EFTA01246761.pdf

Vaia THE SCHOOL DISTRICT OF PALM BEACH COUNTY Elementary Student Transfer To Be Completed for All Transfers (Print or Type) Psychological on file Yes Li No Copy of form attached Yes O N/A EL. Physical Exam on file Yes No Cl Date Sifq)q 3 Immunization Dates: ..54*DPT g'1410 MMRa - shq/93 Health Problems/High Risk Yes U N/A "ant .41611Ge-x., Avezvviti • 64/- bag -Soh scimuTh ltesstedA-c-ts, teter-e-nAtit-ti-- PAxi mted - 6.1f-sezn- nix" 17-7.557 W. hiat. eii,a- EL .0 IA/. 12 ,412. -16truit As. _P5Of 4 REGULAR INSTRUCTION PROGRAM INFORMATION Copp of Report Card Method Teacher Name(s). r ename A 09. i)-itt Instructional Materials (indicated level) GRADE KG 1 2 3 5 PAGE Mathematics KG 1 2 3 rti C. 5 Level Level Level Level LeveUeyfi l9 Level Macmillan O fiedfA I ,,, i . L. r iceekSu-5r4 Reading FOCUS O / r i-i Teter%I.- r 9 .0- Other ei / 8,14 Maid; e Student meeting Pupil Progression Standards Yes No O /Student currently repeating grade ... Yes O No a. Pupil Progression Letter sent Yes O No Wei , School Patrol Yes O No IL Letter signed Yes O No Ore Workbooks sent with student Yes O No ILS Disk Yes O No OW SPECIAL INSTRUCTIONAL PROGRAM INFORMATION student is in special Program (drcle) EH LAD Speech Alt. Ed. Migrant Current-. Date N/A ta, EMH SEH SOI ESOL 504 Staffing/Testing in Progress Gifted SLD VE Chapter 1 Other (name program) OBLIGATIONS FULFILLED Textbooks returned Yes CV No O Library books etumed ....Yes No O ITCCAnd7e)(1 198 Ocnc'Eg. TIAGEsts PEW 0938 (REV 8/99) alAtAvilh sluded vaLOwisen ng school office PiNKtcumdative folder MMUS-M LIL.A I A-UU0U /0 3501.135-025 CONFIDENTIAL Page 1 of 1 EFTA_00066395 EFTA01246761