Present Levels of Academic Achievement and Functional Performance
Name   IEP Date

 
CST ELA   Math   Science
 
  History   Writing
 
CMA ELA   Math   Science
 
        Writing
 
CAPA English/Language Arts   Mathematics   Science
 
CELDT   Listening   Speaking   Reading   Writing
 
Hearing Date Hearing Date Vision Date Vision Date
 

 
Other Assessment Data Other Assessment Data  (e.g., data from last triennal such as WJ, WIAT)
 
Preacademic/Academic/Functional Skills Preacademic/Academic/Functional Skills
 
Communication Development Communication Development
 
Gross Motor Development Gross Motor Development
 
Fine Motor Development Fine Motor Development
 
Social-Emotional/Behavioral Social-Emotional/Behavioral
 
Health Health    Health Care Plan
 
Pre-vocational/Vocational Pre-vocational/Vocational
 
Adaptive/Daily Living Skills Adaptive/Daily Living Skills
 
Areas of need to be addresed in goals for student to receive educational benefit Areas of need to be addresed in goals for student to receive educational benefit