Professional Documents
Culture Documents
Parent’s/Guardian’s Name:
Parent’s/Guardian’s Address:
Street City Zip Code
Parent’s/Guardian’s Telephone Number: ( ) Cell Phone:
9. Parent/Guardian Signature:
10. Date:
FOR SCHOOL USE ONLY
THIS FORM MUST BE COMPLETED EVERY YEAR WITH CURRENT TEST DATA
If a language other than English is spoken more often (see question #2), the student qualifies as bilingual on application for
accreditation.
If a language is spoken less often, student qualifies as bilingual on application for accreditation if he or she meets one of the following:
scores 35% or below on norm-referenced test (NRT) on the composite reading score.
Scores limited knowledge or unsatisfactory on Reading Oklahoma Core Curriculum Tests (OCCT).
Designated Limited English Proficient on the ACCESS for English language learners (ELLs) Test.
Documentation of test results for students who marked less often:
NRT Test Date: Name of the NRT: Reading Total Composite Score:
Reading OCCT Date: ______________ Score on Reading OCCT: Limited Knowledge Unsatisfactory Satisfactory Advanced
ACCESS for ELLs Test Date: Score on ACCESS for ELLs:
WIDA ACCESS for ELLs Placement (K-W-APT or W-APT) Date: Score on K-W-APT or W-APT:
Pre-K Language Screening Tool Date: Score on Pre-K Language Screening Tool:
The Oklahoma State Department of Education complies with the provision of the Family Education Rights and Privacy Act of 1974 (Buckley Amendment) which was enacted to protect the
privacy of education records, to establish the rights of students to inspect and review their education records, and to provide for guidelines for the correction of inaccurate or misleading
data. Revised February 2009