EFTA01709707

EFTA01709707 EFTA01709708 Spring 2003 FLORIDA COMPREHENSIVE ASSESSMENT TEST (FCAT) READING SUNSHINE STATE STANDARDS PERFORMANCE TASKS Student Report IZZ=1=E3 Grade 10 This report provides your results on the FCAT 2003 Reading FCAT 2033 performance tasks. Each performance task on FCAT requires you READING PERFORMANCE TASKS to respond with either a short response or a longer, more detailed response. Short-response tasks are scored on a 2-point rubric and extended-response tasks are Sawed on a 4-point rubric. Student Name One of the short-response tasks is shown below with a Copy Of Student Number your answer. The number of points you earned for your answer is School Name ShOwn in the box to the right. School Number District Name This task required you to read a passage about an American District Number zoologist's attempts to rehabilitate two young gorillas in Africa. All Reading Describe how Coco and Pucker change as a result of their This Performance Performance Task Task Response Responses experience with Dan Fossey. Use details and informatiOn from the story to explain your answer. Points Possible 2 12 Points Earned eah Cao-racurRns wev wccit-r Saiveds att 63 Ot. reSUR bF their ressyJi -may nealinr10 -Mei( -Per OP- YlutraYIS ,Don SI*RM(oriociA kfnit.ucc- -Mod rip mitem-t- -VOW May pexv Pj C isiWYtag viedtakti01- ThiCitXp heir Ondfro WAN TRIC.O M161 4-nlsk. Data Run Date: 05/07/2003 0084103 853200565 EFTA01709709 Spring 2003 FLORIDA COMPREHENSIVE ASSESSMENT TEST (FCAT) FCAT Ibrz.,(c,?reens if Anwar -T1(.0 MATHEMATICS SUNSHINE STATE STANDARDS PERFORMANCE TASKS Student Report Grade 10 This report provides your results on the FCAT 2003 Mathematics FCAT 2003 performance tasks. Each performancetask on FCAT requires you MATHEMATICS PERFORMANCE TASKS to respond with either a short response or a longer, more detailed response. Short-response tasks are scored on a 2-point rubric and extended-response tasks are scored on a 4-point rubric. Student Name One of the short-response tasks is shown below with a copy of Student Number your answer. The numbe-r of points you earned for your answer is School Name shown in the box to the right. School Number District Name District Number This Performance All Mathematics Performance Task Task Response Responses Points Possible 2 16 Points Earned The students in the senior class al Paradise Island High School have decided to raise money by selling graphing calculators and geometry tool kits. They have set aside 5.3,000 to purchase the items they need to sell. They will spend 575 for each calculator, and 520 for each tool kit. From past experience, they know that twice as many students will buy the calculators as will buy the tool kits The inequality and equation below can be used to determine the number of each nem the senior class should have available to sell, where c is the number of calculators and t is the number of tool kits. 75c t 20t sa 3,000 c = 2t How many tool kits should the senior classc put o chase' Show your work. • 30no Li,oc_6, /‹.0brzsct) Ze-0 -aO&l< 3O0O 0, Number of tool kits 17 20 (Dab Data Run Date: 05/07/2003 0084104 854200209 EFTA01709710 STUDENT HEALTH EXAMINATIONS Date Ft. I N..•n,. Phone Race Birthdate School A. HEALTH EXAMINATION Hecht Weight Blood Pressure (✓)N_ormal•N; Abnormal•A N A COMMENT: Abnormal Findings, by number 1 Appearance 2. Skin/Nose 3 Head/Scalp Eyes 5. Visual Acuity IR b U 6. Ears, 7 Auditory Acuity (R 8 L) 8. Nose 1 Throat 9. Mouth. Teeth and Gums 10. Chest / Lungs 11 Heart 12. Abdomen 13 Genitals and Anus 14. Musculo-Skeletal 15 Neurological 16 Alertness 17 Emotional / Mental/ Behavior Prot 18 Handicap. physical/ other (Specify) 19. Activity Restrictions (Specify) 20. Abuse. substance/ Physical / emotional 21 Nutntion 22 Other B. HEALTH HISTORY (Serious Illnesses Inures explain) (attach narrative it additonal space needed) C. I ARARATARY Ina inelinlaelli type date Tuberculin test e Sickle Cell result NAME: TITLE: ADDRESS: (Please Print) r-rdl- Authorized Signature-- Date OH 3040. 10116 (lieplooli 14R5-14 Form 3040 which easy be used) Mock Plumbot. 5744400.3040-2) EFTA01709711 FLORIDA CERTIFICATION OF IMMUNIZATION Legal Authority: sections 232.032, 402.305, 402.313, Florida Statutes; rules 64D-3.011, 65C-22.006, 65C-20.011, Florida Administrative Code LAST NAME FIRST NAME MI 4:10B NIO/DAJYR PARENT OR GUARDIAN CHILD'S SS# (optional) STATE IMMUNIZATION ID#1 Directions: • Enter all appropriate doses and dates below. • Sign and date appropriate certificate (A-I, A-2, B, or C) on reverse side of form. • If the child is presenting for the 7th grade requirement only and has previously filed a Certificate of Immunization (DH 680, Part A-1) with their current Florida school, fill in boxed areas below and complete Part A-2 on the reverse side of this form. • For additional information: See Immunization Guidelines for School and Child Care Facilities for information and instructions on form completion and immunization requirements. Guidelines are available from the local county health department. VACCINE DOE Dose I Dose 2 Dose 3 Dose 4 Dose 5 CODE MO/DA/YR MO/DA/YR MO/DA/YR MO/DA/YR MO/DA/YR DTaP/DTP2 A DT3 Td' PoHod HIV MMR (Combined) (Separate G, H, I Hepatitis B9 Varicella1 ' Varicella Disease L 1 The state immunization ID# is an identifier supplied by the state immunization registry (optional). 2 DTP/DTaP 5 doses required. If the 4th primary dose is administered on or after the 4th birthday a 5th dose is not required. 3 DT (pediatric) is acceptable if pertussis vaccine is medically contraindicated. (Complete Part C for pertussis contraindication.) 4 Td (adult) vaccine is recommended for children 7 years of age or older. S Polio 4 doses required. If the 3'd dose in an all OPV or all IPV series is administered on or after the 4th birthday, a 4th dose is not required. Polio vaccine is not required for children 18 years of age or older. 6 Hib is required for child care, family day care and preschool entry and attendance only. 7 First dose valid if given on or after birthday. Second dose (measles) valid if given at least I month after l" dose. A 2"1 dose of measles (preferably MMR) is required for students in grades K-6 and 7'th grade entry and attendance effective with the 1997/1998 school year. In each subsequent year thereafter, the next highest grades arc included. S Includes single measles vaccine (G), single mumps vaccine (H) or single rubella vaccine (I). 9 Hepatitis B vaccine series is required for 7th grade entry and attendance effective with the 1997-1998 school year and kindergarten entry and attendance effective with the 1998-1999 school year. In each subsequent year thereafter the next highest grades are included. Hepatitis B vaccine series is required for preschool entry and attendance effective with the 2001/2002 school year. 10 Varicella vaccine is required for entry and attendance in preschool and kindergarten effective with the 2001/2002 school year. In each subsequent year thereafter, the next highest grades arc included. Susceptible children 13 years of age or older should receive 2 doses, given at least 4 weeks apart. Varicella vaccine is not required if child has documentation of history of varicella disease. EFTA01709712 LAST NAME FIRST MI DOB (MO/DANR) Certificate of Immunization for K-12 Excluding 7th Grade Requirements PART A-1 (immunizations are complete for school entry and attendance grades kindergarten through 12 with the exception of the 7th grade requirement.) DOE Code i I have reviewed the records available, and to the best of my knowledge, the above named child has been adequately immunized against diphtheria, tetanus, pertussis, polio, measles, mumps, rubella and hepatitis B (for kindergarten effective with the 1998/99 school year) and varicella, varicella vaccine not indicated if history ofdisease either physician documented or parental recall or kinde :anen elective with the 2001/2002 school year)for school attendance as documented on the reverse side of this form. Physician or Clinic Name: Physician or (Print or stamp) Authorized Signature Address: Date: Certificate of Immunization Supplement for 7th Grade Requirement PART A-2 (Immunizations are complete for students who enter or attend the 7th grade after the beginning of the 1997/98 school year. Each subsequent year thereafter. the next highest grade will be included in the requirement.) DOE Code 8 I have reviewed the records available, and to the best of my knowledge, the above named child has received the following immunizations requiredfor entry and attendance in 7th grade effective with the 1997/98 school year: tetanus-diphtheria booster, hepatitis B vaccine series, and second dose ofmeasles vaccine as documented on the reverse side of thisform (boxed areas). Physician or Clinic Name: Physician or (Print or stamp) Authorized Signature: Address: Date: -3 Temporary Medical Exemption PART B (For children in child care, family day care, preschool and grades kindergarten through 12 who are incomplete for immunizations in Part A-I or A-2.) Invalid without expiration date. DOE Code 2 1 cerrifi, that the above named child has received the immunizations documented on the reverse side of thisform and has commenced a schedule to complete the required immunizations. Additional immunizations are not medically indicated at this time. Physician or Clinic Name: Expiration Date: (Print or stamp) (t5 days after next immunization appointment) Physician or Address: Authorized Signature: Date: Permanent Medical Exemption PART C For medically contraindicated immunizations, list each vaccine and state valid clinical reasoning or evidence for exemption: DOE Code 3 I cent& that the physical condition of this child is such that immunizations) as indicated in Pan C above is medically contraindicated. Physician or Clinic Name: (Print or stamp) Physician Signature: Address: Date: DII 450, Pd2000, obsoletes whet canons (Stack Number 5740 MI 01e^ 1) EFTA01709713 THE SCHOOL DISTRICT OF PALM BEACH COUNTY (SDPBC) 4.7,jaWIMT:t New and Returning Student Registration NEW STUDENTS: Complete all non-shaded areas on both sides of the form. RETURNING STUDENTS: Review botlisides. If the pre-printed information is incorrect, correct the Information by carefully and lightly crossing out the incorrect information and writing the correct information above it. • Ica • (haw) (r.1, cos) (6) MAILING ADDRESS (nouso no. a neat nem.) Opt_ nal (nth RoYAtAim 457itel Istata) pi .3till (z* code) . (9)SEX (10) RACEETHNIC ORIGIN (apobna) 1-American Indian/Alaskan Native O 0 A-Asia - on-Hispanic O H-Hispanic O Islander Non-Hispanic O M-Mularacial 0 0 DATE OF BIRTH (12) PLACE OF BIRTH (S)/sralotounliy) (13) RESIDENT STATUS (14) USA ENTRY DATE (MMODAYTY) O O. Foreign Exchange Student a Sli . O 1. Out-of-county Resident .., Out-of-state Resident O_ 2 (15) FEDERAL IMPACT SURVEY OJ 1. In-county Resident YES NO (16)PFIESCHOCI. ENROLLMENT INFORMATION ' O O A. The student resides on federal property. Place an X by each program attended Also. indioste with O O B. The student resides in low rent housing. an asterisk(*) theprogram your child was in the lonast. O (7 C. The parent is employed on federal property located in Palm Beach County. 0 N. Non-subsidized Child Care O M. Migrant Pre.l< • O D. The parent is employed on low rent housing located in Palm Beach County. O D. Pre-K Disabilities . O H. Headstart O O E. The parent is in the uniformed services of the United States. O I. Pre-K Early Intervention O C. Chapter 1 O S. Subsidized Child Care O O. Other. O O If E. is YES, is the parent on active duty? Check service below: . (17) is THE STUDENY A (18)CURRENT GRADE LEVEL • Air Force O Army O Coast Guard O Marines O National Guard O Navy .. -.,,.-. EYES SINGLE P N , ef 14 TARN .. . (19) NAME OF SCHOOL TRANSFERRING FROM. (20) CI1Y OR LOCA1:09 . (21) LAST A N:TANCE DATE (22) LAST GRADE LEVEL (23) LAST PUBLIC SCHOOL ATTENDED IN PALM BEACH COUNTY (T4) CATE Al TENDED IN PDC, C E Etti!„ . 07„6661, . . . , (25) Students will receive non-invasive health screenings pursuant to Florida Statute § 381.0056(7)(d). Non-invasive RIC .0/1 • screenings may include vision, hearing, scoliosis, height, and weight. These tests may be given individually or in groups. Parents or guardians, however, have the right to request an exemption in writing. It you DO NOT want (27) LI:g eyalaIn l oBrVg 1d an your child to receive the.screenings, write the words "Do not screen" here: reduced lunch? (This exemption will cover all types of screenings) O YES laie15- (26) I give permission for my child to participate in the sodium fiouride program to prevent tooth decasEVIESO N r (Application is ptbvided (Permission is valid through 6 grade) with this form PAVOIMPOINAZAIAMEACitgq. 0,14 itItit&e,t, A ,y,t (28) HOME LANGUAGE SURVEY YES N± :),,/ O ri ff s..Is a language other than English used in the home? If YES, what language? O 8 ..-2. Does the student have a first language other than English? If YES, what language? O B '2.3. the student most frequently speak a language other than English? ? If YES, what language? ? (29) 4. What language is spoken in the home by the parent or guardiap? 5i< (30) 5. What language is the student's first language? Ch./Erb S 4 . (32) STTENT IJVES WITH: kitedcone) (31) What is the date of entry into an ESOL program? V2 MotherO Father O Both Parents (33) DISCLOSURES FOR ENTRY INTO PBC SCHOOL DISTRICT VOtper ‘ 214t sbPstiCEWKS YES 14)," (34)CUSTOOY STATUS OF STUMM' i thedrone) O 4 . _A. Has the student ever been expelled from school? O ril i 2. Has the student ever had an arrest resulting in a charge? O Mother O Father V Shared Custody O NY 3. Has the student ever had any juvenile justice actions? O Other • (35) Is there a court order barring either parent from removing or contacting the student during the school day? O YES .NO If YES, provide the school with a copy of the court order. - ' PBSD 0636 (REV. 4/6/2001) page 1 of 2 EFTA01709714 THE SCHOOL DISTRICT OF PALM BEACH COUNTY - NEW AND RETURNING STUDENT REGISTRATION (36) FATHER OR LEGAL GUARDIAN 031st mkIdle Alia( Ms° (37 ADDRESS (SOW nomboS 7-4" 94 4:1311Tvnlixdpber) IIIIIIIIIIIIIIIIIM CITY STATE ZIP CODE CITY STATE ZIP CODE , • . .4y#6_ pAhn Se:i/g4- a s tym • . ..__. , OCCUPATION GC-CUPKTION ' ' ' • 1 \ /(Er Fl EMPLOYMEN'T IIIIIII HOME TELEPHONE BUSINESS TELEPHONE CELIWAGER NUMBER HOME TELEPHONE BUSINESS TELEPHONE • •.• . . . EMAIL ADDRESS (opfkaa0 EMAIL ADDRESS (axis* Ngigq..kraWatt4. 1W. a ialici rlifiaggean4cVnt it eitt. W4*.Staitl •.. Person(s) other than parent authorized to pick up student (36) PASSWORD pin 10 tbarsderl) NAME Crs( =doe Wig. fast (41) NAME PIA middle Ms,. MR) ADDRESS (street Jxe er, excel. 40401990199:0590 • ADDRESS (shoot number, street oporfmeof number) STATE ZIP CODE CITY STATE DP CODE • ilfr& Alin A:9mA H 3.50-ac (40) AUTHORIZED FOR TELEPHONE RELATONSHIP (42) AUTHORIZED FOR • T rzow ile"SHIP IMENENCY PICKUP EMERGENCY PICKUP U! .1ES • NO 0 YES • NO (43) If school personnel are unable to contact you incase of illness or accident. (44) MEDICAL INFORMATION five student'anossos, bohanior. health Aso s. artergs, mediations or ortfor physkod NostoCons) may we have your permission to call your doctgrkir, I • .... • % . emergency stivices 011) for tranSporloto the hospital? Bla 0 NO (45) FAMILY PHYSICIAN (413) PHYSICIAN PHONE µe7 Does your child currenV have health insurance? BYES 0 NO If YES, indicate: (07) HOSPITAL PREFERENCE . 0 Medicaid airivate 0 Healthy Kids/Kid Cam 0 Interested in receiving information eittiS •i p ER, tpl.PeEtliii,„_, ,,,,,_ cfrk oil _ ,§q.,pp 73, (49) NAME OF CHILD (fast k( mktile MN) SCHOOL ATTENDING STUDENT NO. (opOona9 GRADE DATE OF BIRTH (50) NAME OF CHILD (toss finds,* irMY80 SCHOOL ATTENDING STUDENT NO. (ackonal) GRADE DATE OF BIRTH (51)NAME OF CHILD (lost Eras mickne Mal) SCHOOL ATTENDING STUDENT NO. (optional) GRADE DATE OF BIRTH (52) NAME OF CHILD (fast Erg mktila Coda.) SCHOOL ATTENDING STUDENT NO. (optional) GRADE DATE OFBIRDI ( PARENT/GUARDIAN SIGNATURE Iiiiitikirg laKSWE I verify that the information given is true and accurate to the best of P:A? my knowledge. ,... ,,.. , adyra.%,„,..!, „... ?,&.,„„;, v-nk , k•:!: . . isinvEr co;pkaniaatrace....swato ,5"titiiiilai 41.a*I.104:.,rrrol Faisaggigh . ca e a.S..4S r.,.>,.' • daia zgEtiiit it "i: nilLi; hts ita Ms OSk•rS .4. ." ; f me -.,. ,it.v .... •, ' .Vrt " ' Atrn.MF 'I'''. SIGNATURE OFPARENT/G DATE r'hs *VA " PBSD 0636 (REV. 4/6/2001) EFTA01709715 (1) STUDENT NUMBER (2) SAC CODE (3) GRADE LEVEL 4)- .1OOL Oa's% THE SCHOOL DISTRICT OF PALM BEACH COUNTY (SDPBC) • No New and Returning Student Registration 12 yea/tip NEW STUDENTS: Complete all areas on both sides of the form except areas specified. RETURNING STUDENTS: Review both sides. II the pre-printed information is incorrect, correct the information by carefully and lightly crossing out the incorrect information and writing the correct information above it. Complete any areas that are blank. DIST TCHR NBR:O47 STDT CRS: SEC:OO1 BLDG:O3 RM:212 O6 11 O4 (4) STuDENT LEGAL NAME Oast first middle) (5) ALSO KNOWN AS = Il= (4) LOCAL ADDRESS (hOUSO PO. S sac name) (apt no) NAY) able) Pro coda) ROYAL PALM BEACH FL 33411 (7) MAILING ADDRESS (house na a sisalname) (apt. no) (ulY) (stale) MP 0,(0!) BO SOCIAL SECURITY NO. Toptrone0 (9) HOME TELEPHONE NO. (10) 1(11)RACFJETHMC ORIGIN y • I-American Indian/Alaskan Native 0 B-Black, Non-Hispanic 0 H-Hispanic F • A-Asian/Pacific Islander 0 W-White, Non-Hispanic 0 M-Multiracial (12) DATE OF MTH (13) PLACE OF BIRTH WA lily Coco (14) RESIDENT STATUS (IS) USA ENTRY GATE (leAUDDIYYYY) 0 0. Foreign Exchange3Student (AMODDAWY) 0 1. Out-of-county Resident I/ Us (Is) FEDERAL IMPACT SURVEY ❑2.Out-of-state Resident 0 YES NO 0 3. In-county Resident El 0 A. The student resides on federal property. (17) PRESCHOOL ENROLLMENT IsFORIAATION Place an X by each program attended. Also. indicate wilh an 0 0 B. The student resides in low rent housing. asterisk (') the program your child was In he longest. 0 0 C. The parent is employed on federal property located in PB County. 0 C. Title I Prekindergarten 0 M. Migrant Prekindergarten 0 0 D. The parent is employed on low rent housing located in PB County. 0 D. Pre-K Disabilities 0 N. None 0 0 E. The parent is in the uniformed services of the United States. 0 F. Fee for SeMces 0 P. Private Prekindergarten 0 H. Head Start 0 T. Teenage Parent Program 0 0 If E. Is YES, is the parent on active duty? Check service below: 0 L Readiness Program 0 Z. Not Applicable 0 Air Force 0 Army 0 Coast Guard 0 Marines 0 National Guard 0 Navy pp Is the student a single parent? N 0 YES 0 NO TRANSFER STUDENT Only students transferring from another school complete this section (19) NAME OF SCHOOL TRANSFERRING FROM (20) CITY /STATE icouNre COUNTRY (21) LAST ATTENDANCE DATE (22) LAST GRADE LEVEL 200 DATE ATTENDED IN PBC (23) Have you ever been enrolled In a Palm Beach County School? 0 YES 0 NO If yes, what school? _ All new and returning students compete the remaining form including page 2 (2s) Students vrill receive non-Invasive health screenings pursuant to Florida Statute § 381.0O56(7)(d). Non-invasive screenings may Include vision, hearing, scoliosis, height, and weight. These tests may be glen Individually or in groups. Parents or guardians, however, have the right to request an exemption in vrriting. If you DO NOT want your child to receive the screenings, write the words "Do not screen" here: (This exemption wit cover at types of screenings) (26) I give permission (or my child to participate in the sodium fluoride program to prevent tooth decay. M YES II NO (Permission is valid through grade 6) YES (27) Does your child currently have health Insurance? 0 YES 0 NO P If YES, Indicate: 0 Medicaid 0 Healthy Kids/Kd Care U Private El Interested in receMng Information (25) HOME LANGUAGE SURVEY (chock ail that an*, 0 A language other than English is used in the home. What language? 0 The student has a first language other than English. What language? 0 The student most frequently speaks a language other than English. What language? (29) DISCLOSURES FOR ENTRY INTO PSC SCHOOL DISTRICT (check aV that apply) 0 The student has been expelled from school. 0 The student has had juvenile justice actions taken against him/her. 0 The student has arrested resulting in a charge. (30) STUDENT LIVES WITH: (check one) (31) CUSTODY STATUS OF STUDENT (aeck tee) 0 Mother 0 Father 0 Both Parents 0 Foster 0 Group Home 0 Mother 0 Father 0 Shared Custody E Other • Other IMPORTANT INFORMATION - MUST BE COMPLETED ($2) Is there a court order barring either parent from removing or contacting the student during the school day? 0 Yes 0 No If YES, provide the school with a copy of the court order. PBSD 0636 (Rev. 03117/2004) page 1 of 2 EFTA01709716 PARENT/LEGAL GUARDIAN INFORMATION (33) FATHER OR LEGAL GUARDIAN (16's( (Mete MAIM 4430 (34) DATE OF BIRTH (44) MOTHER OR LEGAL GUARDIAN (w. middle Witt, last) (45) DATE OF BIRTH (35) ADDRESS Meet number snot aPartmeal number) (46) ADORESS (Heel number, *et apartment number) (36) CITY STATE VP CODE (47) CITY STATE ZI, CODE ROYAL PALM BEACH FL 33411 (37) OCCUPATION (36) HIGHEST (48) OCCUPATION (45) HIGHEST ED. LEVEL ED. LEVEL DISPLACE OF EMPLOYMENT (507 PLACE OF EMPLOYMENT ocs HOME TELEPHONE (41) BUSINESS TELEPHONE (42) CEWPAGER NUMBER (51) HOME TELEPHONE (52) BUSINESS TELEPHONE (53) CELUPAGER NUMBER (43) EMAIL ADDRESS (cpLcnaO (54) EMAIL ADDRESS Osounner) EMERGENCY HEALTH AND SAFETY INFORMATION Provide name(s) of person(s), other than parent, allowed to pick up student. tss) PASSWORD (limit 10 characters) (56) NAME (Ns& middle indiat last) (82) NAME MIL medle Hem( MO (57) ADDRESS (steel number alma( specimen( number) (83) ACORESS (000IIMIllbOr, street alaatanant Awake) SAME (58) CITY STATE ZIP CODE (64) CITY STATE ZIP COOS (59) RELATIONSHIP (60) TELEPHONE (31)CELLSAGER NUMBER (85) RELATIONSHIP (86) TELEPHONE (67) CELUPAGER NUMBER OTHER (88) STUDENTS ALLERGIES (cheek e)) that apply and specify) 0 None 0 Animals 0 Birds 0 Reptiles • Amphibians 0 Plants 0 Food 0 Other Specify (69) LIST STUDENTS ILLNESS. BEHAVIOR ISSUES, MEDTCATIONS OR PHYSICAL LIMITATIONS (TO) FAMILY PHYSICIAN (71) PHYSICIAN PHONE NAMES OF PARENT'S/LEGAL GUARDIAN'S OTHER CHILDREN (72)NAME OF CHILD (Ent middle Wrist, Iasi) (73) SCHOOL ATTENDING (74) STUDENT NO. (*Prism° (75) GRADE (76) DATE OF BIRTH (77) NAME OF CHILD (Tnt middle Milig les0 (78) SCHOOL ATTENDING (79) STUDENT NO. (opeona0 (80) GRADE (81) DATE OF BIRTH (82) NAME OF CHILD (en( middle indict( MO (63) SCHOOL ATTENDING (64) STUDENT NO. fopeone0 (85) GRACE (86) DATE OF BIRTH INFORMATION VERIFICATION PARENT/GUARDIAN CONSENT verify that the Information given is true I understand and agree that all educational records of my child may be shared with the Districts and accurate to the best of my health care partners and other governmental and social agencies jointly seeing the child or having knowledge. a legitimate interest in the records, as needed to provide and evaluate health services and government/social services to students. I also understand and agree that my child's medical records or other medical information that I provide to the school, and treatment records or other medical records created by health care personnel at the school will be shared with school officials who have a legitimate educational purpose for accessing such medical records and information. SIGNATURE OF PARENT/LEGALGUARDIAN DATE SIGNATURE OF PARENT/LEGAL GUARDIAN DATE FOR OFFICE USE ONLY Documentation Checklist Transportation COB US CAL 01 teacher No 0 Immunizations 0 PBC Bus SL Entry Code E01 Reassign. Code 08/11/04 ID Binh Records Verification 0 Palm Iran SI. Enby Dale Binh Vedgeolion 1 ESP. Entry Dale DCF O Social Security Number 0 Parent/Student Transpalation 0 Physical Exams 0 Walk 0 Bike 0 Address Verifcatinri PBSD 0636 (REV. 03/17/2004) page 2 of 2 EFTA01709717 TEST RECORD INFORMATION PESO 0280 (REV. 7/15197) FRT EFTA01709718 tar- es'? )01.10.nboar . .at.- .414.11taISW/rIgarela.".•IN ,.....4014v0 :4al r ........4 ‘...,-41:taiii. eaL • •. - :p.c....a 814.4*.uwatea. - - - itte-iteNCA.A.C/i nscaswasuAareArb,..110 4. FLORIDA Verification of Receipt :1 ID ral (NOTE: This is not the application for the scholarship.) requi I verify that I have received and read the initial eligibility year of the Florida Bri ht Futures Scholarship Program for the Name (please print) Signature SCHOLARSHIP PROGRAM Date 912,1-1/2)01 Please return to your high school guidance counselor AnNIESAI NUMBER EXTENSION Wag EVA EFTA01709719 THE SCHOOL DISTRICT OF PALM BEACH COUNTY DIRECTIONS: Write in the aooroonate code number or letter in the corresoondino boxes. Student Discipline Referral EFTA01709720 Parent/Guardian of Date: El School: Phone: ROYAL PALM BEACH, FL 33411 RE: GRADE: 12 Dear Parent/Guardian: regret to inform you that on your son/daughter was notified that a suspension was being consi ered based on the following incident(s): DISOBED/INSUBORDINAT REP DISOBED/INSUBORD Section 1006.09(1)(b), Florida Statutes, provides that a school principal may suspend a student from school. In accordance with section 1006.09(1)(b),F.S., a meeting was held in my office on 12/07/2004 at which your son/daughter had the opportunity to explain why the suspension should not be imposed, after receiving oral and written notice of the charges and an explanation of the evidence against him or her. On the basis of the evidence available, i am hereby suspending from school attendance for a period of 3 school days effective In accordance with Section 1003.01(5)(a),F.S., your son/daughter is remanded to your custody with specific homework assignments to complete during the suspension. Please contact my office to obtain these assignments. Please be advised that Section 984.13(1)(b),F.S., allows a law enforcement officer to take your son/daughter into custody when the student is suspended and is not in the presence of the parent/guardian. Your son/daughter will be in violation of this suspension if he/she is on any public school premises and/or any other school-sponsored activities without prior permission from the principal or designee. It is most important that you contact the principal/designee prior to your son/daughter returning to school. c fl SCHOOL STUDENT GRD RACE SU N ATE DAYS ESE 504 LEP 12 w 003 N N N PBSD 0262 (REV. 4/04) EFTA01709721 4--p,00,44,,, THE SCHOOL DISTRICT OF PALM BEACH COUNTY IZ High School tOja Grade andlor Course Change ❑ Middle School Documentation 0 Elementary School $11JOS SCHOOL ECTION MASER CHANGE DOCUMENTATION GRADING PERIOD GRADE EXAM CONDUCT From From From 7 Y To To To From From From To To To Change course code From To Reason for change 0 Recalculated Grade Average ❑ Student Completed Work Other (explain below) ,deitutte tc./ebd pm devmpard. -e2-7.4,0--ez et:1,J APPROVAL SIGNATURES (two of three required) DATA PROCESSOR CONFIRMATION I confirm that the grade/course change has /21)1 been implemented. DATE /A? y DATE SIGNATUR DATE SIGNATURE Of AREA ADIRN,STRATOR DATE PRINT NAME PESO 0797 (REV. 0/14/2004) ORIGINAL Cumulative Folder Copy - Office File EFTA01709722 WI LLLLL 0 BELLSOUTHMobility' FIRSTCLASSMAX U.S. POSTAGE P.0. Box 3050 Bcca Raton, FL 33431.095..) is now PAID Attn: Boca Matl Unit OTS X cingular WIRELESS billing statement en lined AV 01 048 153 993048229 A..€0OT 'ROYAL PALM BtACM, FL 354'1.6103 pn EFTA01709723 • " ' OD BELLSOUTH Mobility' FIRST{XASSMAR. wiatilSS US. POSTAGE P.O. 80x 3050 Sitca Raton, FL 33431.OS5S is now PAID Attn: Soca mall Unit OTS >:< angular WIRELESS billing statomont on losod Ay ni nagisl onlmmon A":ccr ROYAL PALM BEACH. FL 354,I.ilo3 to EFTA01709724 SVPWICILSOA OF [LCCTIONS 105 I 111,...1 CI 0 ,2"),, DO SOMETHING - ROOM 301 N. OWE AVENUE. US POSTAGL PAII 33S0i-4?fl PALMOCACII. VOTE Vt1 Palm u.r.ICIr I F-inal Randal 11 RETURN SERVICE REQUESTED VOTER IDENTIFICATION A I YOUR PRECINCT RUNNIER IS. PALM BEACH COUNTY. FLORID YOUR POLLING lOCAllON IS. s, go • r.... ; ra..-i I a...c c.v. • I ricanuncesmaartet REORIROJIINIOM 45114/41 MIN ua weInn UGIBUE TO IR ACH sisal v wan l A CI nag Win SOMME 01N n.' . 14 ... 16 8S 3341 1 A • M BEACH L ROYAL PRE St NY THIS CAM AT YOUR PRECINCT WREN YOU VOTE :1g SEE REVERSE VOX FOR CHNIGE.OF.ADORESS *MALICIA), NO11FY M fliC110,4$ aclCE RLOGIRATION ~MAIM W ANY INFOAMATON ON TICS CAM IS NC OAKa. EtICKINS firamAnave.V. SUPERCOR a t. 1,11„Aha,611“Jhllilit IIIIII1111111II1III The Sunshine State ial AL PALI r !E aD Nan Lan RrA1 esna OflATT nom 00-0040 064041 WE ORM* ORGAN D01404 CIStOTS. comer, . sobnety rarNai LI, le . OPV•2301 Oi • INS VOI100 Oral/a EFTA01709725 THE SCHOOL DISTRICT OF PALM BEACH COUNTY - NEW AND RETURNING STUDENT REGISTRATION i (36) FATHER OR LEGAL GUARDIAN (Ng "Able weak sow 37 TN R r L -1 I PDORESS (NNW iwAnt.f. nn,.( NS: CRY STATE ZP COOE STATE a 339/4 Zip COo€ A/MI i rec i c.4 OCCUPATION PLACE OF EMPLOYMENT HOME raiPHONE I BUSINESS TELEPHONE CELUPAGER NUMBER SUSMESS TELEPHONE WAIL ADDRESS (optoima0 J WAIL ADORESS (0060,10) LEMEFIGENCY HEALTH AND SAFETY,-INFORMATION,. . • -?-c-4 . :.4sug;-;.-- . ,•;‘,:w *4-14,w, Person(s) other than parent authorized to pick up student dm PASSWORD Arm ro otaiToCte:3) (3S) NAME gat. mdcaeinilia( Imo (At) NAME Oat A400* MO* WO ADDRESS (Moot Ofeet •Partmea numb.) ADDRESS 04Amt ntabee. ante( apartment WY A iitt, 49fin gerth ty 3.30z4. STATE ZIP COOS CiTY STATE ZIP CODE (40)AUTHORIZED FOR RELAY/Cf.:SHIP (M2) AUTHORIZED FOR C pcbt o t113 EME:VENCY POW EMERGENCY PICKUP D' IES 0 NO 0 YES 0,NO (43) If school personnel are unable to contact you Incase of airless or accident, (44) MEDICAL INFO(LMATION 0ist stmloes!esse; basImmor. heath may we have your permission to call your doctor or issues. Sews. nx s. ce oftve panted hmeations) . emergency services (911) for transport to the hospital? Ef<S 0 NO (45) FAMILY PHYSICIAN ill tPiCIAN PHONE (M6) Does your child currently have health insurance? IVES 0 NO If YES, indicate: :47) HOSPITAL PREF ERL NCL 0 Medicaid gilivate 0 Healthy Kids/Kid Care 0 Interested in receiving information RARENTSiGUARDIAN'S OTHER CHILDREN 1N7:1211:11/113aceiTh011#S a,t , 116P4S, sot NAME Of CHILD pm. most rnoole sa,aii SCHOOL ATTENDING STUDENT NO (op0:040 GRACE DATE OF 12M3D4 (50) NAME OF CHILD OAR first. mickla it,) ...flan ATTENDING STUDENT NO. (tipAbre) GRADE DATE OF BIRTH MI NAME OF CHILD (MA gra muse SW) mini ATTENDING STUDENT NO. (002nN) GRADE DATE OF RIM (S2) NAME OF CHILD ant try. nag* at40 SCHOOL ATTENONG STU004T NO. (0priNNO GRADE DATE OF BIRTH I PARENT/GUARDIAN SIGNATURE FOR OFFICE USE ONLY (S3)SCH NO. (5<)STUDE NT NO I verify that the information given (55) COO (56) ENTRY CODE I(5T) SAC (SS) GRADE LEy is true and accurate to the best of k11:;Aer. gttah4">14 -9 my knowledge. W al° MEM . 62) Mppril 463 Btft WERE A. V " nil No (66)DATA /GUARDIA DATE REV:10636 (REV 416,2001) page 2 of 2 EFTA01709726 12t r emae (Form: 23(3 SSN: NA 2004 ASVAB RV RESULTS Ain No 0017 MILITARY CAREERS 12th Percentile Scores AND ASVAB Results Credo Standard 12th Grade Standard Score Bands 12th Gtaile 12th Grad. 12th Grade ENTRANCE SCORES Scores Females Males Students Two more scores can be especially use- ful to you. The Military Careers Score is Career Exploration Scores a composite of the ASVAB verbal, math, 'Verbal Skills mechanical, and electronics tests. The Math Skills Military Careers Score provides a link to occupations described in Military Science and Technical Skills Careen.You will be able to see how well your skills, abilities, and career interests ASVAB Tests match those of Service personnel cur- rently working in military occupations. General Science (GS) lvlilitaly Careers provides you with a Arithmetic Reasoning (AR) clear image of what workers do in these Word Knowledge (WK) occupations, as well as other useful in- formation about the occupations. Paragraph Comprehension (PC) The Military Entrance Score (also called Mathematics Knowledge (MK) AFQT, which stands for the Armed Electronics Informations (ED Forces Qualification Test) is the score Auto and Shop Information (AS) used to determine your qualifications for entry into any branch of the United Mechanical Comprehension (MC) States Armed Forces or the Coast Guard. The Military Entrance Score predicts in a general way how well you might do in Military Careers Score 5 training and on the job in military occu- Military Entrance Score (AFQT) 85 pations. Your score reflects your stand- mg compared to American men and women 18 to 23 years of age. the same or better than65 out of every 100 females lion test. Taking a course or obtaining a part- USE OF INFORMATION EXPLANATION OF YOUR timejobin thisareawouldincreaseyour knowl- ASVAB STANDARD SCORES in the 11th grade. Personal identity information(name,so- edge and improve your score if you were to Your ASVAB results arereported as standard scores For purposes of career planning, knowing your take it again. cial security number, street address, and relative standing in these comparison groups is telephone number) and test scores will in the above graph. Your score on each test is USING ASVAB RESULTS IN not be released to any agency outside of identified by the "X" in the corresponding bar important. Being male or female does not limit your career or educational choices. There are CAREER EXPLORATION the Department of Defense (DoD), the graph. You should view these scores as esti:micro( Armed Forces, the Coast Guard, and your true skill level in that area.If you took the test noticeable differences in how men and women score in some areas. Viewing your scores in light Your career and educational plans may change your school. Your school or local school again, you probably would receive a somewhat over time as you gain more experience and system can determine any further re- different score.Many things, such as how you were of your relative standingboth to men and women may encourage you to explore areas that you learn more about your interests. Exploring Ca- lease of information. The DoD will use feeling during testing, contribute to this difference. might otherwise overlook. reers: The ASVAB Career aplonftion Guide your scores for recruiting and research This difference is shown with gray score bands in can help you learn more about yourself and the purposes for up to two years. After that the graph of your results. Your standard scores are You can use the Career Exploration Scores to world of work, to identify and explore potential the information will be used by the DoD based on the ASVAB tests and composites based on evaluate your knowledge and skills in three ggeeen- goals, and develop an effective strategy to real- for research purposes only. your grade level. eral areas (Verbal, Math, and Science and Techni- ize your goals. The Guide willhelp you identify The score bands provide a way to identify some of cal Skills). You can use the ASVAB Test Scores to occupations in line with your interests and your strengths. -Overlapping score bands mean gather information on specific skill areas. To- skills. As you explore potentially satisfying your true skill level is similar in both areas, so the gether, these scores provide a snapshot ofyour careers,you will develop your career explora- real difference between specific scoresmightnot be current knowledge and skills. This information tion and planning skills. Visit: www.asvabprogram.com meaningfullf the score bands do not overlap, you will help you develop and review your career goals and plans. Meanwhile, your ASVAB results can help go: probably are stronger in the area that has the higher in making well-informed choices about hi score band. The ASVAB is an aptitude test. It is neither an high school courses. Use Access Code: absolute measure of_your skills and abilities nor a YOUR ASVAB PERCENTILE SCORES perfect predictor of your success or failure. A We encourage you to discuss your ASVAB Your ASVAB results are reported as percentile high score does not guarantee success, and a low results with a teacher, counselor, parent, family Access code expires: July 1st score does not guarantee failure, in a future edu- member or other interested adult. These indi- scores in the three columns to the right of the graph. viduals can hap you to view your ASVAB Percentile scores show how you compare to other cational program or occupation. For example, if students- males and females, and for all students - you have never worked with shop equipment or results in light of other important information, such as your interests, school grades, motiva- SEE YOUR COUNSELOR FOR inyour grade.For example, a percentile score of 65 cars, you may not be familiar with the terms and FURTHER INFORMATION for an 11th grade female would mean she scored concepts assessed by the Auto and Shop Informa- tion, and personal goals. DD FORM 13044 1 JUL 02 - PREVIOUS EDITIONS OF THIS FORM ARE OBSOLETE EFTA01709727 4 frortDia. THE SCHOOL DISTRICT OF PALM BEACH COUNTY (E1 High School X Grade andlor Course Change 0 Middle School 0 Elementary School 4 Documentation - 1111111•111Cal6 GRADE LEVEL I 7 2 Sai YEAR COU7JAKEN CHANGE DOCUMENTATION EXAM CONDUCT GRADING PERIOD GRADE From From From To To To From From From To To To To Change course code From Reason for change ❑ Recalculated Grade Average EI Student Completed Work El Other (explain below) laegie_ 6 — PROVAL SIGNATURES (two of three required DATA PROCESSOR CONFIRMATION I confirm that the grade/course change has been implemented. & ( Q -or SIGa DATE DATE PRINT NAME SIGNATURE OF AREA ADMINISTRATOR ORIGINAL - Cumulative Folder Copy • Office File PBSD 0797 (REV. 511412004) EFTA01709728 STUDENT N STUDENT NAME: 7) 15-71 0 (9 6C 120t) PREVIOUS COURSES COMPLETED c/ SY T COURSE NO# COURSE TITLE SA CREDIT CREDIT CREDIT FINAL FLGS HC PS TAKEN DS CODE ATTP EARN SCHL 0_6 3 ■ COUNSELOR DATE:, ^!7 OP: • DATE: r73-/ -0 y EFTA01709729 iv ( %/14,49, ez THE SCHOOL DISTRICT OF PALM BEACH COUNTY Grade / Course Change Documentation IL_ —11I'd GENERAL INFORMATION en GRADE LEVEL RCM YEAR COURSE TAKEN STUDENT NAME 4M /1 02003— e) V , CO CciSf CTION NUVBER . CHANGE DOCUMENTATION EXAM CONDUCT GRADE r GRADING PERIOD From From FrOm To To A/46, To From From From To To To To Change course code From Reason for change: 0 Recalculated Grade Average Student Completed Work 0 Other (explain below) APPROVAL SIGNATURES (two et three required) 07 - 0? -.0K DATE SIGMA FURS OF TEACHER S DATE SIGNATURE OF AREA ADMINISTRATOR DATA PROCESSOR CONFIRMATION . DATE SIGNATURE OF DATA PROCESSOR ORIGINAL - Cumulative Folder Copy -Office File PBS() 0797 (REV. 9/12/2001) EFTA01709730 Spring 2003 Florida Comprehensive Assessment Test (FCAT) SUNSHINE STATE STANDARDS Grade 10 Student Report student has the ability to learn and succeed. The purpose of the FCAT is to ensure that The.Florida Department of Education believes that succeed In the competitive 21st Century Job market. Florida's public schools are providing the best uca ion possible, and preparing students to system that allows you to track a student's academic achievement from year to Working with teachers, the State has developed a measurement In a year's time. This system also allows you to compare a student's score to a year and determine if a year's worth of learning has occurred the 'grade lever score, then they are performing at a level above score that represents 'oracle lever achievement. If a students score Is above the 'Content Scores,' you are able to Identify any specific academic their current grade. If it is below, they are in need of Improvement. Using skills needing Improvement. previous years. The chart on the right side of Below you will find your 2003 FCAT Reading and Mathematics scores" as well as your scores from the page shows your score compared to the score that represents grade level achievement. Reading 2003 Reading Content Sco es Points Points Content Areas Possible Earned 2000 ss Words/Phrases 9 CO Main Idea/Purpose 14 Comparisons 13 I U LL 1000 Reference/Research 16 I Year 2001 2002 2003 500 Grade Tested Achievement Level Grades Grads 4 Grades Grades Grader 11+ FCAT Score • L • Your Sco e ❑ On Grade Level Mathematics 2003 Mathematics Content Scores Points Points Content Areas Earned Number Sense 11 FCAT Score Measurement 10 Geometry 14 I I Algebraic Thinking 14 I I Data Analysis 11 I Year 2001 2002 2003 Grade Tested Achievement Level Grads 3 Gush. 4 Grades Grade Gras FCAT Score • ■ Your Soo e O On Grade Level test numerous times, it is likely that all of your scores would • These scores show your achievement on the day you were tested. If you had taken this range. Your 2003 FCAT Reading scores probably would have been between 2197 and 2381. have been within a certain Your 2003 FCAT Mathematics scores probably would have been between 2106 and 2172. NT = Not Tested NR =Not Reported NA= Data Not Available 0165053 Data Run Date: 05/09/2003 EFTA01709731 student Name Spring 2003 Florida Comprehensive Assessment Test (FCAT) Stu eat umber NORM-REFERENCED TEST I! eand Number GRADE 10 Student Report Florida Comore entire Assessment Test This report shows your results from the FCAT National Norm-Referenced Test. The FCAT Norm-Referenced Test measures your achievement on a test that was given to a national sample of students. Your norm-referenced scores in Reading Comprehension and in Mathematics Problem Solving describe your performance in relation to the performance of students throughout the nation. Your scores are shown below. SUBJECT SCORES National Scale Percentile Score Rank Stanine Reading Comprehension Mathematics Problem Solving The Scale Score expresses your performance on the test and allows for comparisons from year to year. Reading Comprehension Scale Scores range from 527 to 817. Mathematics Scale Scores range from 568 to 863. The National Percentile Rank and Stanine Indicate your relative standing in comparison to the national reference group. National Percentile Ranks range from 1 to 99. Stanlnes range from 1 to 9. If you took the test again, your National Percentile Rank might be slightly higher or lower than stated here. However, your National Percentile Rank would probably fall within a certain range. For Reading Comprehension, your National Percentile Rank should be between 47 and 78. For Mathematics, your National Percentile Rank should be between 88 and 97. CONTENT SCORES Number of Number of Number of Questions Correct Questions on Test Responses Attempted Reading Comprehension 51 initial Understanding 8 I Interpretation 22 I Critical Analysis 9 I Strategies 12 I Mathematics Problem Solving 48 I Problem Solving 6 I Algebra 6 I Statistics 6 I Probability 5 I Functions 5 I Geometry-Synthetic 7 I Geometry-Algebraic 4 I Trigononetry 3 Discrete Math 3 Precalculus 3 Data Run Date: 04/30/2003 0145471 EFTA01709732 • • A;mow. &BELLSOUTH Mobility FIRST•CIAS Ala WIRILI$$ US. POSTAGE P.O. Box 3050 Boca Raton, FL 33431.0960 is now PAID Attn: Boca Mail Unit OTS >a<angular WIRELESS billing statement enclosed till AV 01 048153 993048229 An5DGT ROYAL PALM BEACH, FL 33411.6103 •• Tr' ..... ••••••ArWIV.,” • 4. :Is neeIWO.WA nrt /14 •4• vv. ••.; ...• EFTA01709733 I rit IWO n •-•• TIONS SUPERVISOR Of ELEC UE. ROOM 106 SOMETHING - US POSTAGE PAD 301 N OLIVE AVEN DO lAbsl Palm Rnach, FL 1-4795 VI PALM REACH. FL 3340 VOTE Permrl Number 169 ESTED RETURN SERVICE REQU VOTER IDENTIFICATION . FLORIDA PALM BEACH COUNTY ousnunos DOS. FEC•tillt•DO•itaa•Plit 05/10/01 INCT WHEN YOU YOU SENT 11113 CAM AT YOUR PREC 8 FOR CHANGE ORADORESS INST RUCHON‘ E NOWT TIE ELECTIONS OFFIC RMATION IMMEDIATELY W ANY INFO RRECT, ON 11113 CARD IS INCO Rwapa IL R0 LIIllIluhJI1L1JL1JLll 1111 lilt III1 1 II I St The Sunshine State a PEST 00311.0 Oa F SOS DLPLICAR OPE° 0003-00 0140-01 svi DRARA ORGAN DONOR by APR RUIN Eob,rWr vegan., consINAss *Newt TRM Sands "MN* EFTA01709734 () BEACH COUNTY (SDPBC) THE SCHOOL DISTRICT OF PALM New and Returning Student Registration the form. areas on both sides of NEW STUDENTS: Complete all non-shaded information by If the pre-printed information is int/affect, Correct the RETURNING STUDENTS: Review both sides. correct inform ation above it. information and writing the carefully and lightly crossing out the incorrect (6) MAILING AD/DRESS (not (10) RACEETHNiC ORIGIN (*Mona, (7) SOCIAL SECURITY NO. 01-American Indian/Alaskan Native 0 B-Black. Non-Hispanic 0 H-Hisp anic g4 -While, Non-Hi spanic 0 M-Mult iracial 0 A-AsiaruPacific Islander RECEN T STATUS (14) USA ENTRY DATE (13) (44/MDEvrern (11) DATE OF BIRTH (t2)PUCE OF BIRTH (004tasimuniro 0 0. Foreign Exchange Student 0 I.Out-of-county Resident 0 2, Out-of-state Resident (15)FrnFRN IMPACT SURVEY al In-county Resident YES NO (16) pRESCH OOt ENROLLMENT INFORMATION Pima an x by each pograen attended Also, indicate with O 0 A. The student resides on federal property. an asterisk (line program yOur did was in the ionsiest. O 0 B. The student resides in low rent housing. M. Migrant Pre-K Beach County. 0 N. Non-subsidized Child Care 0 O 0 C. The parrot is employed on federal property located ininPalm 0 H. I-leadstart located Palm Beach County. 0 D. Pre-K Disabilities O 0 D. The parent is employed on low rent housing 0 C. Chapter 1 0 I. Pre-K Early Interven tion O 0 E. The parent is in the uniformed services of the United States. 0 S. Subsidi zed Child Care 0 O. Other on active duty? Check service below: LS THE moon A ( 8) CURREN T GRADE LEVE O 0 If E. is YES, is the parent (17) SINGLE P 0 National Guard 0 Navy 0 Air force 0 Army 0 Coast Guard 0 Mannes 0 YES 7 O 111 AST ATTFISIOAMCE DATE 9) NAME OF SC1400L TRANSFERRING FROM (24) DATE•ATTENDED IN PBC (22)LAST GRADE LEvEt. (23)LAST PUBLIC SCHOOL ATTENDED W4 PALM BEACH GOWN asive pursuant to Florida Statute §381.0056(7)(d). Non-inv 1251 Students will receive non-invasive health screenings tests may be given individually or in screenings may include vision, hearing, scolios is, height, and weight. These (27) Have you filled out an or guardia ns, howeve r, have the right to reques t an exemption in writing. If you DO NOT want application for free and groups. Parents here: reduce d lunch? ngs, write the words *Do not screen.' your child to receive the screeni (This exemption will cover all types of screeni ngs) 0 YES RicC flouride program to prevent tooth decas fV'ES O NO (Application is pawided (26) I give permission for my child to participate in the sodium with this form (Permission is valid through 6 grade) ta$1.03k€ UmIGUAGE SURVEY YES NC11, If YES. what language? O No Is a language other than English used in the home? ? if YES. what language? O rit2. Does the student have a first language other than English e? language other than English? II YES, what languag O 847 Does the student most frequently speak a or guardian? e 1'04 1/ SA rzai 4. What language is spoken in the home by the parent e? Ana 4r//S lj (30) 5. What language is the student's first languag uvEs want (chock one) (31) What is the date of entry into an ESOL program? Mother 0 father 0 Both Parents (33)D1SCLO‘UPFS FOR ENTRY INTO PBC SCHOOL DISTRICT Vothe, agh-bhtkatirs one) YES NO (34)CUSTOOY STATUS OF STUDENT "Schork O A. Has the student ever been expelled from school? 0 Mother 0 Father Q'Shared Custody O V. Has the student ever had an arrest resulting in a charge? 3. Has the student ever had any juvenile justice actions? 0 Other O g or contacting the student during the school day? 0 YES (as) Is there a court order baning either parent from removin If YES, provide the school with a copy of the court order. page 1of 2 PBSD 0636 (REV. 4/6/2001) EFTA01709735 - nian orat.ti COUNTY (35)FATIM-R OR LEGAL GUAR CKAN Real mine kiss roo4 - NEW AND RETURNING ST UDENT REGISTRAT (3 MOTI ION AOOQ AA (stripe( numbo, IVOR aportemiat tuen(s) CITY STATE ZIP CODE OCCUPATION /1, c.pA-in, Sees STATE fi 3.011 ETP CODE RACE OF EMPLOYMENT • •:.0.Acir -"` Nat TELEPHONE BUSINESS TEt EPI4ONE CEUPAGER NUMBER .. • zassza.• BUSINESS TELEPHONE EMAIL ADORES j 5:05Imm EMU. ADDRESS (000 1100 EMERGENCY HEALTH AN D SAFETY INFORMATIO N Person(s) other than par ' ' -/ ', T.' ent authorized to pick . 09)RNA( t.,-, up student (U) PASSWORD pernit 10 • charades's) (4)) NAAR (fat mkkAs mbal . Iasi) ....1.a....mr...-•••••••• ADDRESS Wean nuentxv. stree t womnat numbed STATE ZIP CODE CM Afin g€ STATE ZIP CODE Pf 3, 472 : op ONSHIP (40) AUTHOR/fe y FOR (43) pschool personnel are unable to a0: NO RELATIONSHIP (42) AUTHOR2f0 FOR EMERGENCY PICKUP DYE 0 NO may we have your permission contact you incase of illness or accident, (4) MEDICAL INFORIAATION OS MAW, Orospa to call your doctor or awn. sioroos. modkmicers. or oils "sta tsMistAM boat - emergency services (911) for transport to the hospital? r lindolions) (45)FA/MLY PHYS/CIA N EKS 0 NO IA IAN PHONE NO Does your child currentl y have health insurance? L7YES 0 No (0)HOSPRAL PREFEREN CE If YES, indicate: 0 Medicaid [5-4 5Etate 0 Healthy Kids/Kid Care U Interested in receiving info w-.'" " St0 itd. AT-5'OTNE rmation R iiEia nla rt04i IIIM ALIIII M tAckliptIANTef; (49) NAME OF CHAD Oast MR mid* nem° „,__ SCHOOL ATTENDING mamma eseue GRADE DATE OF BIRTH (a0) NAME OF CHILD Past ERE Malt PA40 SCHOOL ATTENDING STUDENT NO (0010, 69 GRADE DATE OF MTh (51)HALE OF CHILD SR first middistmINO SCHOOL ATTENDING STUDENT NO. (00600•0 GRADE DATE OF BIRTH (UMW OF ow)pat MC mea ts SCHOOL ATTENDING STUDENT NO- (00600•) GRADE DATE OF BIRTH PARENT/GUARDIAN SIGNATURE Ftheidgnettianitilici. I verify that the inform ation given is true and accurate to the best of my knowledge. t . 0 r-,- • fi (66) 0 AV . -. . ,__ La. :• 4t, ell.' .G.-Pt w•-• •—•'51 1 • ..- - /GU DATE DATE PI3S0 0636 (REV. 4/6/2001) : ;;;ik 'hz. page 2 of 2 EFTA01709736 WV @ BELLSOUTHMobility' ARSMASSMML U.S.POSTAGE P.O. Box 3C50 Soca Raton, FL 33431.0950 nttn: Boca •Mail Unit is now PAID OTS X cingular WIRELESS billing statement enclosed loolistillailialmilmilell 41., 01 044,51 993048999 A`•50OT ROYAL PALM BEACH, Ft 33411.6103 EFTA01709737 3--//7// Ataige-a. Pet4vIetteA, Q. 331n „iteLe2.“.4t.q g ciaecoll Atikze.) 4 outo age—/--- Th21 17 _L IMP • &pm Jan. Bu d" Atlantic • Ca. ba. EFTA01709738 S ,JA iiiPIERWSOR-OF ELECTION M 105 30 t H.OUVE AVENUE. ROO 95 DO SOMETHING - US. POSTAGE MID W PALM BEACH. FL 1340 1-47 VOTE Wen Pam Beach. Permit Runts 164 RETURN SERVICE REQUESTED VOTER IDENTIFICATION RIDA PALM BEACH COUNTY. FLO PRIMO' OS/10/01 INCT MIEN you of PRESENT 1)•3 CAJW AT YOUR PREC IS ORESSINSTRuavow. SEE REVERSE SCE FOR Ca•NOE-OF-AD TKIM S MIC E NOTIFY THE MAC TION RATMOLATILY IF ANY INFORMA ON 'IRS CARO N INCORRECT. IIIIIIIII II VIII IlitlitIlululull IIIIIIIIIIIIIIIIIIIIII theStam 23411 ROT 8,04 Rev .07 eon pawn 00-03-03 " r0-01 06- wE ORNER ORGAN 0000OR IS6 rty sat IOCAP N one* it. any sobe Sass ens semems EFTA01709739 7fruiwa ett t i F ; 2 4, •; Aettie.a. J dibe i Ale: * it sue( Atic n•-e- ii/34 4,-4 / jaVaj 17caw/ Wiry. Benda Tin AU tic Booby;Gew EFTA01709740 :Kay 7, 2001 'lb Whom It %lay Conant letter is to recomme or placement in your drama program. been a student in my drama class or t past two years. She is one of my most takntedstu ents in both performing and creativity in production. been an active member of the juniorThespian Society and this year site was As a cmerger,asBiwa: (264 to auditionfor andparticipate in the district andstatefestivals. She has receivedsuperior andexcel-lint ratingsfor her monologue pelormances has also hehlmaybr roles in the club's productions. I know thatawoua be an asset to your program. If I can be of anyfurther assistance or antivenin, questions, pleasefeeffree to contact me. Sincerely, EFTA01709741 THE SCHOOL BOARD OF BROWARD COUNTY,FLORIDA SCHOOL BOARD Chairperson Vice Chairperson April 23, 2001 To Whom It May Concern: This letter is to inform you that has been in band at 1. 0for the past three years. e is a and is in thell.11 this year. has participated in all the band performances this year including She also performe at Sincerely, Transforming Education: One Student At A Time Drotvard County Public Schools Is An Equal Opportunity/Equal Access Employer EFTA01709742 1117 "l it"- _ $2023 The School Board of Broward County, Florida CREDIT-BY-EXAMINATION 05/29/01 Dear Parent/GUardian: School Board of Broward County rewards ' Credit-bY7Examination is one, way that The hard work and initiative. The completio' advanced middle school students for their t earned, is awarded when students pass of high school coursework, including credi tency tests. By providing this specially designed district-developed compe not only does the student benefit by earning .opportunity to middle school students, but he/she also has the opportunity of :high school credit while in middle school, school. taking higher level coursework during high :r La, c one or more of the Broward County Publi This spring, your child was assessed on test results: ;Schools competency tests. Based on the , has passed the • high GEOMETRY Credit-by-Examination and will receive GEOMETRY if he/she also receives a • school credit for ded credit does not carry a grade but is recor ,Passing grade in the course. This ent as cript. Please keep this docum .as a "P" for Pass on the high school trans achie vement even though the Testing and additional verification of your child's tive staff at the designated high school. Assessment staff will notify the administra er success. Please contact the Guidance We congratulate you and your child on his/h have any questions. Counselor at your child's school if you EFTA01709743 y, Florida The School Board of Broward Count CREDIT-BY-EXAMINATION 05/30/00 r Dear Parent/Guardian: y rewards that The School Board of Broward Count Credit-by-Examination is one way ative . The completion their hard work and initi 7,advanced middle school students for when stude nts pass ding credit earned, is awarded of high school coursework, inclu ding this competency tests. By provi .specially designed district-developed it by earning nts, not only does the student benef .opportunity to middle school stude oppor tunity of 0 school, but he/she also has the high school credit while in middle g high school. taking higher level coursework durin • . . -.---__--___ u.l' more of the Broward County Public This spring, your child was assessed on one or Schools competency tests. Based on the test results: , has passed the Credit-by-Examinatio n and will recei ve high ALGEBRA ALGEBRA if he/sh e also recei ves a school credit for is recor ded not carry a grade but passing grade in the course. This credit does docum ent as e keep this as a "P" for Pass on the high school transcript. Pleas vement even though the Testing and additional verification of your child's achie staff at the designated high school. Assessment staff will notify the administrative success. Please contact the Guidance We congratulate you and your child on his/her any questions. Counselor at your child's school if you have — I-----'7 _ • L EFTA01709744 Student Warne FLORIDA COMPREHENSIVE ASSESSMENT TEST (FCAT) 2001 u en um r SUNSHINE STATE STANDARDS Student Report Grade 08 District Name and Number This report shows your results from the FCAT Sunshine State Standards Test. The FCAT Sunshine State Standards Test measures your performance on selected benchmarks in reading and mathematics as defined by the Sunshine State Standards. Scores on this test are one indication of your achievement of the challenging content that Florida students are expected to know. On the FCAT, you can attain one of five possible achievement levels. The table below shows the scale score ranges for each Student Achievement Level. Student Achievement Level Descriptions FCAT Student LEVEL 5: Performance at this level indicates that the student has success with the most challenging content of the Sunshine State Standards. A Level 5 Achievement Levels student answers most of the test questions correctly, Including the most challenging questions. Scale Score Ranges LEVEL 4: Performance at this level indicates that the student has success with the challenging content of the Sunshine State Standards. A Level 4 student Reading Mathematics answers most of the questions correctly but may have only some success with questions that reflect the most challenging content. Level 5: 394,500 371-500 LEVEL 3: Performance at this level indicates that the student has partial success with the challenging content of the Sunshine State Standards, but Level 4: 350-393 347-370 performance is inconsistent. A Level 3 student answers many of the questions correctly but Is generally less successful with questions that are Level 3: 310-349 310-346 most challenging. Level 2: 271.309 280-309 LEVEL 2: Performance at this level Indicates that the student has limited success with the challenging content of the Sunshine State Standards. Level 1: 100-270 100-279 LEVEL 1: Performance at this level indicates that the student has little success with the challenging content of the Sunshine State Standards. Your scores are shown below. SUBJECT SCORES CONTENT SCORES State Number of Number of State Comparison: Points Points Comparison: Student Thirds Achievement Scale Possible Earned Thirds Level Score Lowest Middle Highest Reading Lowest Middle Highest Reading Words/Phrases Mathematics Main Idea/Purpose Comparisons If you took the test again, your scores might be slightly higher or lower than the scores on Reference/Research this report. However, your scores would probably fall within a certain range. For reading. your scale score should be between 364 and 432. For mathematics, your scale score should Mathematics be between 372 and 402. Number Sense Measurement The check marks ( ✓ ) show if you scored In the lowest, middle, or highest third of grade 08 Geometry Florida students who took this test. Algebraic Thinking Data Analysis The Content chart shows the number of points possible and the number of points earned for each category. Each question on this portion of the test was worth one point. The results on your performance items will be reported separately. Run Date: 04/26/2001 0388352 EFTA01709745 Student Name FLORIDA COMPREHENSIVE ASSESSMENT TEST (FCAT) 2001 u en um er NORM-REFERENCED TEST School Name and Number Student Report •r N me and Number Florida Comprehensive Assessment Test Grade 08 This report shows your results from the FCAT National Norm-Referenced Test. The FCAT Norm-Referenced Test measures your achievement on a test that was given to a national sample of students. Your norm-referenced scores in Reading Comprehension and in Mathematics. Problem Solving describe your performance in relation to the performance of students throughout the nation. Your scores are shown below. SUBJECT SCORES CONTENT SCORES National Number Number Number Scale Percentile of Points of Points of Questions Score Rank Stanine Possible Earned Attempted Reading Com•rehension Reading Initial Understanding Comprehension Interpretation Critical Analysis Mathematics Problem Solving Strategies Mathematics Problem Solving The Scale Score expresses your performance and allows comparisons from year to year. Measurement Reading Comprehension Scale Scores range from 510 to 820. Mathematics Problem Solving Estimation Scale Scores range from 527 to 836. Problem Solving The National Percentile Rank and Stanine Indicate your relative standing in comparison to the Number Relationships national reference group. National Percentile Ranks range from I to 99. Stanines range from 1 to 9. Number Systems Patterns & Functions If you took the test again, your National Percentile Rank might be slightly higher or lower than Algebra stated here. However, your National Percentile Rank would probably fall within a certain range. For Reading Comprehension, your National Percentile Rank should be between 81 and 96. For Statistics Mathematics Problem Solving, your National Percentile Rank should be between 91 and 98. Probability a Geometry Each question was worth 1 point. Run Date: 04/26/2001 0391890 EFTA01709746 OFFICE of VITAL STATISTICS CERTIFICATE OF LIVE BIRTH FLORIDA 109 - LOCAL MI AO OATH OM on Yr I IASI IHUt( milt • NATO C V TOWN OR LOCATION OF BARTH Keg'let -NAME Ol ne U OTHER NAME MOO IOU Of ATI (ROAN! AT BIRTH 4 AT SIGNO 'Mo. Clay. YOM) nal Int tell of my knowledge and NMI .NOT tonceemng IM CNI tS kut to I cutely InalIbe MAW Alp. f n Suer bol Sa drills el Ok MING ADDRESS (5trtel or RIO I a .nrl CERTIFIER -NA • • DAT CEIVED BY REGISTRAR IMo. NY Yr I ST RICASTRUT GO r d AGE TM Mme STATE OF Nilt RAM on/SA ova armo 6. 'Spsm i 16 lAiOOL LAST al mip \1/2... %NI'S. 1100401-MAMEN lb 2/ nn) U OF TIELOLNCE INSIDE OTT Rf El AN0 NII LIMITS 'Speed? 7 -' 7a CITY. 10601 OR tOCADON COUNTY le"' YR.'S.̀ .II AfsmEia SIAM BIS T ,. • k .. , 'I II SIt enter bp Cade coley? ‘,4,6-7.,: WINER 6 WANG ADOIESS-itt Wile name (Owner 1/2. AGE PM bee STATE Of BATH II nor OSA h. 0 i, LASI Or M.3boa) N nn MIDDLE ....\\, Jr EA1 R—IFARE FIRST 1C0 30 TOC H. r' SOCIAL CuRitf NU BEA 10. mknonledge and be , onetel en u6s ceche ricerma R. BR tem la Intim, ULM Ow Wailed UNKNOWN tia tWainine elInt -- 4 4 CERTIFIED COPY ON FILE IN THIS OFFICE OF THE OFFICIAL RECORD AND CORRECT COPY THIS IS A CERTIFIED TRUE NOT MENT IS PROHIBITED BY LAW DO ANY REPRODUCTION OF NHS DOCU OF INC STATE PAPER WITH RAISED GREAT SEAL ACCEPT utkESS ON SECURITY WARNING. Or FLORIDA ALTERATION OR ERASURE VOIDS TINS CERTIFICAT ION EFTA01709747 Florida Power & Light Company, P.O. Box 025576, Miami, FL 33102 0 FPL January 3, 2002 Re: Account 4: ROYAL PALM BEA , 411 Dear Customer, Thank you for your interest in FPL's Free Automatic Funds Transfer (AFT) program. The benefits of using AFT are that you save time, postage cost and you don't have to worry about late or missed payments. ENROLL BY U.S. MAIL - Please complete this application and mail it with your bill payment or a voided check to: FPL, General Mail Facility, Miami, FL 33188. Please allow 5 days to process your mailed application. OR ENROLL ON OUR WEB SITE - Avoid the delays and enroll at www.fpl.com, click on "Pay My Bill", then 'AFT". It is secure and it takes effect within minutes. - You will receive a letter & a bill message to confirm your AFT participation. - Your monthly FPL bill will show the AFT withdrawal date from your bank account. - Some banks charge for AFT, please check before you enroll. Na Ac AUTOMATIC FUNDS TRANSFER (AFT) AUTHORIZATION Name: ervice Address: City: R CH State: FL Zip Code: 33411 Phone Number: Bank Name: A U.S. funds bank account is required. Ciente Teoneil Kli irrshar• Rnate Ann^. wt. A4,.whnv • ••••;4.-O1„salt..,:: EFTA01709748 • TAO mei © BELLSOUTH° r FIRST-C 0. 072.0 4:" 'W aseen.....~ u.s. pa P.O. Box 43210 "Eel Atlanta, GA 303364210 JAII 0 4'0 2 ,„,,gi 034 z" Pa 7'69536 U.S. POSTAGE.!.! METER d0 welcome here's everything you need to know about your new BellSouth° service. RYL PALM BCH FL 33411-4210 ,1111.....111,1„1111111 ' •• . • , • ' • • ., .• :••!..1,„6.c.:iff.:546 • .'• • • • "• • ••• •.. •••• • • •• :I • EFTA01709749 TO - DISTRICT: 0000050 SCHOOL: IM DEMOGRAPHIC INFORMATION FILE: SRTS12IS GRADE LEVEL: 09 PREPARED DATE: 04/29/2002 CURRENT DISTRICT: PAGE 01 FL STUDENT ID: SSN: CURRENT SCHOOL: LEGAL NAME: IIIII MAILING ADDRESS: ROYAL PALM BEACH FL 33411 DISTRICT STUDENT ID: FL STUDENT ID-ALIAS: PARENT/GUARDIAN (NAME/CODE): RACIAL/ETHNIC CATEGORY: W SEX: F PARENT BIRTH DATE: BIRTH VERIFICATION: I BIRTHPLACE: IMMUNIZATION STATUS: PERMANENT IMMUNIZATION CERTIFICATE VACCINE STATUS, DATE- VACCINE CERTIFICATE EXPIRATION DATE: TYPE DOSE DATE DOSE DATE DOSE DATE DOSE DAT DOSE DATE DTP POLIO HIB MMR HEPATITIS 8 VAR DISEASE COURSE INFORMATION DISTRICT: YEAR: 2001-2002 GRADE LEVEL: 09 SUBJECT CRSE CREDIT sr T COURSEN COURSE TITLE AREA FLAG GRD ATT./EARN APR 30 2002 GPA QTY PTS GPA QTY PTS DISTRICT-TERN: STATE-TERM: 2001-2002 ANNUAL DAYS-PRESENT: ■ ABSENT: SUMMER TERMS DAYS-PRESENT: ABSENT: EFTA01709750 TO - DISTRICT: SCHOOL: IM COURSE IN PROGRESS FILE: SRTS12IS GRADE LEVEL: 09 PREPARED GATE: 04/29/2002 CURRENT DISTRICT: PAGE 02 FL STUDENT ID: SSN: CURRENT SCHOOL: LEGAL NAME: I= • COURSE IN PROGRESS, DISTRICT: • SCHOOL: YEAR: 2001.2002 GRADE LVL: 09 NUMBER OF WEEKS IN EACH GRADING PERIOD: 09 -1ST GRADING BLOCK- -2ND GRADING BLOCK- 15.1 2/40 3RD 1ST 2ND 3RD SUBJECT CRSE CREDIT CRSE COURSE 09 09 09 EXM CUM 09 09 09 EXM CUM I COURSEN COURSE TITLE AREA F WKS WKS GRO GRD 2 2 2 2 2 EFTA01709751 TO - DISTRICT: SCHOOL: GRADUATION SUMMARY FILE: SRTS12IS GRADE LEVEL: 09 PREPARED DATE: 04/29/2002 CURRENT DISTRICT: PAGE 03 FL STUDENT ID: SSN: CURRENT SCHOOL: LEGAL NAME: I= ******CUMULAT IVE SUMMARY DISTRICT CLASS RANK• EFFECTIVE DATE: AS OF: 04/29/2002 CLASS RANK, NUMERICAL POSITION: • CLASS RANK, PERCENTILE: • - - CREDITS CLASS RANK, TOTAL NUMBER IN CLASS: SUBJECT TOTAL TOTAL TOTAL * AREA TO DATE NEEDED REMAINING * COMMUNITY SERVICE HOURS: 0 REQUIREMENT MET: N ENGLISH (EN) • MATHEMATICS (MA) SCIENCE (SC) * AMER HISTORY (AH) • • WORLD HISTORY (NH) • ECONOMICS (EC) * AMER GOVERNMENT (AG) • VOCATIONAL/ (V0/ * PERFORM FINE ART PF) * LIFE MGMT SKILLS (LM) • PHYSICAL ED (PE) • • FOREIGN LANGUAGE (FL) • LANGUAGE ARTS (LA) * SOCIAL STUDIES (SS) • ELECTIVE (EL) ESE (EX) • COMPUTER ED (CE) * CREDITS, CUMULATIVE: * * TOTALS INCLUDE VOCATIONAL & PERFORM FINE ARTS* GPA CITY PTS GPA OTY PTS * * DISTRICT: I= STATE: IM • ********Or******************* +4+144.• 4-14++++++++++++++++++++++1.+++++++1++4 +++++ +CERTIFIED BY: +SIGNATURE: +DATE: EFTA01709752 TO - DISTRICT: SCHOOL: IM COMMENTS FILE: SRTS12IS GRADE LEVEL: 09 PREPARED DATE: 04/29/2002 CURRENT DISTRICT: PAGE 04 FL STUDENT ID: SSN CURRENT SCHOOL: LEGAL NAME: IIIII DEFINITION OF TERM CODES CODE DEFINITION CODE DEFINITION CODE DEFINITION CODE DEFINITION CODE DEFINITION 1 SEMESTER 1 S COMBINED SUMMER B TRIMESTER I E OUINMESTER 1 J SIX WEEKS 1 2 SEMESTER 2 SESSION C TRIMESTER 2 F OUINMESTER 2 K SIX WEEKS 2 3 ANNUAL T INTERSESSION 1* D TRIMESTER 3 G OUINMESTER 3 L SIX WEEKS 3 4 SUMMER SESSION 1 U INTERSESSION 2* 6 OUARTER 1 N QUINMESTER 4 H SIX WEEKS 4 5 SUMMER SESSION 2 V INTERSESSION 3* 7 QUARTER 2 I OUINMESTER 5 N SIX WEEKS 5 R SHORT COURSE** W INTERSESSION 4* 8 QUARTER 3 Y YEAR OF 0 SIX WEEKS 6 X INTERSESSION 5* 9 QUARTER 4 NONENROLLMENT*** * USED (INSTEAD OF SUMMER SCHOOL SESSIONS) WITH YEAR-ROUND SCHOOL RECOROKEEPING ** USED ONLY FOR WORKFORCE DEVELOPMENT EDUCATION (ADULT GENERAL AND POSTSECONDARY VOCATIONAL EDUCATION) *** USED ONLY FOR REPORTING STUDENTS WHO HAVE WITHDRAWN BETWEEN SCHOOL YEARS STATE GRADING SCALE FOR HIGH SCHOOL STUDENTS (REGARDLESS OF ENTRY DATE) EFFECTIVE SCHOOL YEAR 1997-1998 GRADING SCALE, EFFECTIVE 07/01/2001 GRADE QUALITY GRADE QUALITY GRADE QUALITY GRADE EQUIVALENT POINTS GRADE EQUIVALENT POINTS GRADE EQUIVALENT POINTS A = 90 - 100 4.00 8 = 80 - 89 3.00 C = 70 - 79 2.00 D = 60 - 69 1.00 F = 0 - 59 0.00 GRADING SCALE, PRIOR TO 07/01/2001 GRADE QUALITY GRADE QUALITY GRADE QUALITY GRADE EQUIVALENT POINTS GRADE EQUIVALENT POINTS GRADE EQUIVALENT POINTS A = 94 - 100 4.00 8 . 85 - 93 3.00 C = 77 - 84 2.00 D = 70 - 76 1.00 F = 0 - 69 0.00 NOTE: FROM THE 1987-1988 THROUGH THE 1996-1997 SCHOOL YEARS, FOR STUDENTS ENTERING HIGH SCHOOL DURING THESE YEARS, THE GRADE EQUIVALENTS FOR C, 0, AND F WERE: C = 75-84, D = 65-74, AND F = 0-64; QUALITY POINTS AND ALL OTHER GRADES WERE THE SAME AS THOSE SHOWN IN THE CURRENT STATE GRADING SCALE, ABOVE. EFTA01709753 TO - DISTRICT: SCHOOL: COMMENTS FILE: SRTS12IS GRADE LEVEL: 09 PREPARED DATE: 04/29/2002 CURRENT DISTRICT: 50 PALM BEACH PAGE 05 FL STUDENT ID: SSN: CURRENT SCHOOL: LEGAL NAME: STATE DEFINED COURSE FLAGS E=ACADEMIC SCHOLAR-ELECTIVE R=ACADEMIC SCHOLAR-REQUIREMENT 9=NINTH GRADER G=GIFTED H=HONORS N=NO CREDIT I•INCLUDE IN GPA X=EXCLUDE FROM GPA W=EXCLUOE FROM STATE GPA P=COURSE IS IN PROGRESS S=CREDIT AWARDED BY SLEP EXAM T=TRANSFERRED COURSE VOCATIONAL SUBSTITUTION COURSES- S=JCURNALISM SUB FOR PRAC ARTS 0=JROTC SUB FOR PRACTICAL ARTS 1=COMP ED SUB FOR PRACTICAL ARTS 2=SUB FOR BUS EN I 1001440 3=SU8 FOR BUS EN I 1001440/II 1001450 4=SUB FOR MA I 1205540 5=SUB FOR NA I 1205380/II 1205390 6=SUB FOR GEN SCI 2002310 7=SUS FOR ANAT PHYSIO 2000350 8=SUB FOR PRE ALGEBRA 1200300 A=JROTC CST GD SUB FOR SCIENCE B=JROTC AIR FORCE SUB FOR SCIENCE K=JROTC NAVY SUB FOR SCIENCE 0=OROTC ARMY SUB FOR LIFE MGMT Q=JROTC MARINE SUB FOR LIFE MGMT D=SUB FOR BIO TECH 2000430 B=SUB FOR ENV SCI 2001340 X=SLIS FOR PHY SCI 2003310 LEP INSTRUCTION- M=HOHE LANGUAGE INSTRUCTION B=HOKE LANGUAGE II/OR ESOL INSTRUCTION (ELEMENTARY SELF-CONTAINED) D=ESOL INSTRUCTION EFTA01709754 TO - DISTRICT: SCHOOL: CATEGORY B INFORMATION FILE: SRTSI2IS GRADE LEVEL: 09 PREPARED DATE: 04/29/2002 CURRENT DISTRICT: PAGE 06 OF 06 FL STUDENT ID: SSN: CURRENT SCHOOL: LEGAL NAME: WITHDRAWAL-DATE: CCOE: STUDENT NAME, AKA: IM HOKE LANGUAGE SURVEY DATE: 08/14/2001 COUNTRY OF BIRTH: US UNITED STATES NATIVE LANGUAGE: EN ENGLISH PRIMARY ROME LANGUAGE: EN ENGLISH HEALTH EXAMINATION, SCHOOL ENTRY: Y SCHOOL ENTRY HEALTH EXAMINATION CERTIFIED. EFTA01709755 Rohde Power & Light Company, P.O. Box 025576, Miami, FL 13102 C FPL January 3. 2002 RYL PALM BCH, FL 33411 Re: Account It R YAL PALM BEA H, L 33411 Dear Customer, Thank you for your interest in FPL's Free Automatic Funds Transfer (AFT) program. The benefits of using AFT are that you save time, postage cost and you don't have to worry about late or missed payments. ENROLL BY U.S. MAIL - Please complete this application and mail it with your bill payment or a voided check to: FPL, General Mail Facility, Miami, FL 33188. Please allow 5 days to process your mailed application. OR ENROLL ON OUR WEB SITE - Avoid the delays and enroll at www.fplcom, click on Pay My Bill", then "AFT". It is secure and it takes effect within minutes. - You will receive a letter & a bill message to confirm your AFT participation. - Your monthly FPL bill will show the AFT withdrawal date from your bank account. - Some banks charge for AFT, please check before you enroll. FPL Account Number. AUTOMATIC FUNDS TRANSFER (AFT) AUTHORIZATION Name: Service Address: City: ROYAL PALM BEACH State: FL Zip Code: 33411 Phone Number: Bank Name: A U.S. funds bank account is required. kl••••••••••••• I. EFTA01709756 SELLSOUPT k etis-ortZe.Th' • AR: US. P.O. Box 43210 tylsOini JAW 0 4'0 2 et Si t Atlanta, GA 30336-3210 034 ttcasi rra 536 l EP • PI:PAGE -1,k% welcome herds everything you need to know about your new BellSouth° service. ALM H FL 33411-4210 EFTA01709757 HEALTH EXAMINATIONS r / Student's Date Full Name Phone Age I 4/ Race Sex P Address Bat indate Name of Parent or Guarepao School A. HEALTH EXAMINATION Height Weight Blood Pressure (1) NormalcN; Abnormar-A COMMENT: Abnormal Findings, by number I APpearance 2. Skin/Nose 3 Head/Scalp 4. Eyes 5. Visual Acuity IR & LI 6. Ears 7. Auditory Acuity (R d L) 8. Nose / Throat 9. Mouth. Teeth and Gums 10. Chest / Lungs 11. Heart 12. Abdomen 13. Genitals and Anus 14 Musculo-Skeletal 15 Neurological 16 Alertness 17 Emotional / Mental/ Behavior Prot ) 16. Hargicao. physical/ other ISOeollYI 19. Activity Restrictions ISPectly) 20. Abuse, substance/ physical / emotional 21. Nutrition 22 Other B. HEALTH HSTCRY • byUrnt tallach natralide d adoitit,nai soace itteoitiii C. type dale ruberCulin lest results NAME: TYRE: ADDRESS: (Please Print) Authorized Signature Date EFTA01709758 ii-TEALT FLORIDA CERTIFICATION OF IMMUNIZATION Legal Authority: sections 232.032, 402.305, 402.313, Florida Statutes; rules 64D-3.01I, 65 -22 a Administrative Code T NAME FIRST NAME MI OB MOMMYR PARENT OR GUARDIAN CHILD'S SS# (optional) STATE IMMUNIZATION IDdl Directions: • Enter all appropriate doses and dates below. • Sign and date appropriate certificate (A-I, A-2, B, or C) on reverse side of form. • if the child is presenting for the 74 grade requirement only and has previously filed a Certificate of Immunization (DH 680, Part A-I) with their current Florida school, fill in boxed areas below and complete Past A-2 on the reverse side of this form. • For additional information: See Immunization Guidelines for School and Child Care Facilities for information and instructions on form completion and immunization requirements. Guidelines are available from the local county health department. VACCINE DOE Dose 1 Dose 3 Dose 4 Dose 5 CODE MO/DA/YR MO/DA/YR -re- • ... MO/DA/YR MO/DA/YR MO/DA/YR DTaP/DTP2 A Td' Polio. Bib` M MR (Combined)' (Separate)8 G. H. I Hepatitis B9 Varicella1. Varicella Disease L 1 The state immunization ID# is an identifier supplied by the state immunization registry (optional). 2 DTP/DTaP 5 doses required. If the 4th primary dose is administered on or after the 4°' birthday a 5th dose is not required. 3 DT (pediatric) is acceptable if penussis vaccine is medically contraindicated. (Complete Part C for pertussis contraindicat ion.) 4 Td (adult) vaccine is recommended for children 7 years of age or older. 5 Polio 4 doses required. If the 3rd dose in an all OPV or all IPV series is administered on or after the 4th birthday, a 4th dose is not required. Polio vaccine is not required for children IS years of age or older. is required for child fai:ii::. :L.::: and lac...I:dal ante' and attendance only. First dose valid if given on or :rile] bimay. Second dose (measles) valid if given at least 1 month after 1" dose. A 2" dose of measles (preferably MM FO is rcouired tar melons in grades K-6 and 7th grade entry and attendance effective with die 1997/1998 school year. In each subsequent year thereafter, the next highest grades arc included. 8 Includes single measles vaccine (G), single mumps vaccine (H) or single rubella vaccine (I). 9 Hepatitis B vaccine series is required for 7th grade entry and attendance effective with the 1997-1998 school year and kindergarten entry and attendance effective with the 1998-1999 school year. In each subsequent year thereafter the next highest grades arc included. Hepatitis B vaccine series is required for preschool entry and attendance effective with the 2001/2002 school year. 10 Varicella vaccine is required for entry and attendance in preschool and kindergarten effective with the 2001/2002 school year. In each subsequent year thereafter, the next highest grades are included. Susceptible children 13 years of age or older should receive 2 doses, given at least 4 weeks apart. Varicella vaccine is not required if child has documentation of history of varicella disease EFTA01709759 --- - t_;,ii NA it 1It. MI Certificate of Immunization for K-I 2 a A/YR) -eluding 7th Grade Requirements PART A -I (Immunizations arc complete for school entry and attendance grades kindergarten throug the 7th grade requirement.) DOE Code I h 12 with the exception of / have reviewed the records available. and to the best of m knowledge, the above named child has been diphtheria, tetanus, perussis, polio. measles. mumps, adequately immunised against rubella and hepatitis B (for kindergarten effective with the varicella varicella vaccine net intheafed h:chay 1998/99 school year) and dINg'.15C either plipiCiOll documented or parental recall 2001/200,1school year)fire school intendancy us docume thy with the nted on the reverse side of thisform. Physician or Clinic Name: (pith, or stamp) Physician or Authorised Signature: Address: Date: Certificate of Immunization Supplemen t for 7th Grade Requirement PART 42 (Immunizations are comple te for students who enter or attend the 7th grade after school year. Each subsequent year thereafter, the beginning of the 1997/98 the next highest grade will be included in the requirement.) DOE Code 8 I have reviewed the records available, and to the best of my knowledge, the above named child has receive requiredfor entry and attendance in 7th grade effectiv d the following immunisations e with the 1997/98 school year: tetanus-diphtheria booster and second dose ofmeasles vaccine as documented on the , hepatitis B vaccine series, reverse side ofthisform (boxed areas). Physician or Clinic Name: (Print or stamp) Physician or Authorized Signature: Address: Date: r Temporary Medical Exemption PART B (For children in child care, family day care, preschool and grades kindergarten through 12 immunizations in Part A-I or A-2.) Invalid withou who are incomplete for t expiration date. DOE Code 2 / certifi, that the above named child has received the immunizations documented on the reverse side of thisform complete the required immunizations. Additional immun and has commenced a schedule to izations are not medically indicated at this time. Physician or Clinic Name: (Print or stamp) Expiration Date: (IS days after nest Immunizatien appointment) 'Physician or Address: Authorized Signature: Date: Permanent Medical Exemption PART C For medically contraindicated immun izations, list each vaccine and state valid clinica exemption: DOE Code 3 l reasoning or evidence for ”ash that onnmni7ction(s)as indicated in Part C above is medically contraindicated. Physician or Clinic Name: (Print or stamp) Physician Signature: Address: Date: DH 6lat BRn00. dueled' tuba edam& (Stock Martha SiasS6) EFTA01709760 Mc=rs-44* OFFICE of VITAL STATISTICS CERTIFICATE OF -LIVE BIRTH IOLA; iril • FLORIOA 109- POUR Ski 7 FEF1ALE (CONTI' Of BIRTH DIY IONA OR OCANON Of flifinf Mo Day Yea I NAut ARO III LE Of ATI [MANI I BIRTH • Olfetil 4 rc fpB 0 Mp. I Sur Wit °SIAM, (Mo 017. J •Sirm•Ati SIAN Of BAIN I/ al eu USA turn[ ~tin oLIONR-LLAUN MAUI Ii60( 0 V 7. MSala -STA!! car. TOM( OR LOCATION LIANTSIS9 OESN INSO4RS WRING 40MSS--our as Mat trarrnakratr AG( YU wt SIAIL Of BOTH (Oaf 0 USA. Aare carom," 11001E LAST of On torAl IFAINUI-NALLE LOST 100 3O f SOON. SECURITY NuisMA A to bad Odd ItrilAy Wilke penonal pal TIC (MOWN e/Pme40 ► CERTIFIED COPY IN 1141$ OFFICE OF THE OFFICIAL RECORD ON FILE c !S A Ce.RTIFIEn •OkiE AND CORRECT COPY LAW. CO NOT 14 - 71 ANY rif PRODUCT ION Of THIS DOCUMENT iS PROHIBITED BY SEAL Of ATE STATE ACCEPT UNLESS ON SECuat I v PAPER WITH RAISCO GREAT WARNING. Of f 1.00P0A Al TERA 'NON OR ERASURE v0.0S TI'S CEA TTEICATTON MMI•20 OltAlas APO .?‘ • •••STATIK MAMMA EFTA01709761 FLORIDA COMPREHENSIVE ASSESSMENT TEST (FCAT) 2001 ISM SWUM Number NORM-REFERENCED TEST School Name and Number Student Report In l N m Number Grade 08 This report shows your results from the FCAT National Norm-Referenced Test. The FCAT Norm-Referenced Test measures your achievement on a test that was given to a national sample of students. Your norm-referenced scores in Reading Comprehension and in Mathematics Problem Solving describe your performance in relation to the performance of students throughout the nation Your scores are shown below. SUBJECT SCORES CONTENT SCORES National Number Number Number Scale Percentile of Points of Points of Questions Score Rank Stanine Possible Earned Attempted Readin. Com•rehension Reading Initial Understanding Comprehension Interpretation Critical Analysis Mathematics Problem Solving Strategies Mathematics Problem Solving The Scale Score expresses your per romance and allows comparisons from year to year. Measurement Reading Comprehension Scale Scores range from 510 to 820. Mathematics Problem Solving Estimation Scale Scores range from 527 to 836. PrOblem Solving Tne National Percentile Rank and Stanine indicate your relative standing in comparison to the Number Relationships national reference group. National Percentile Ranks range from 1 to 99. Stanines range from I to 9. Number Systems Patterns & Functions II you took the test again, your National Percentile Rank might be slightly higher or lower than Algebra stated here. However, your National Percentile Rank would probably fall within a certain range. For Reading Comprehension, your National Percentile Rank should be between 81 and 96. For Statistics mathematics Problem Solving, your National Percentile Rank should be between 91 and 98. Probability Geometry Each question was worth 1 point. Run Date: 04/26/2001 0391690 EFTA01709762 nt N m FLORIDA COMPREHENSIVE ASSESSMENT TEST (FCAT) 2001 Student Number SUNSHINE STATE STANDARDS and Number Student Report net Name and Number Grade 08 This report shows your results from the FCAT Sunshine State Standards Test. The FCAT Sunshine State Standards Test measures your performance on selected benchmarks in reading and mathematics as defined by the Sunshine State Standards. Scores on this test are one indication of your achievement of the challenging content that Florida students are expected to know On the FCAT, you can attain one of five possible achievement levels. The table below shows the scale score ranges for each Student Achievement Level. Student Achievement Level Descriptions FCAT Student LEVEL 5: Performance at this level indicates that the student has success with the most challenging content of me Sunshine State Stanaaras. A Level Achievement Levels student answers most of the test questions correctly, Including tne most challenging questions. Scale Score Ranges LEVEL 4: Performance at this level indicates that the student has success with the challenging content of tne Sunshine State Standards. A Level 4 student Reading Mathematics answers most of the questions correctly but may have only some success with questions that reflect the most challenging content. I Level 5: 344-500 371-500 LEVEL 3: Performance at this level indicates that the student has partial success with the challenging content of the Sunshine State Standards, but Level 4: 350-393 347.370 performance is inconsistent. A Level 3 student answers many of the questions correctly but is generally less successful with questions that are Level 3: 310-349 310-346 most challenging. Level 2: 271.309 280-309 LEVEL 2: Performance at this level Indicates that the student has limited success with the challenging content of me Sunshine State Standards. Level 1: 100-270 100.279 LEVEL 1: Performance at this level Indicates that the student has little success with the crialiengirg content of the Sunshine State Standards. Your scores are shown belo... SUBJECT SCORES CONTENT SCORES State Number of Number of State Comparison: Points Points Comparison: Student Thirds Achievement Scale Possible Earned Thirds Level Score LOwest I Middle I Highest Reading Lowest Middle Highest Reading Words/Phrases Mathematics Main idea/Purpose Comparisons It you took the test again, your scores might be slightly higher or lower man the scores on Reterence/Researen this report. However, your scores would probably fall within a certain range. For reading, your scale score should be between 364 and 432. For mathematics, your scale score should Mathematics be between 372 and 402. Number Sense Measurement The check marks ( J ) snow it you scored in the lowest, middle, or highest third of grade 08 Geometry Florida students who took this test. Algebraic Thinking Data Analysis The Content cnart shows the number of points possible and tne number of points earned for each category. Each question on this portion of the test was worth one point. The results on your performance items will be reported separately. Run Date: 04/2812001 0388352 EFTA01709763 The School Board of Broward County, Florida CREDIT-BY-EXAMINATION 05/30/00 Dear Parent/Guardian: of Broward County rewards Credit-by-Examination is one way that The School Board initiative. The completion advanced middle school students for their hard work and awarded when students pass of high school coursework, including credit earned, is By providing this specially designed district-developed competency tests. benefit by earning opportunity to middle school students, not only does the student also has the opportunity of high school credit while in middle school, but he/she taking higher level coursework during high school. This spring, your child was assessed on one or more of the Broward County Public Schools competency tests. Based on the test results: , has passed the ALGEBRA Credit-by-Examination and will receive high school credit for ALGEBRA if he/she also receives a passing grade in the course. This credit does not carry a grade but is recorded as a "P" for Pass on the high school transcript. Please keep this document as additional verification of your child's achievement even though the Testing and Assessment staff will notify the administrative staff at the designated high school. We congratulate you and your child on his/her success. Please contact the Guidance Counselor at your child's school if you have any questions. EFTA01709764 The School Board of Broward County, Florida CREDIT-BY-EXAMINATION 05/29/01 Bear Parent/Guardian: Credit-by-Examination is one way that The School Board of Broward County rewards advanced middle school students for their hard work and initiative. The completio. of high school coursework, including credit earned, is awarded when students pass specially designed district-developed competency tests. By providing this opportunity to middle school students, not only does the student benefit by earning high school credit while in middle school, but he/she also has the opportunity of taking higher level coursework during high school. This spring, your child was assessed on one or more of the Broward County Public . Schools competency tests. Based on the test results: has passed the GEOMETRY Credit-by-Examination and will receive high school credit for GEOMETRY if he/she also receives a passing grade in the course. This credit does not carry a grade but is recorded as a "P" for Pass on the high school transcript. Please keep this document as additional verification of your child's achievement even though the Testing and Assessment staff will notify the administrative staff at the designated high school. We congratulate you and your child on his/her success. Please contact the Guidance Counselor at your child's school if you have any questions. EFTA01709765 THE SCHOOL BOARD OF BROWA RD COUNTY, FLORIDA SCHOOL BOARD Cheitpenom Vice Chairpetsese April 23, 2001 To Whom It May Concern: This letter is to inform you that has been in band ate 111 or the past three years. She is a this year. and is in the has participated in all the band performances this year including . She also performed at • Sincerely, Translisrminp Education: One Student At A Time &maul County Public Schools Is An Equal Opportunity/Equal Access Employer EFTA01709766 flay 7, 2001 'lb crlYrom Is flay Concern- ifs fetter is to recommenclal for placement in your drama programnias been a student in my drama classfor the past two years. She is one ofmy most taintedstudents in both performing andcreativity in production. INk has been an active member ofthe Junior 'Thespian Society andthis year she was president. As a memberMtvas a64 to auditionfor andparticipate in the district andstatefestivals. She has receivedsuper:Or andercce&nt ratingsfor her monologue pelonnancesefias also &felmajor roles in the club's productions. I know thaMMIwouLdbe an asset to yourprogram. If I can be ofannul-flier assistance or answer any questions, pleasefeeffree to contact me. EFTA01709767 1 4-14-n2. Afizized, a_t /r' ! liter>, 14-en-A 33/7/ „ILL ikt) zz-Act7 544 ) 188164c 2 s, °fre-aai s: lau. I9.: cif d •...lie ALF.Ittie Boatnc Co.Lc A-Adkry /4/6,- EFTA01709768 I Ind ul Surf RVISOR IX (EEC 11044 - ING US. POMACE LAID :IJI el OLIVE AVEI.1.1E.ITO OM IOS I 4 )9$ DO SOMETH ve I.4I M DEACIE I L VOTE VArM Palm Rennel %JOANN 164 RETURN SERVICE REQUESTED YOURPRECINCT ImeARER VOTER IDENTIRCATI0N YOUR OOLONG LOCATION IS, PAl FA BEACH COUNTY. FLORIDA IMACSICI INOTTUSIOROMT AIMMItAllOviamER OSiI0/01 0 A YOUR PRECINCT VANN YOU VOTE ROYAL PRESENT 1111$ CARO AT FOR OLANGEDIADDRESS INSTRUCITOrp- SEE REVERSE SIDE OFFICE RIMISTRATION NVN NOW" ON ELECTIONS IMMEDIATELY W ANY aont anost 14 ON nes CARDS INCORRECT. ROYAL PA lufludhanIA.All Lill IhAhA.ha.li State The Sunshine ROYAL. nn °COPS ax F 6-06 if-Sit 0 00-00-00 0E-10-01 gill/ wejciM iNft#M111. ti<ves, wo. rI %Ong ID Or, te twt, COnarseei ciniewl MOP% WitiOr• OpetetOn el • EFTA01709769 3/ 7// • 0 \-14: all 1fl &M -4S4 Aettieed. fe„,,fraa, Q. 3301/ Afita,z, y em-LIA-e/ "Li eac,- oi, 1, zit,c/ Kle t aided7 W e> Oier„_, r andji j‘: A jtk." pity I cm skaz &farm mutiny ,ade,<. Bandol Tau 4:40 Aki.nut Boalinc EFTA01709770 6 6)22 1- 0<s>, THE SCHOOL DISTRICT OF PALM BEACH COUNTY (SDPBC) 2 New and Returning Student Registration • NEW STUDENTS. Complete all non-shaded areas on both sides of the form. RETURNING STUDENTS: Review both sides. If the pre-printed information is incurred, correct the information by cer)e Carefully and lightly crossing out the incorrect information and writing the correct information above I V) Wei trio code) o/yei L Alai /J4'// el ,,,yi, !rm....GM:MRCSS (noose mammy/ name, Oa no) (0,4 (axe) ('I code) (I) SOCIAL SECURITY NO. (a) HOME TELEPHONE NO (9) SEX (10)RACEJETHNICOR.GIN (44444.49 01 -American Indian/Alaskan Native 0 6-Btack. Non-Hispanic 0 H-Hispanic 0 A-AsiantPacific Islander White, Non-Hispanic 0 M-Multiracial (lilt:PATE OF MATH (12)PLACE OF BERTH (atyluanioxerry) (3) RESIDENT STATUS (14)USAEN1RY DATE 04449904/YYY) LI 0. Foreign Exchange Student OM a 514 . 0 1. Oul-of-county Resident 0 2. Out-of-state Resident (D) FEDERAL IISACT SURVEY 1:414. In-county Resident YES NO (16)PRESCHOCX ENROLLMENT INFORM* ION 0 0 A The student resides on federal properly Place an X by each program allenCled Als0. Inchoate with an asterisk r) the program your CND was in the longest 0 0 B. The student resides in low rent housing. 0 0 C. The parent is employed on federal property located in Palm Beach County. O N. Non-subsidized Child Care 0 M. Migrant Pre-K 0 0 D. The parent is employed on low rent housing located in Palm Beach County. III D. Pre-K Disabilities 0 H. Headstart 0 0 E. The parent is in the uniformed services of the United States. 0 I. Pre-K Early Intervention 0 C. Chapter 1 0 S. Subsidized Child Care 0 O. Other 0 0 If E. is YES, is the parent on active duty? Check service below: (IntS DC STUDENT A ( 8) CURRENT GRADE LEVEL . 0 Air Force 0 Anny 0 Coast Guard 0 Marines 0 National Guard 0 Navy SINGLE P ey dfrc, 0 YES NO • •/ I9 NAME OF SCHOOL TRANSf RRiNG FR M CflY OR LOCATION . (21) LASTA CAM .. e6 Ada/ (22) LAST GRID( LEVEL I (73) LAST PUBLIC SCHOOL Anna° IN PALM BEACH COUNT' (24) DATE ATTEHDED IN PBC I Eta. CREENMONF.ORMATIONW-4v ' if4REE,9,1 1 EDUCED t2S) Students will receive non-invasive health screenings pursuant to Florida Statutes 381.0056(7)(d). Non-invasive e.RIGEiti.INCH screenings may include vision, hearing, SCO1i0SiS, height, and weight. These tests may be given individually or in . (27) iaipapViel groups. Parents or guardians. however, have the right to request an exemption in writing. If you DO NOT want free your child to receive the screenings. write the words to not screen here: reduced lunch? (This exemption will cover all types of screenings) cy" „ 0 YES RTC (2t) I give permission for my child to participate in the sodium flounde program to prevent tooth decay_ YESti NO (Application is pThvided (Permission is valid through 6 grade) I with this (on' NEWASEJDESITS)TREAMKDEACH•COUNN,V5SQ1/2MOSMIaatel:k ; "v;4.. 4281440mE LANGUAGE SURVEY YES N!:2--- O 3 j„... Is a language other than English used in the home? If YES. what language? ❑ L' .- 2. Does the student have a first language other than English? S If YES. what language? • E❑r3-7-Does the student most frequently speak a language other than English? If YES, what language? est t yeal languase is spoken in ilvt home by the parent or guardiaP?--- _6042/1 A (3th 5. Wnat lanouace is the student's b:51 language? 4 32) STUDEVY LIVES !MTH (c one) Olt What is the date of entry into an ESOL program? g /Mother ci Father 0 Both Parents (33) DISCLOSURES FOR ENTRY INTO PBC SCHOOL OrSTRICT E POther ozeto,,b_PAi-ei./rs YES NO DalCUSTODY STATUS OF STUDENT Meek One) o n.„A. Has the student ever been expelled from school? 0 Mother 0 Father Shared Custody O I. Has the student ever had an arrest resulting in a charge? ❑ &" 3. Has the student ever had any juvenile justice actions? ❑ Other (ss) Is there a court order barring either parent from removing or contacting the student during the school day? 0 YES -EFIC If YES, provide the school with a copy of the court order. PBSD 0636 (REV 4/6(2001) Page 1 of 2 EFTA01709771 /a. tit • .....1/4 14.1Pi t Y - LLGAL Glplia3W4 (&w , ;ease aria Ent NEW AND RETURNING STUDENT REGIST ; MICINSS • woe:. eowelmArrearnmee) I CITY STATE ZIP CODE • OCCUPATION STATE OO 3zIPs i eqc.4 . . . ILACE or ErAPLOYA • UNI ICE TELEPHON E 1BUSINESS TELEPH ONE CELUPAGER NUMBER I COSINESS TEL CE EMAIL ADDRESS (ANNAN; (MAL ADDRESS NPINAIN EMERGENCY HE AL TH AND SAFETY ANFORMAYION •• Person(s) oth !, '-t rtY,Lt:Irreealt*fi rt'": md er than parent 31: , ' ,Il 39 authorized to ick up student 1477 4.4,*.fit (38) PASSWOR D &nit 10Chiragen) (41)NAME fle sra a idie exaa. lay) ADDRESS tume/x/no w. stvet Wm? n‘abeol A, 4.4., Atm eere-4 F STATE ZIP CODE CRY / 3.302<- RE ize4NSINP rl STATE ZIP CODE ENE V' A/CYPIMP TELEPHONE RELATICNSHIP (42)AuTHORIZEO FOR WP CES 0 NO EMERGENCY PICKuP 00 If school perso nnel are unable may we have you to contact you inc r permission to ase of illness or O YES O NO call your docto occident (44) TACTICAL INCOR . emergency service r or IAANO i"tves. sikai,es, inedabN pc McAlear* Manse& behave0t. he s (911) for trans ons, of NS) FAMILY (tees port to the hosp piusacAISANAINAD ital? EKS °`A°" 106 SICIU4 PHONE O NO INN Does your child currently have health insura 1 nce? E1 (4?) I-9)5MM PRE 'YES O NO FERENCE II YES, indicate: ....... ID Medicaid Off5rivate O Healthy Kids/K rd Care .PAREter*qqA ID Interested in receiv ing information RDIATS .OTHEIft:Cl (49) NAME OF CHILD ial&Fliqiii.iPAC mu. fry, m•lcue Ne tifjeialliaciarle ar/ ili901.9;;;.‘-b SCHOOL ATTENDIN - i . W:frit ar G STUDENT NO (ocons4 GRADE DATE OF SiRT• (SO) NAME Of CHAO Rau. feu erkfou ....A.I.7 I SCHOOL ATTENDIN G STUDENT NO (cpeam t) GRADE DATE OF BIRTH WO NAME Of CHID Past feu. mics NA A SCHOOL AMA:TAN G ST HT HO lopoona) GRADE DATE OF BIRTH ISZ) NAME OF CHILD (4s I. ANL n•AMM noel VmOr's ATTENDING STUDENT IFO (AP INFIN) ceinF DATE OF BIRTH PARENT/GUARDIA N SIGNATURE FOR OFFICE I verify that the info USE ONLY rmation oiven r (93) SOF NO. ... (sgSr I uer.ut no. is true and accurate i (SS)COS I (SS) an ny CODE 1 tsn to the best of ..I" : ."!'•AA.I. 4:- . si•C I (MICK/41c 1-EV I 0 12) CAL- my knowledge. ,' 4.,".• • •-: :,. DATE . .74;cLci PESO 0636 (R EV. cr612031) page 2 of 2 EFTA01709772 THE SCHOOL DISTRICT OF PALM BEACH COUNTY (SDPBC) New and Returning Student Registration NEW STUDENTS: Complete all non-shaded areas on both sides of the form. RETURNING STUDENTS: Review both sides. If the pre-punted information is incorrect. correct the information by carefully and lightty crossing out the incorrect information and writing the correct information above it. • _41Al SO KNOWN AS MD coca) nom nom. no 4 At Ahrl Zetti ( 33911 (en code' alWart sEcumnr NO. (9) SEX (10) RAGE/ETHNIC ORIGIN popearag 01-AMOTIGErn Indian/Alaskan Native 0 Balac. Non-Hispanic 0 H-Hispanic 0 A-Asian/Pacific Islander 1;44-White, Non-Hispanic 0 AA-Multiracial (11)DATE OF BIRTH (12) PEACE OF MTh feentemeteatto) (13) RESIDENT STATUS (%4 ) USA ENTRY DATE (MWDONYYY) ❑ O. Foreign Exchange Student a 514 0 1. Oul-of-county Resident 0 2. Out-of-state Resident (15) FEOERAL IMPACT SURVEY Di In-county Resident YES NO (16)PRERrtthol ENROLLMENT as ORmAT)ON O 0 A. The student resides on federal property. pia an by each program amended Also, indicate with at wan* r) the program your thud was in the longest O 0 B. The student resides in low rent housing. O 0 C. The parent is employed on federal property located in Palm Beach County. ID N. Non-subsidized Child Care El M. Migrant Pre-K O 0 D. The parent is employed on low rent housing located in Palm Beach County 0 D. Pre-K Disabilities 0 H. Headstart O 0 E. The parent is in the uniformed services of the United States. 0 I. Pre-K Early Intervention 0 C. Chapter 1 0 S. Subsidized Child Care 0 O. Other O 0 If E. is YES, is the parent on active duty? Check service below. (MIS THE SlIJOENT A ( 10CURRENT GRADE LEVEL. ❑ Air Force 0 Army 0 Coast Guard 0 Marines 0 National Guard 0 Navy SINGLE P 0 YES (1t) Polarf Or SCHOOL Trewe ERR NG RCM OW OR LOCATION tit ACT anetnANGEna (271LAST GRADE LEVEL 123) LAST Nate SCHOOL ATTENDED IN PAW BEACH COMM (24)DATE ATTENDED IN PBC as) Students will receive non-invasive health screenings pursuant to Florida Statute §381.0056(7Xd). Non-invasive screenings may include vision, hearing, scoliosis, height, and weight. These tests may be given individually or in groups. Parents or guardians, however, have the right to request an exemption in writing. If you DO NOT want (277 Have you filled out an application for free and your child to receive the screenings, write the words 'Do not screen* here: reduced lunch? (This exemption will cover all types of screenings) 0 YES Rical (26) I give permission for my child to partiopate in the sodium flounde program to prevent tooth decaW('ES0 NO (Application is prOvided (Permission is 7. alid through 6 grade) with this loan (25) NOME LANGUAGE SURVEY YES NOV ❑ ff 1. Is a language other than English used in the home? If YES, what language/ O NJ 2 Does the student have a first language other than English? If YES, what language? • E!"-IDoes the student most frequently speak a language other than English? If YES. what language? ;25) 4 What language is spoken in the home by the parent or guardian/ col 5 What language is the student's first language/ (32)S7 E re T DYES taint (mathOne) (31) What is the date of entry into an ESOL program? Mother 0 Father 0 Both Parents (33)DISCLOSURES FOR ENTRY INTO PSG SCHOOL DISTRICT VotherAgarhiMitaTS YES NO (34) CUSTODY STATUS OF STUDENT f/ Bone) O _A. Has the student ever been expelled from school? ❑ nI2i )2. Has the student ever had an arrest resutting in a charge? 0 Mother 0 Father Shared Custody ❑ :.W• 3. Has the student ever had any juvenile justice actions? 0 Other (3s) Is there a court order barging either parent from removing or contacting the student during the school day? 0 YES 421;(0 II YES, provide the school with a copy of the court order. P8SD 0636 (REV. 416/2001 ) page i of 2 EFTA01709773 LEGAL NAME: TEST INFORMATION: SCORE SUDJECT SCORE SCORE TEST Lem. SUBJECT SCORE SCORE SU3,IECT SCORE TEST CONTENT TYPE TYPE CONTENT TYPE TYPE CONTENT TYPE. TYPE 3RD DATE NAME FORM UORO NP WORD SS WORD NC 04 02/03/1997 STA L 06 GAP/MECH NP CAP/MECH SS CAP/MECH NC NP VOCAB SS VOCAB NC VOCAS USAGE/FX NP USAGE/EX SS USAGE/EX NC 04 03/0S/1997 STA L 06 COMPREHE NP COMPREHE 5S COMPREHE NC LANGUAGE NP LANGUAGE SS LANGUAGE MC REA0<lj NP READ<T) SS REAO(T) NC 04 03/02/1997 SiA L 06 STUDYSKL NP STUDYSKL SS STUDYSKL NC SPELLING NP SPELLING SS SPELLING NC CONCEPTS NP CONCEPTS SS CONCEPTS MC 04 03/02/1997 STA L Ot LISIEN/T NP LISTEMIT SS LISTEN/T NC COMPUTAT NP COMPUTAT SS COMPUTAT NC BASICBAT N BASICBAT n BASICRAT NC 40 04 03/03/1997 STA I. 06 PROM/SLA N PROD/SLV S PROBISIV NC SCIENCE N SCIENCE S. SCIENCE NC MATH(T) N MATH<T) S MATH<T) NC 04 03/0n/1997 STA L 06 SOCSCIEN N SOCSCIEN 5; SOCSCIEN NC 04 01/21/1992 WAP E UR EXPOS 5 N WORD 5 WORD N• 03 04/22/1996 STA J 05 WORD CAP/NECK N CAP/MECH S CAP/MECH N N VOCAD S VOCAB N. VOCAL usAnut:x USAGE/EX 5- USAGE/EX N 03 04/22/1996 STA J 05 COMPREHE N COMPREHE 5 COMPREME N LANGUAGE N LANGUAGE S! LANGUAGE N• READ<T) READ(T) $ READ(T) N e 03 04/22/1996 STA J OS STUDYSKL N STUDYSKL S STUDYSKL N SPELLING N SPELLING S SPELLING N CONCEPTS N CONCEPTS S CONCEPTS N 03 04/22/1996 STA J 05 LISTEN/I. S LISTEN/T N e LISTEN/T N COMPUTAT N COMPUTAT S COMPUTAT N • EFTA01709774 ~RENT DISTRICT: CURRENT SCHOOL: TEST INFORMATION: TEST TEST LEVEL SUBJECT SCORE SCORE SUBJECT SCORE. SCORE SUBJECT SCORE SCORE GRO DAIS NAME FORM CONTENT 111II: TYPE CONTENT TYPE TYPE CONTENT TYPE TYPE. Oh 03/01/1.999 8fA J OS SORG NP WORD SS WORD NC CAP/MICH NP CAE/MUCH SS GAPINLCH NC VOCAB NP VOCAB SS VOCAO NC 06 03/01/5999 STA J OF, USAGE/EX NP USAGUIFX SS USAGE/EX NC COMPREHE UP COMPREHE SS COMPREMC NC LANGUAGE NP LANGUAGE SS LANGUALIE NC 06 03/01/1999 SIA J OS REAO(T) NP REA0(7) SS READ(T) NC STUOYSKL NP STUOYSKI SS STUOYSKL NC SPELLING NP SPELLING S.: SPELLING NC 06 03/01/1999 81A J OU CONCEPTS HP CONCEPTS SS CONCEPTS. NC LISFEN/Y HP LISTEN/T 3S LISTEN/7 NC COMPUTAT NP CONPOTAT SS COMPUTAT NC 06 03/0I/1?99 STA J 08 3ASICBAT HP BASICBAT SS BASTCDAT NC PROD/SIV NP PROB/SLV SS PRO0/51V NC SCIENCE NP SCICNCE 5S SCIENCE NC 06 03/01/1999 STA J 00 MATH(T) N MATH(T) sr HATH(T) NC SOCSCIEN N SOCSCIEN SS SOCSCIEN NC 05 03/02/1990 STA J 07 WORD HF WORD SS WORD NC CAP/MECH NE CAP/MECH SS CAP/MECH NC VOCAL N VOL/di rc VOCAB NC OS 03/02/1990 STA J 07 USASE/EX NF USAGE/EX 5 USAGE/EX NC U comrnnw N COMPRTMC SE GOMPREHE NC LANGUAGE Ni LANGUAGE (I, LANGUAGE NC 05 03/02/1990 STA J 07 READ(T) NI READ(T) S. READ(I) NC STUOYSKL N STUDYSKL S STUDYSKL NC SPELLING HF SPELLING SE SPELLING NC O 05 02/02/1998 STA J 07 CONCEPTS N CONCEPTS S CONCEPT'S NC LISTEN/T N LISTEN/T S LISTEN/7 NC 0 COMPUTAT N COMPUTAT S COMPUTAT NC • 05 03/02/1990 STA J 07 BASICBAT NI BASICBAT S BASICBAT NC • PROB/SL.V N PROB/3LV PROB/SLV NC • SCIENCE N SCIENCE S SCIENCE NC • 05 03/02/1998 STA J 07 MATH(T) N MATH(T) S MATU(T) NC SOCSCIEN N SOCSCIEN S SOCSCIEN NC • • • • • ToTrIc 0000006 SCHOOL: IIIIIITEST INFORMATION FILE: SRTS12A5 EFTA01709775 TO - DISTRICT, SCHOOL: FILE; GRADE LEVEL: 0 DATE: CURRENT DISTRICT: FL STUDENT ID: PAGE 04 SSN: CURRENT SCHOOL: FOAL NAME: STATE OETINED COURSE FLAGS VOCATIONAL SUOST I TUTION COURSES- - SPJOURNALISH SUB FOR PRAC ARTS OPJROTC SUD II)R PRACTICAL ARTS TROMP ED SOD FOR PRACTICAL ARTS 2PSUB FUR BUS EN I 1001440 3=SUD FOR BUS EN X 1001440/II 1001450 4 --SITU FOR HA 5.,,SUB FOR MA I 12053RO/II 1205390 6=SUB FOR 6E0 SET I 1205540 2002310 7,-SOD FOR ANAT PHYSIO 2000350 8 -SUB FOR PRE ALGEBRA 1200300 A'JROTC CST GO SUB FOR SCIENCE OP.:ROTC ATR FORCE SUB FOR SCIENCE :: .JR(IC NAVY SUB FOR SCIENCE ()JROTC ARMY SUD FOR LIFE MGMT 0:-JROTC MARINE SUB FOR LIFE MONT LIP INSTRUCTION- M.HOME LANGUAGE. INSTRUCTION OLHOME LANGUAGE h/Ok SUL INSTRUCTION (ELEMENTARY SELF-CONTAINED) OP-ESOL INSTRUCTION 110 GENERAL. COMMENTS DISTRICT FLAGS: U == AUDIT, • V P HONORS COURSE - ADDITIONAL 1.0 QUALITY POINT PER SEMESTER L ADVANCED PLACEMENT OR I/D COURSE - ADDITIONAL 2.0 QUALITY POINT PER SEM. ACCREDITED DY THE SOUTHERN ASSOCIATTON OE COLLEGES AND SCHOOLS (SACS). ONE CREOIT A MINIMUM OF 150/135 HOURS OF. DITNAFIDE INSTRUCTION. A MINIMUM 2.0 STATE OPA IS REQUIRED TO GRADUATE. SSAT (HSCT) - STATE STUDENT ASSESSMENT TESTS REQUIRED FOR GRADUATION CLASS RANK IS COMPUTED ON ALL. DISTRICT ATTEMPTS. FINAL CLASS RANK IS DETERMINED ON COMPLETION OF THE SECOND SEMESTER OF THEIR SENIOR YEAR. CATEGORY O INFORMATION UITHORAUAL-DATE: 06/15/2001 CODE: UO2 HOME LANGUAGE SURVEY DATE: 08/31/1992 COUNTRY OF HIRT:: US UNITED STATES NATIVE LANGUAGE: EN ENGLISH PRIMARY HOME LANGUAGE: EN ENGLISH HFALTII EXAMINATION, SCHOOL ENTRY: Y SCHOOL ENTRY HEALTH EXAMINATION CERTIFIED. DROPOUT PREVENTION PROGRAM INFORMATION DROPOUT PREVENTION PROGRAM PLACEMENT REASONS OUTCOMES DISCIPLINARY PROGRAMS DISCIPLINARY REFERRAL(S) NO DECREASE IN DISCIPLINARY ACTION TEST INFORMATION TEST INFORMATION: TEST TEST LEVEL SUBJECT SCORE SCORE SOPJECT SCORE SCORE SUBJECT SCORE . SCORE IRD DATE NAME FORM CONTENT TYPE TYPE CONTENT TYPE TYPE CONTENT TYPE TYPE 08 02/21/2001 IJAP C NR EXPOS SS EFTA01709776 ~.. a TO DISTRICT: SCHOOL: CANPSF INFORMATION FILE: SRTS12AS GRADE LEVEL: OR PREPARED DATE: CURRENT DIS1 s, : PAGE 03 fl. STUDENT 1D: SSW: CURRENT SCHOOL: 'd LEGAL NAME: DISTRICT: SCHOOL: YEAR: GRACC. LEVEL: 07 Cv CUM , STATE-1EkO: CUM: :999-2000 ANNUAL DAYS-PREGCNT: ASSENT: 4 SUMMER TERMS DAYS PRESENT: ABSENT: ACADEMICALLY PROMOTED DISTRICT: IMMISCHOOL: YEAR: 75p0-2001 GRADE LEVEL: 08 GPA SPA DISTRICT-TERM: ■ CUM: STATE-TERM: CUM: 2000-2001 ANNUAL DAYS-CRCS:ENT: ABSENT: SUMMER TERMS DAYS-PRESENT: ABSENT: ACADEMICALLY PROMOTED FLAGS: U 4 AUDIT; P . COURSE IN 2ROGRESS T-TERM: 1 ' SEMESTER 1, 2 SEMESTER 2, 3 . ANNUAL, 4 SUMMER SESSION 1, 5 m- SUMMER SESSION 2, S s SUMMER SESSION I AND 2 6 u QUARTER 1, 7 R QUARTER S. 8 " QUARTER 3, 9 = QUARTER 4, A ,, ANNUAL, R n TRIMESTER 1, C TRIMESTER 2, D TRIMESTER 3 EFTA01709777 ripIPP' ,"" TO - DISTRICT: GRADE LEVEL: OS PREPARE DATE: SCHOOL: CURRENT DISTRICT: i MATZOH FILE: SRTS12AS IP FL STUDENT ID: SSN PAGE 02 CURRENT SCHOOL: LEGAL NAME: • (954) 680-1100 DISTRICT: SCHOOL: YEAR: 1994-1995 URAOE LEVEL: 02 DISTRICT:IIII SCHOOL: • YEAR: 1997-1998 GRADE: LEVEL: 05 SUBJECT CRSE CREDIT T COURSEt COURSE TITLE SUBJECT CRSE AREA FLAG ORO ATT./EARN CREDIT 3 5100000 SECOND GRAPE T COURSES COURSE TITLE • NC AREA FLAG CRD ATT./ 3 5100110 FIFTH GRADE CREDIT, TERM: NC P I MI CREDIT, TERM: • • DISTRICT-TERM: CUM: STATE TERN: DISTRICT-TERM: CUM: CUM: In STATE--TERM: • • 1994-1995 ANNUAL. MAYS -PRESENT: ■ ABSENT: CUM: • SUMMER TERMS DAYS. PRESENT: ACADEMICALLY PROMOTED DISTRICT:. SCHOOL: NO COURSES TAKEN ABSENT: (997-1998 ANNUAL. DAYS-PRESENT: SUMMER TERMS DAYS-PRESENT: ACADEMICALLY PROMOTED ABSENT: ABSENT: • • YEAR: 1995-1996 GRADE. LEVEL: NA DISTRIC1:11ISCHOOL: 1 • YEAR: 98-1999 &RAUL LEVEL: 06 SPA DISTRICT-TERM: CUM: • 4 STATE-TERM: CUM: 1995-1996 ANNUAL. DAYS -PRESENT: ALLSENT: • • SUMMER TERMS DAYS-PRESENT: ABSENT: ACADEMICALLY PROMOTED (40 DISTRICT: III SCHOOL: YEAR: 1996.1997 SUBJECT CRSE CREDIT • T COURSEI COURSE TITLE AREA FLAG (3 RD ATT./ 3 5100100 FOURTH GRADE NC DISTRICT-TERM: CON: CREDIT, TERM: STATE-TERM: CUM: EPA (998-4999 ANNUAL DAYS-PRESENT: DISTRICT-TERM: ABSENT: III 011 CUM: summr.R. TERMS DAYS-PRESENT: STATE-TEAM: ABSENT: CUM: ACADEMICALLY PROMOTED 1996-1997 ANNUAL DAYS--PRESENT: ABSENT: SUMMER TERMS DAYS -PRESENT: ABSENT: ACADEMICALLY PROMOTED • ASSISTANT REGISTRAR • *** *************A.*** .4* * *******A (' 4 FLAGS: U = AUDIT; P .4*/.A. ,****A*.O. A*fl,AAA**,*****A*****A AAAA**A*34.44LAA*.*AAAA;A***** COURSE IN PROGRESS ***** 4#11.11******,%******4#0,*AA** **A*4 T-TERM: 1 SEMESTER 1, 2 = SEMESTER 2, 3 = ANNUAL, 4 = SUMMER SESSION 1, 5 = SUMMER 6 = QUARTER 1, 7 = QUARTER SESSI ON 2, S = SUMMER SESSION 1 ANL! 2 LI 2, 8 = QUARTER 3, 9 = QUARTER A, A A ANIMAL, B = TRIMESTER 1, C = TRIMESTER 2, 0 = TRIMESTER 3 c (41 • _ Ak EFTA01709778 • TO - DISTRICT: SCHOOL: DEBOORAPEITC INFORMATION FILE: SRISJ2AS GRADE LEVEL: OR ' .° ' DATE: 00/01/2001 CURRENT DISTRICT: PAGE 01 • FL STIIDEN1 1U: SSA: CURRENT SCHOOL.: LEOAL NAME: • MAILINS fl OORESS: .1STRICT STUDENT ID: FL STUDENT ID-ALIAS: • '1(NT/EUARDIAN (NAME -ODE): RACIAL/EIHN U SEX: F PARENT BIRTH DATE: BIRTH VERIFICATION: 1 BIRTHPLACE: • ZATION STATUS: PERMANENT CERT/FICATE DOCUMENTING MIDDLE SCHOOL & SEN. IMMUNIZATION REQUIREMENTS • STATUS, SAFE- VACCINE CERTIFICATE EXPIRATION OATE: TYPE HOSE 0411 DuSI DAM nArc nincir nA-lp • DTP TO POLIO OFFICIAL TRANSCRIPT • • HIB MUST BE DELIVERED IN SE:" ED MAR ENVC CPE WON THIS STAMP! '0. HEPATITIS B • • .-------- moon' , FORMATION r -------------------.----- DISTRICT: IM SCHOOL: DISTRICT: II SCHOOL: • YEAR: 1792-1793 0RADE LEVEL: KG TEAR: 1993-1794 GRADE LEVEL: 01 • SUBJECT CRSE CREDIT SUBJECT CRSE CREDIT T COURSE* COURSE TIME AREA FLAG O T COURSES COURSE TITLE AREA FLAG (3RD ATT./EARN • 3 5100060 KINDERGARTEN NC 3 5100070 FIRST GRADE NC • CREDIT, TERM: CREDIT, TERM: • rPA orn GPA • DISTRICT -TERM, CUM: DISTRICT-TERM: CUM: STATE-TERM: CUM: STATE-TERM: CUM: 1992-1993 ANNUAL. DAYS-PRESENT: IIII ABSENT: 1993-1994 ANNUAL DAYS PRESENT: ASSENT • SUMMER TERMS DAYS-PRESENT: ABSENT: SUMMER TERMS DAYS-PRESENT: ASSENT: • ACADEMICALLY PROMOTED ACADEMICALLY PROMOTED • DIRTRICT:MIISCHOOL: DISTRICT:IIIIScAOOE: • YEAR: 1993-1994 GRADE LEVEL: 02 YEAR: /994-1995 GRADE LEVEL: 03 • SUBJECT CRSE CREDIT SUBJECT CRSE CREDIT T COURSES COURSE TITLE AREA FLAG GRO T commit COURSE TITLE. AREA FLAG GR • S 5100080 SECOND GRADE. NC S 5100090 THIRD GRADE NC P • • • • • • • • • ** ***F4**** * * *****ANA**** 0.**********************k*kk*kkie#k ifek** ******k*****A*4k******4*****kle********h*kkkkh*A-4**k*k*Mik*M4********* • FLAGS: U AUDIT: r = COURSE IN PROGRESS • T-TERM: 1 = SEMESTER 1, 2 = SEMESTER 2, :3 ANNUAL, 4 , SUMMER SESSION 1, 5 = SUMMER SESSION 2, S • SUMMER SESSION 1 AND 2 6 = QUARTER 5, 7 QUARTER 2, n QUARTER 3, 9 = QUARTER 4, A = ANNUAL, R = TRIMESTER 1, C ' TRIMESTER 2, n m TRIMESTER 3 • • • • EFTA01709779