Teaching and Learning
CCSD School: FORMTEXT ?????School Code: FORMTEXT ?????STUDENT INFORMATION FORMTEXT ????? FORMTEXT ?????Last NameFirst Name FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Grade LevelDate of BirthStudent NumberPlease provide ALL foreign transcripts to the Clark County School District for evaluation of high school credits (grades 9–12).Provide original documents and translations (if applicable) to the registrar who will make COPIES to be attached to this form.Submit ALL documents, foreign transcripts, and applicable translations together for evaluation. Transcripts will only be evaluated once.High school credits are issued for courses completed between 9th and 12th grades. Primary schooling records are not necessary and will not be used for evaluation purposes.Any questions regarding evaluated transcripts must be submitted during the same academic year the transcript was evaluated.The evaluation process should take approximately 1 to 5 weeks. Your school registrar will receive the evaluation results via e-mail.Incomplete forms and/or documentation will be returned to the school registrar. FORMTEXT ?????Parent SignatureDate REF Date \h \* MERGEFORMAT Student SignatureDateCCSD School: REF CCSDSchool \h \* MERGEFORMAT School Code: REF SchoolCode \h \* MERGEFORMAT Student Name: REF FirstName \h \* MERGEFORMAT REF LastName \h \* MERGEFORMAT Student Number: REF StuNumber \h \* MERGEFORMAT Date of Birth: REF DateBirth \h \* MERGEFORMAT List each grade the student has attended in school. Please begin with the first Grade/Year of Elementary.Example Name of InstitutionBenito Juárez PrimaryGrade Level1stAge6City, State & CountryGuadalajara, Jalisco, MéxicoSchool Year2012–2013Name of InstitutionGrade LevelAgeCity. State & CountrySchool Year1 FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????2 FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????3 FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????4 FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????5 FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????6 FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????7 FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????8 FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????9 FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????10 FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????11 FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????12 FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????The student’s placement is temporary until transcript is evaluated.Parent SignatureStudent SignatureParent Phone NumberStudent Phone Number (if applicable) REF Date \h \* MERGEFORMAT REF Date \h \* MERGEFORMAT DateDateProgram and School InformationDid you attend school last year? FORMCHECKBOX No FORMCHECKBOX YesWere you studying English in your last school? FORMCHECKBOX No FORMCHECKBOX YesHow many years have you studied English? FORMCHECKBOX 1–2 FORMCHECKBOX 3–4 FORMCHECKBOX 5–6 FORMCHECKBOX More than 7How proficient are you in speaking English? FORMCHECKBOX I do not speak English. FORMCHECKBOX I speak English at a beginning level. FORMCHECKBOX I speak English at an intermediate level. FORMCHECKBOX I speak English at a proficient level.How proficient are you in reading and writing English? FORMCHECKBOX I do not read and write English FORMCHECKBOX I read and write English at a beginning level. FORMCHECKBOX I read and write English at an intermediate level. FORMCHECKBOX I read and write English at a proficient level.What math classes have you taken? FORMCHECKBOX Algebra FORMCHECKBOX Geometry FORMCHECKBOX Advanced Algebra FORMCHECKBOX Trigonometry FORMCHECKBOX CalculusDuring which school year did you take Physical Education (PE)? FORMCHECKBOX 09th Grade FORMCHECKBOX 1–3 Hours/Week FORMCHECKBOX 4–5 Hours/Week FORMCHECKBOX 10th Grade FORMCHECKBOX 1–3 Hours/Week FORMCHECKBOX 4–5 Hours/Week FORMCHECKBOX 11th Grade FORMCHECKBOX 1–3 Hours/Week FORMCHECKBOX 4–5 Hours/WeekTranscript(s) Provided to School Registrar (Check all that Apply):9th Grade Student10th Grade Student11th Grade Student12th Grade Student FORMCHECKBOX 8th grade transcript FORMCHECKBOX 9th grade transcript FORMCHECKBOX 09th grade transcript FORMCHECKBOX 09th grade transcript FORMCHECKBOX 10th grade transcript FORMCHECKBOX 10th grade transcript FORMCHECKBOX Unable to obtain ALL transcripts FORMCHECKBOX 11th grade transcript FORMCHECKBOX Unable to obtain ALL transcript ................
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