):
Use codeson W-2.
Record the information for the annual goals listed above and record progress Pr AG = Progress Toward Annual Goal R= Reason
Date: Date: Date: Date:on dates mastery reviewed. (If you do not anticipate meeting a goal, note the reason.)Goal
#Beginning/EndingDates of Services:
Physical Locationof Services:
Frequency T.A.Progress Reason Progress Reason Progress Reason Progress Reason*
Revised July 20, 2009
METHOD(S) OF MEASUREMENT PROGRESS TOWARD ANNUAL GOAL REASON FOR NOT MEETING ANNUAL GOAL1. Written Observation 1. Anticipate meeting goal 1. More time needed2. Written Performance 2. Excessive absences/tardies
* Check if goal is a transition activity. (students ages 14 – 20)
W –
3b
Page _____ of _____
EXPLANATION OF CODING SYSTEM
6. Demonstration/Performance 3. Goal met (Indicate date) 7. Other (Specify)
3. Oral Performance 2. Do not anticipate meeting goal 3. Assignments not completed4. Criterion-Referenced Test (Note reason) 4. Need to review/revise IEP5. Time Sample 5. Other (Specify)
SPECIAL EDUCATION SERVICE GOAL (NON SCD)Student’s Name:Goal
#MEASURABLE ANNUAL GOALS: Method(s) of
MeasurementArea(s):
Use codeson W-2.
Record the information for the annual goals listed above and record progress Pr AG = Progress Toward Annual Goal R= Reason
on dates mastery reviewed. (If you do not anticipate meeting a goal, note the reason.)
Revised July 20, 2009
Student’s Name: PARTICIPATION IN STATEWIDE AND DISTRICTWIDE ASSESSMENT PROGRAMS Indicate the type of assessment in which the student will participate (state or district assessments). TYPE OF TEST (SPECIFY BELOW.) Indicate whether the assessment is Grade Level or an Alternate Assessment. Refer to Making Assessment Decisions for Students with Disabilities under IDEA.
Grade level (Circle the appropriate grade level.)*
Mississippi Alternate Assessment of Extended Curriculum Frameworks (MAAECF) for SCD students ONLY (Circle the appropriate grade level.)** Type of Assessment
Elementary Middle Elementary Middle MCT2 Language Arts MCT2 Math MS Elementary and Middle Grades Science Test
Grades 4 & 7 Writing Other (please specify)
SECONDARY ASSESSMENT PROGRAMS (Based on scheduled courses for school year - ) Check the applicable assessment(s)* MAAECF (Grade 12) for SCD students ONLY** Algebra I Mathematics Biology I Science English II English II Writing Language Arts US History from 1877 MS-CPAS *If the student cannot take the grade/course level assessment or grade/course level assessment with accommodations (allowable accommodation or accommodation approved through the petition for special consideration), then explain why the student’s disability requires the administration of a grade/course level alternative assessment and indicate the subject and grade/course level alternative assessment the student will take. **For non-graded students (coded 56, 58, or 78), the peer grades are based on the student’s age as of September 1st of the applicable school year (8 yrs old = grade 3, 9 yrs old = grade 4, 10 yrs old = grade 5, 11 yrs old = grade 6, 12 yrs old = grade 7, 13 yrs old = grade 8, and 18 yrs old = grade 12 [See MAAECF (high school) below]).
NONPARTICIPATION IN HIGH SCHOOL SUBJECT AREA TESTS I have had Mississippi’s assessment system explained to me. I understand that all students will be assessed in some way, but only those students who pass every subject area test and pass the courses will be eligible to receive a regular high school diploma. Signature of Parent: Date:
Page _____ of _____
W -4
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Name: Name: Name: Name: Name: Name: Name: Name:
Special Education Teacher General Education Teacher Agency Representative Parent(s)/Guardian Student, if Applicable Other Other Other
Names and positions of excused IEP Team Members (Documentation must be included in the student’s file.):
Names and positions of excused IEP Team Members (Documentation must be included in the student’s file.):
Date of Meeting: Date of Meeting:
IEP Meeting conducted via alternate means of technology: Video Conferencing Conference Call Other (Specify):
IEP Meeting conducted via alternate means of technology: Video Conferencing Conference Call Other (Specify):
Date copy of the IEP is given to the parent/guardian: Date copy of the IEP is given to the parent/guardian:
Projected date of Review/Revision of the IEP: *Does not require signatures; this section is utilized only to document individuals present at the meeting.
Page of
IEP COMMITTEE MEETING MINUTES
Student's Name:
School:
Committee Members' Signature and Position:
Points of Discussion
Date: Time-From To:
Concerns
Recommendations
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