Example: Title I Student Selection Process Worksheet ...
TITLE ISTUDENT SELECTION PROCESS WORKSHEETREADING/LANGUAGE ARTS AND MATHSchool _ABC____Teacher ___Mr Learning______________Grade __4___ Room __210 _ Date _12/01_Completed by _____Mr Learning__________________Check Only One:Reading/Language Arts ______ Math __X__STUDENT SELECTION PROCESS CRITERIA OPTIONS:___ISTEP/CTBS Total Reading6. ___Curriculum/Standard Based Assessment_X_ISTEP/CTBS Total Math7. ___Teacher input (Grades K-2 only)___NWEA Reading8. ___DIBELS___NWEA Math9. _X_Other Assessment: 4th Grade Benchmark___Lexile Range10. ___Other Assessment: _________________Your school must keep official copies of this documentation for federal audit purposes.STUDENT SELECTION PROCESS CRITERIA OPTIONS:___ISTEP/CTBS Total Reading6. ___Curriculum/Standard Based Assessment_X_ISTEP/CTBS Total Math7. ___Teacher input (Grades K-2 only)___NWEA Reading8. ___DIBELS___NWEA Math9. _X_Other Assessment: 4th Grade Benchmark___Lexile Range10. ___Other Assessment: _________________Your school must keep official copies of this documentation for federal audit purposes.DateStudent’s NameCriteria# __2_Criteria# _9__AlternateCriteria # ____TOTAL RANKCheck (√ ) if participatingReason for not receiving Title I ServicesDataRankDataRankDataRank11/15Student A39%140%12√11/15Student B70%260%1311/15Student C78%360%1411/27Student D17%10%12√11/28Student E98%599%510-463550406400All students in the building with a Total Rank of 1 must be selected before any student with a Total Rank of 2. All students in the building with a Total Rank of 2 must be selected before any student with a Total Rank of 3, etc... 00All students in the building with a Total Rank of 1 must be selected before any student with a Total Rank of 2. All students in the building with a Total Rank of 2 must be selected before any student with a Total Rank of 3, etc... ................
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