Alcorn School District Teacher Support Team   

       2009-2010    School Year   

     Updated:  January 19, 2010

        Forms for an 
ACADEMIC FOLDER
  (based on sample notebook given to TST)

TST1-Teacher Support Team Checklist
TST2-Access Record for Student Folder
TST3-Statement of Confidentiality
TST4-Parent Contact Form
TST5-Summary of the TIERS (see sample notebook)
TST6-Student Data Sheet
TST7A-Hearing and Vision Screening and TST7B-Parent Letter
TST8-Cumulative Folder Copies (see sample notebook)
       Report Card Copy (see sample notebook)
       MCT/SATP/Other Testing (see sample notebook)
       Physician's Notes & Reports (see sample notebook)
       MSIS Discipline Report (see notebook)
       SASI Attendance Report (see notebook)
TST9-Parent Notification of Instruction Assistance Plan
TST10-Social/Emotional Issues Worksheet
TST11A-Learning Styles Inventory K-4
TST11B-Learning Styles Inventory 5-12
TST12-Student Classroom Observation Report
TST13-20 Day Parent Notification (insert as needed)

TIER I
TST14-Observation of Tier I Instruction
TST15-Tier I Intervention-Checklist form
TST16-Individual Work Narrative for Documentation
       Work Samples (see sample notebook)

TIER II
TST17-Tier II Documentation of Interventions
TST18-Six Weeks Documentatiion of Tier II
TST19-Calendar of Interventions (see sample notebook)
TST20-Progress Monitoring Graphs (see sample notebook)
TST21-Individual Work Narrative for Documentation
      Work Samples (see sample notebook)
TST22-Request to the TST Team

TIER III
TST23-Parent Invitation to TST Meeting
TST24-TST Meeting Summary Form
TST25-Tier III Documentation of Interventions
TST26-Calendar of Interventions (see sample notebook)
TST27-Progress Monitoring Documentation and Graphs (see sample notebook)
TST28-Individual Work Narrative for Documentation
       Work Samples (see sample notebook)

                             MISC
Policy
TST Binder Cover
MSIS Data Entry Form
Parent Notice Services No Longer Needed
Parent Letter-Permission for Information to be Sent
Student Assessment Analysis  
Oral Reading Fluency Chart
Intervention Documentation Checklist
Minor Incident Report
RTI Intervention Web Sources

         Forms for a 
BEHAVIOR FOLDER
     (based on sample notebook given to TST)

TST1-Teacher Support Team Checklist
TST2-Access Record for Student Folder
TST3-Statement of Confidentiality
TST4-Parent Contact Form
TST5-Summary of Student Experiences (see sample notebook)
TST6-Student Data Sheet
TST7A-Hearing and Vision Screening and TST7B-Parent Letter
TST8-Cumulative Folder Copies (see sample notebook)
       Report Card Copy (see sample notebook)
       MCT/SATP/Other Testing (see sample notebook)
       Physician's Notes & Reports (see sample notebook)
       MSIS Discipline Report (see notebook)
       SASI Attendance Report (see notebook)
TST9-Parent Notification of Instruction Assistance Plan
TST10-Social/Emotional Issues Worksheet
TST11A-Learning Styles Inventory K-4
TST11B-Learning Styles Inventory 5-12
TST12-Student Classroom Observation Report
TST13-20 Day Parent Notification (insert as needed)

Tier I packet
TST14-Observation of Tier I Instruction
TST B15-Tier I Interventions -Checklist form for Behavior

Tier II packet
TSTB16-Tier II Interventions-Checklist form
TSTB17-Tier II Interventions-Blank form
TSTB18-Tier II Documentation of Interventions
TSTB19-Request to the TST Team

Tier III packet
TSTB20-Parent Invitation to TST Meeting
TSTB21-Tier III Documentation of Interventions
TSTB22-TST Meeting Summary Form
TSTB23-Tier III TST Recommendation Form
TSTB24-Functional Behavior Assessment form
TSTB25-Student Behavior Contract
TSTB26-Intervention Chart

   Use as Needed:

Academic and Behavioral  INTERVENTION SITES and INTERVENTION IDEAS

Assisting Students Struggling in Mathematics
Assisting Students Struggling in Reading
Utah State Behavioral Materials
PASS   (Parallel Alternative Strategies for Students)
(PASS) volumes are unique, supplemental materials written to help
 students with various learning needs achieve success in the classroom.
http://www.pass.leon.k12.fl.us/Special%20Documents/Book%20Subject%20Areas.aspx
Rubberband Intervention
Intervention Chart
Ways to Adapt Instruction for Students
Sample Interventions-Tier II
Sample Language Arts Interventions-Tier II
RTI Intervention Web Sources
Reading Skill Areas for Interventions
Mathematic Skill Areas for Interventions
Behavioral Areas for Interventions                                              

  Sample TST 
Student Notebook
or
Student Folder

(This file was too large for this server. So, it has been uploaded to each schools server. For directions as to how to download this sample notebook from your school's server, send an email request to kwalden@alcorn.k12.ms.us  .) 

(If all TST Teams will organize documentation for the student folder or student notebook in this manner, the evaluation process will be faster.)