THE SCHOOL BOARD OF BROWARD COUNTY, FLORIDA



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TITLE I, PART A STUDENT ELIGIBILITY CHECKLIST FOR GRADES 3-5

School:      

Teacher:       Year of Service: 2019–2020

Student:       Grade:     

Complete the information below regarding the student’s performance in Reading and/or Math. Each description must be rated.

Enter a “1” for descriptions that apply and “0” for descriptions that do not apply to the student. A total score of 5 or more will qualify a student for services in the content area.

|READING |Rating |MATH |Rating |

|Classroom performance is below grade level |  |Classroom performance is below grade level |  |

|Inability to decode phonetically regular multisyllabic words. (Example: |  |Demonstrates poor understanding of place value; Unable to write numbers both in |  |

|Abracadabra) | |numerals and words | |

|Limited understanding of antonyms, synonyms homophones, and homographs |  |Struggles to order and compare numbers for grade level |  |

|Struggles with differentiating between different literary genres such as |  |Lacks ability to understand algebraic concepts |  |

|fiction and nonfiction | | | |

|Shows inability to draw conclusions or identify main idea based on a reading |  |Weak understanding of number patterns; Unable to count by skip count |  |

|passage | | | |

|Word structural analysis is below grade level |  |Knowledge of measurement is low |  |

|Limited ability to properly use grammar in written sentences such as periods, |  |Lacks ability to conceptualize the 4 basic operations in mathematics |  |

|question marks, commas, and apostrophes | | | |

|Weak understanding of common prefixes and suffixes |  |Weak in understanding geometric concepts |  |

|Shows weakness in following multistep oral and/or written directions |  |Poor ability to solve word problems |  |

|Writing ability is below grade level |  |Estimation skills are below grade level |  |

|Total Score |  /10 |Total Score |  /10 |

Developed by Catapult Learning in conjunction with HISD

Principal’s Signature

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