REEVALUATION DETERMINATION PLAN

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West Virginia Department of Education March 2017 REEVALUATION DETERMINATION plan _______________County Schools Student s Full Name ________________________________ Date __________________________________ School ________________________________________ ____ Date of Birth ___________________________ Parent(s)/Guardian(s) _______________________________ Grade _________________________________ Address ________________________________________ ___WVEIS# _______________________________ City/State/Zip ______________________________________Te lephone ______________________________ Triennial REEVALUATION Due Date_________________ Names of Most Recent evaluation & Dates Administered Description of Student s Current Performance Evaluate/ Reevaluate Y/N Academic Information Achievement_____________________________ _______________________ Classroom Performance_________________ _____________________________________ Teacher Report________________________ _____________________________________

REEVALUATION DETERMINATION PLAN ... Functional Behavioral Assessment ... Information from Parents _____Audiological _____ Functional Listening Evaluation (Ages 3-5) CONTINUE Names of Most Recent Evaluation & Dates Administered Description of Student’s Current Performance ...

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