Student History Worksheet

KEEP IN PERMANENT
RECORD FILE

Student Name:
________________________
_______________________

Initial Date of Enrollment in U.S. Schools:

Student ID: ________________________

Date Identified as LEP:

Schooling Outside
U.S.

School
Year

Grad
e

This form can help

Where

All
or
Parti
al
Scho
ol
Year
?
(A,P
)

Total
Time
Enrolle
d If
Partial
(NS =
No
schooli
ng)

_______________________

Schooling in U.S.

Where

Enrolled
60
Consecut
ive
School
Days
(Y or N)

Program
Participa
tion

School Year of
Enrollment in U.S.
(Designated LPAC
member to sign and
date each year)

TELPAS
Reading
Rating

Test
Decision

KEEP IN PERMANENT
RECORD
keep track of a students LEP status, program participation, years in U.S. schools, and TELPAS reading
rating; FILE
monitor extensive absences of schooling outside the U.S. and the schooling patterns of students who move in and out of the
U.S.; and
summarize a students test history.