English Language Learners Check-In List

Zebulon B. Vance 2014-2015

English Language Learners Check-in List

Student Name ______Student Id # ______Grade _____

Level of Service
□  Novice / □  Intermediate / □  Advanced
Accommodations / Modifications
□  Regular Testing Without Accommodations
□  Word to Word English/Native Language Dictionary
□  Extended Time ____ minutes
□  Testing in a Separate Room
□  Read Aloud (Student request/everything)
□  Multiple Testing Sessions
□  Other ______
I read and understood the accommodations and modifications that I will be provided. If I need additional help, I understand that it is my responsibility to request additional help as needed.
______
Signature
______
Date / □  Standard instruction without modifications
□  Provide visuals and graphic organizers
□  Question/Sentence starters
□  Group interaction (verbal and written)
□  Simplify language, modify speech, clarify key concepts, sufficient wait time
□  Students repeat key concepts
□  Pre-teach vocabulary
□  Peer support
□  Word Banks
□  Alternative Responses (oral or graphic)
□  Paired oral, visual and written instructions
□  Guided outline
□  Highlight tests and study guides
□  Modify tests (not state tests)
□  Repeated reviews and drills
Access Scores
Listening ______/ Speaking _____ / Reading ______/ Writing _____ / Composite_____
Proficiency Levels
1-  Entering / Knows and uses minimal social language and minimal academic language with visual support
2-  Beginning / Knows and uses some social English and general academic language with visual support
3-  Developing / Knows and uses social English and some specific academic language with visual support
4-  Expanding / Knows and uses social English and some technical academic language
5-  Bridging / Knows and uses social and academic language working with grade level material
6-  Reaching / Knows and uses social and academic language at the highest level measured by this test
Goals (Choose 1 or 2)
□  Exit ELL Status (4 Reading, 4 Writing, 4.8 Overall Composite)
□  ACCESS Score Improvement
□  Improve Grades
□  Attendance
□  Study Skills
□  Social and Personal Goals / Goals Notes:
______
______
______
______

Form Completed by:______Date:______