DOCUMENTATION OF APPROPRIATE INSTRUCTION
SECONDARY GRADES	

STUDENT’S NAME: _________________________________DATE:_______________

CHECK ALL ITEMS THAT APPLY TO THE STUDENT

____ 	The student has participated in a reading intervention program.

____ 	The student has participated in a math intervention program.

____	The student has participated in a drop-out intervention program.

____ 	The student has participated in a remediation program for the Alabama High School Graduation
 	Exam.

____ 	The student has received standards based instruction by a highly qualified teacher.

____	The student’s data has been reviewed and appropriate instructional strategies have been
implemented in the classroom based on the student’s needs.

____	Other__________________________________________________________________________

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Name of person completing this form: ____________________________________________________