Page ___ of ___ INDIVIDUALIZED EDUCATION PROGRAM _______________County Schools Student’s Full Name ___________________________________ Date___________________ Alternate Assessment – Indicate the appropriate WV Measures of Academic Progress Assessment by checking standard conditions or standard conditions w/accommodations. If the district requires a "District Wide Assessment", all selected WVMAP accommodations apply. Alternate Assessment: ____ Standard Conditions ____ Standard Conditions w/Accommodations NOTE: must For Alternate Assessment eligibility, the student exhibit significant cognitive disabilities, be instructed through Alternate Academic Achievement Standards and be pursuing an alternate (modified) diploma. Justification for Alternate Assessment: __________________________________________________________________ Alternate Assessment Accommodations all that apply) PRESENTATION ACCOMMODATIONS: RESPONSE ACCOMMODATIONS: ___ P03 Braille Paper ___ R04 Scribe (including ELA full write) ___ P06 Certified sign language interpreter ___ R05 Abacus ___ P13 Documented need text-to-speech (including ELA ___ R11 Assistive technology (Alternate response passages) options) ___ P14 Documented need human read aloud (including ELA passages) TIMING ACCOMMODATIONS: ___ P22 Enlarge text on screen ___ T03 Take more breaks (no studying) (All WV-MAP tests) ___ P23 Magnification device ___ T04 time ___ P24 Translator or Electronic) (GSA science only) ___ T07 Flexible scheduling ___ P28 High color contrast ___ T09 Separate setting ___ P39 Color overlays ___ P47 Alternate Vision Form (DLM Only)
Page ___ of ___ INDIVIDUALIZED EDUCATION PROGRAM _______________County Schools Student’s Full Name ___________________________________ Date___________________ – Alternate Assessment Indicate the appropriate WV Measures of Academic Progress Assessment by checking standard conditions or standard conditions w/accommodations. If the district requires a "District Wide Assessment", all selected WVMAP accommodations apply. Alternate Assessment: ____ Standard Conditions ____ Standard Conditions w/Accommodations NOTE: For Alternate Assessment eligibility, the student must exhibit significant cognitive disabilities, be instructed through Alternate Academic Achievement Standards and be pursuing an alternate (modified) diploma. Justification for Alternate Assessment: __________________________________________________________________ Alternate Assessment Accommodations all that apply) PRESENTATION ACCOMMODATIONS: ___ P03 Braille Paper ___ P06 Certified sign language interpreter ___ P13 Documented need text-to-speech (including ELA passages) ___ P14 Documented need human read aloud (including ELA passages) ___ P22 Enlarge text on screen ___ P23 Magnification device ___ P24 Translator or Electronic) (GSA science only) ___ P28 High color contrast ___ P39 Color overlays ___ P47 Alternate Vision Form (DLM Only) RESPONSE ACCOMMODATIONS: ___ R04 Scribe (including ELA full write) ___ R05 Abacus ___ R11 Assistive technology (Alternate response options) TIMING ACCOMMODATIONS: ___ T03 Take more breaks (no studying) (All WV-MAP tests) ___ T04 time ___ T07 Flexible scheduling ___ T09 Separate setting
SpecialEducationProcessFormswithInstructionsRevisedSeptember%202017.docx