Appendix K

P-12 STUDENT DIVERSITY DEMOGRAPHICS

OF STUDENTS SERVED
BY WSU EDUCATION MAJORS

Check one: Licensure Area/s: _____________________

X Field Experience ________K-6__________________________

Practicum A ____________________________________

Clinical Practice ____________________________________

Practicum B ____________________________________

WSU Student’s Name Classroom Teacher’s Name

Kate Lexvold Angela Lash
School District School Name
Rochester Public School District Washington Elementary School

Please estimate the number of students Please specify the number of students with
you served who are described by the Individual Education Programs (IEPs):
following categories:
___ Autism Spectrum Disorder
_1_ African-American ___ Blind-Visually Impaired
___ American Indian ___ Deaf-Blind
_2_ Asian ___ Deaf and Hard of Hearing
_2_ Hispanic ___ Developmental Cognitive Disabilities
___ Migrant _2_ Developmental Delay (Birth to Age 7)
___ Multi-Ethnic ___ Emotional/Behavioral Disorders
_15_White ___ Learning Disabilities
___ Other Health Disabilities
(includes Attention Deficit Disorders)
___ Gifted and Talented ___ Physically Impaired
_1__Limited-English Proficiency ___ Traumatic Brain Injury
___ Title I (Reading/Math)

Please return this form by __________ to

_________________________________________.

Address:
___________________________________________________________________.