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STUDENT INFORMATION NM PED AdoptedStudent Name:High School Entry Date:Student State ID Number:Target Graduation Date:Student Email Address:Course of Study:BirthdateAgeCheck those that apply: 504 Plan FORMCHECKBOX IEP FORMCHECKBOX ELL FORMCHECKBOX SAT FORMCHECKBOX Grade Level:9th FORMCHECKBOX 10th FORMCHECKBOX 11th FORMCHECKBOX 12th FORMCHECKBOX 13th FORMCHECKBOX 14th FORMCHECKBOX 15th FORMCHECKBOX 16th FORMCHECKBOX School Designee:Date Initiated:1/11/2016CAREER GOALPERSONAL GOALPOST-GRADUATION GOALWork Full-Time: Yes FORMCHECKBOX No FORMCHECKBOX Career Cluster: Work Part-Time: Yes FORMCHECKBOX No FORMCHECKBOX Enter the Military: Yes FORMCHECKBOX No FORMCHECKBOX Occupation:Apprenticeship: Yes FORMCHECKBOX No FORMCHECKBOX ACADEMIC GOAL2-Year Training: Yes FORMCHECKBOX No FORMCHECKBOX Occupation Skill Sets:2-Year Degree: Yes FORMCHECKBOX No FORMCHECKBOX 4-Year Degree: Yes FORMCHECKBOX No FORMCHECKBOX Undecided: Yes FORMCHECKBOX Wage Info:FAMILY AND COMMUNITY SUPPORT SYSTEMSNotes:Occupation Demand: EXTRA HELP STRATEGIES (Extra Assistance)ACADEMIC ENHANCEMENT OPTIONS/Scholarship Requirements EXTRA/CO-CURRICULAR ACTIVITIESPOSTSECONDARY/CAREER ENHANCEMENT OPTIONSINDUSTRY CERTIFICATION GOAL ATTACHMENTSWhat industry certification will be pursued FORMCHECKBOX Interest Inventory FORMCHECKBOX Transcript FORMCHECKBOX Degree RequirementsTarget Date for Completion: FORMCHECKBOX Assessment Results FORMCHECKBOX Semester Schedule FORMCHECKBOX Course Credit Check Certification Completed: Yes FORMCHECKBOX No FORMCHECKBOX Met Standard Yes FORMCHECKBOX No FORMCHECKBOX FORMCHECKBOX Transition Assessment (required for students receiving special education services) FORMCHECKBOX Other: PROGRAM OF STUDY:(Name)Diploma Options (Students with Disabilities):Standard Diploma FORMCHECKBOX Career Readiness FORMCHECKBOX Ability FORMCHECKBOX (INSERT SCHOOL LOGO)9TH GRADE10TH GRADE11TH GRADE12TH GRADECourse NameCodeCourse name CodeCourse Name CodeCourse Name Code State of New Mexico Graduation RequirementsMathematics English Language ArtsSocial StudiesScience Physical EducationCluster/Workplace/Language Health Education School District Graduation RequirementsCareer Pathway Requirements/Elective General ElectivesCourses Required to be RepeatedMandatory AssessmentsOptional Assessments Codes:Advanced Placement = APDistance Learning = DLInternational Baccalaureate = IBOther:Dual Credit = DCHonors Course = HCOnline Line Class = OLOther:(INSERT STUDENT NAME and ID)2 year – College or Program Name:Degree Name /Training Program:4 year University Name: Degree Name:Year 1Year 2SummerFallSpringSummerFallSpringGeneral Education Requirements for the POS/Degree/Training PlanDegree/Training Emphasis Courses (Major)ElectivesOf the courses listed above, highlight those that are transferable to any other NM public higher education institution. State law at Section 21-1B-1 to 6 NMSA 1978, directs the New Mexico Higher Education Department to establish policies designed to allow core courses successfully completed by students at New Mexico public higher education institutions to guarantee transfer to any other New Mexico public higher education institutions. The listing of transferable courses can be found at . Next Step Plan Signature Page (INSERT STUDENT NAME and ID)We have reviewed and approved this Next Step Plan (Legal Guardian may be substituted for Parent where applicable)Parent Name:Phone Number:Email Address:Entering 9th GradeEntering 10th GradeEntering 11th GradeEntering 12th GradeStudent Signature Date Student Signature Date Student Signature Date Student Signature Date Parent Signature DateParent SignatureDateParent SignatureDateParent SignatureDatePrint Parent NamePrint Parent NamePrint Parent NamePrint Parent NameParent Signature DateParent SignatureDateParent SignatureDateParent SignatureDatePrint Parent NamePrint Parent NamePrint Parent NamePrint Parent NameSchool Official Signature DateSchool Official SignatureDateSchool Official SignatureDateSchool Official SignatureDateComments (Entering 9th Grade):Comments (Entering 10th Grade):Comments (Entering 11th Grade):Note: Review the attached Final Next Step Plan at this time in preparation for the senior year). Comments (Entering 12th Grade):*POSTSECONDARY INSTITUTIONS TO CUSTOMIZE THIS PAGEFinal Next Step Plan To be completed by all exiting Seniors (INSERT STUDENT NAME and ID )Select the option(s) you plan to pursue after graduation. Note: Use additional pages to address plans of action and follow-up.Program OptionsProvide information about your selections under Program Options.Signatures below confirm review and approval of this Final Next Step Plan. Bachelor Degree Program:Student Applied Yes FORMCHECKBOX No FORMCHECKBOX If no, include a plan of action.Student Admitted Yes FORMCHECKBOX No FORMCHECKBOX Name of Degree Plan Student SignatureDateName Public College/University Name Private College/University Parent SignatureDateAssociate Degree Program: Student Applied Yes FORMCHECKBOX No FORMCHECKBOX If no, include a plan of action.Student Admitted Yes FORMCHECKBOX No FORMCHECKBOX Name of Degree Plan School DesigneeDateName Postsecondary institution Trade Certification Program :Student Applied Yes FORMCHECKBOX No FORMCHECKBOX If no, include a plan of action.Student Admitted Yes FORMCHECKBOX No FORMCHECKBOX Notes:Name of Certificate program Name of Training Institution Military Service:Student Applied Yes FORMCHECKBOX No FORMCHECKBOX If no, include a plan of action.Student Admitted Yes FORMCHECKBOX No FORMCHECKBOX Branch Work Study/Apprenticeship Program:Student Applied Yes FORMCHECKBOX No FORMCHECKBOX If no, include a plan of action.Student Admitted Yes FORMCHECKBOX No FORMCHECKBOX Career Area of Focus Employment:Student Applied Yes FORMCHECKBOX No FORMCHECKBOX If no, include a plan of action.Student Hired Yes FORMCHECKBOX No FORMCHECKBOX Career Area of Focus Has the student applied for financial aid/scholarships?Yes FORMCHECKBOX No FORMCHECKBOX Include a plan for necessary follow-up:Has the student applied for campus (or other) housing?Yes FORMCHECKBOX No FORMCHECKBOX Include a plan for necessary follow-up:Has the student arranged transportation? Yes FORMCHECKBOX No FORMCHECKBOX Include a plan for necessary follow-up: ................
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