Admin Please the complete box to indicate any documentation included and initial to verify that you have Complete Initials included the documentation. Form R.8 (Notification of Student Performance Did Not Meet Passing Standard, Third Administration) OR – Form R.8 Spanish (Notification of Student Performance Did Not Meet Passing Standard, Third Administration) – Form R.9 (Confirmation of Participation in GPC Meeting Third Administration) OR – Form R.9 Spanish (Confirmation of Participation in GPC Meeting Administration) – Form R.10 (GPC Meeting Minutes Third Administration) OR – Form R.10 Spanish (GPC Meeting Minutes Administration) – Form R.11 (Parent Notification of GPC Decision Third Administration) OR – Form R.11 Spanish (Parent Notification of GPC Decision Third Administration) – CSR (Confidential Student Report) Teacher Notes/Observations Other: __________________________________ Grade Placement Committee Relationship Signature Date Printed Name Principal/Principal Designee Reading Teacher Parent/Guardian Parent/Guardian LPAC Representative (If Applicable) District Designee acting on behalf of the student because no parent/ guardian could be located Other Review of AIP by Receiving Campus Printed Name Relationship Signature Date Principal/Principal Designee Assigned Teacher Other
Complete Admin Initials Please the complete box to indicate any documentation included and initial to verify that you have included the documentation. Form R.8 (Notification of Student Performance – Did Not Meet Passing Standard, Third Administration) OR Form R.8 Spanish (Notification of Student Performance – Did Not Meet Passing Standard, Third Administration) Form R.9 (Confirmation of Participation in GPC Meeting – Third Administration) OR Form R.9 Spanish (Confirmation of Participation in GPC Meeting – Administration) Form R.10 (GPC Meeting Minutes – Third Administration) OR Form R.10 Spanish (GPC Meeting Minutes – Administration) Form R.11 (Parent Notification of GPC Decision – Third Administration) OR Form R.11 Spanish (Parent Notification of GPC Decision – Third Administration) CSR (Confidential Student Report) Teacher Notes/Observations Other: __________________________________ Grade Placement Committee Printed Name Relationship Signature Date Principal/Principal Designee Reading Teacher Parent/Guardian Parent/Guardian LPAC Representative (If Applicable) District Designee acting on behalf of the student because no parent/ guardian could be located Other Review of AIP by Receiving Campus Printed Name Relationship Signature Date Principal/Principal Designee Assigned Teacher Other
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