HOME AND SCHOOL INFO

ASSESSMENT NOTES

Name:

Age:                          Gender:(M / F)

                                  Race:(B / C / H / A / Biracial)

School:

Grade level:

Teacher:

Tutoring at school?

Favorite game / color / book / song?

Brothers and sisters?

Pets at home?

Best friend / favorite playmate?

SKILL AREA TESTED

RESULTING LEVEL

DATE TESTED

USING PHONICS / USING WORD STUDY

GETTING THE MAIN IDEA

FINDING DETAILS

COMPARING AND CONTRASTING

IDENTIFYING CAUSE AND EFFECT

IDENTIFYING FACT AND OPINION

DRAWING CONCLUSIONS

SEQUENCING

MAKING INFERENCES