Principal of Day/Evening School- Revised - Brockton Public

BROCKTON PUBLIC SCHOOLS BROCKTON, MASSACHUSETTS

Principal of Day/Evening School- Revised

The Brockton Public School System is seeking candidates for the Principal of the Day/Evening School to lead a grade 9-12 alternative school. This is a two-year, twelve-month Race to the Top funded position. This administrator will serve as the instructional leader of an experienced staff and diverse student body. The successful candidate will be expected to:

Supervise other alternative pathways programs as designated by the Superintendent Oversee development of the Day/Evening School as a self-supporting Chapter 70 program Manage the daily operations of the Day/Evening School, including student discipline Monitor program referrals, conduct intakes, and develop alternative curricula for college and career

readiness Coordinate efforts of the Day/Evening School with other Alternative Education programs in the district

in order to develop an integrated system of Pathways for the entire district Work with community-based organizations as partners in Alternative Education Programming Serve as a resource to students and parents to re-engage students who are currently out of school Enhance and sustain a superior learning climate to insure academic success Advocate high expectations for students and staff Possess outstanding educational leadership and administrative skills Demonstrate expertise in curriculum development and technology Integrate best practices into the curriculum Possess knowledge of state frameworks, MCAS, NCLB and data analysis Have experience in professional development, staff supervision and evaluation, budget preparation, and

building management Demonstrate successful experience in the field of alternative education Possess at least a Masters’ Degree and appropriate Massachusetts Principal license (or the ability to obtain

proper licensure within one calendar year) Other related duties as assigned by the Deputy Superintendent Salary range: $95,000-125,000

Interested candidates should immediately forward a resume, letter of intent, and a copy of license to:

Dr. Kathleen F. Moran - Human Resources 43 Crescent Street

Brockton, MA 02301 (508)580-7535

FAX: (508)580-7091

Ad Principal of Day/Evening School

The Brockton Public School System does not discriminate on the basis of race, religion, color, national origin, age, sexual orientation or disability in admission to, access to, treatment in or employment in its programs and activities.

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EdisonAcademyBrockton Public Schools

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Table of Contents

Content Page Mission and Vision 2-3 Statement of Need 3-5 Primary Partnerships 5-7 Curriculum, Instruction, Assessment 7-11 Promotion and Graduation Requirements 11 Supportive Environment 12 Intake and Admission Policy and Procedures 13-14 Recruitment 15 Application Process 15-17 Guide for Placement of Students with Disabilities and English Language Learners

17-30

Appendix Application 32-33 Required Documentation Checklist 34-35 Recommendation Form 36 Academic and Behavior Success Plan 37-38 Weekly Progress Note 39 Credit for Work Service 40-46 MA Work-Based Learning Plan 47-50 ELA, Math and Science-Technology-Engineering MCAS Portfolio Checklist

51-59

School Calendar 60-61 Program Schedule 62 Academic Calendar School Closings 63 Individualized Graduation Planner 64 Assessment of Needs and Services 65-82 Interagency Permission To Share Information 83-87

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Edison Academy

Mission Statement

The mission of the Thomas Edison Academy is to implement an innovative program that offers instructional support and

intervention strategies that reconnect students who are over aged and under credited for grade level, and are either at‐

risk of, or have already dropped out of school. Through the establishment of community partnerships and the use of

community resources, the academy seeks to embrace these youth in a rigorous high school diploma program focused on

academics, career training and college readiness. The Academy will accelerate student progress and maximize the

effectiveness of how curriculum and instruction are delivered through the development of 21st Century literacy skills and

a responsive personalized learning experience.

Vision Statement

The Edison Academy is committed to providing excellence in education for all students. The school will offer student‐

centered programs and learning experiences that promote both academic and social achievement. As a richly diverse

community of learners, Edison Academy will assume a central role in the community by linking local agencies,

businesses, and institutions of higher education to the school. The Academy will actively recruit highly qualified

educators who mirror the diverse student population and can offer rich experiences and comprehensive supports in

their content areas.

The Edison Academy will provide a safe and productive learning environment in which students can communicate

effectively, think critically, solve problems and are technologically literate through a variety of curricular and

community‐based programs. Students will learn to understand important concepts, develop essential skills, and apply

what they learn to real‐world situations. Through a challenging course of study with high standards and experiential

learning opportunities, students will become responsible learners who can not only work collaboratively, but also be

accountable for their own academic and developmental progress.

The Academy envisions an approach to learning that starts with each student. This student‐centered learning maximizes

the potential for full participation of each student, and expects of each student an active role in the design of his/her

individual student success plan. Learner support will be built into each day for the review of short term and long term

goals that are part of each Individual Student Success Plan (ISSP). Students will be placed in small advisories for this

purpose.

The Academy plans to build structured learning time into the varied and rich learning experiences that occur for many

students outside the school walls, especially at work sites and community service learning opportunities. Dignity and

self‐esteem are often found through work, along with the economic benefit of wages, and these kinds of experiences

are often worthy of academic credit. The Academy will offer academic credit for well‐structured paid or unpaid

internship experiences that are governed by an agreement between the school and the site, that are monitored by

school staff, and for which students create products and materials that demonstrate important and substantial learning

has occurred.

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To realize its mission, the Academy will ensure that all students have:

A Graduation Coach who serves as an advisor and counselor

An Individual Student Success Plan the students actively design with staff support

Occupational guidance and preparation

Paid and/or unpaid internships at work sites and community service experiences for academic credit

Responsive services to address any challenges they face that may interfere with learning, with the support of

community partners who possess expertise and resources relating to those challenges

Access to technology leading to digital‐age literacy, including distance learning and full use of internet‐based

information sources

Opportunities to take college level courses that earn both high school credit and, simultaneously, college credit

at partnering institutions of higher education (dual enrollment)

Intensive exposure to college expectations to ensure college readiness, including early administration of the

Accuplacer test used by Massachusetts community colleges

The ability to take any and all courses required to satisfy the expectations of the MassCore curriculum, either at

the Academy or via dual enrollment at an institution of higher education

A well‐developed role for their parents/guardians to be active supporters of their education

The school will be designed to offer students a later start in the day and a twelve month program that will include

work based learning experiences as a core component of services. Students will enroll in courses that run from

September through June. From September through June, classes will be held Monday through Thursday from 3:00

PM to 9:00 PM. Students will attend Friday advisory sessions during which teachers will evaluate their individual

progress and assist them in further development of comprehensive essential skills. The summer session will have a

flexible learning schedule that allows students to complete a career exploration, internship, or community service

component.

Edison Academy students will graduate as lifelong learners who will make valuable contributions to their

community. Through the collaboration of school and community, every Edison Academy graduate will be well

prepared for the demands of the 21st century.

Statement of Need

The dropout rate of the Brockton Public Schools during the 2008‐2009 school year was 5.4% which exceeds the state

average of 2.9%. This rate is present despite the efforts the District has implemented to decrease the number of youth

who are disengaging from the educational process. Currently, the Brockton Public Schools offers various distinctive

alternative pathways for serving the needs of students for whom the traditional setting at Brockton High School has not

worked. One alternative, the Afternoon Academy program currently serves English Language Learners who are over‐

aged and under‐credited for grade level. The Night School program, which is the another option, serves over‐aged and

under‐credited students who leave Brockton High school due to a variety of academic, personal, and behavioral issues.

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Both programs serve youth between the ages of 16‐21. By combining these two pathways and providing additional

supports and services, the needs of the two populations will be serviced in a comprehensive and promising manner.

Students who have not experienced success in the traditional school setting need to be offered hands‐on educational

opportunities and varied teaching methodologies that are sensitive to different learning styles. Providing support for

these students as they explore this type of program will empower students to make the connections between success in

school and a productive post secondary career. Students who master new skills take ownership of their learning and are

more likely to seek additional educational opportunities beyond high school.

During the 2009‐2010 school year, 13.6% of the students at BHS were Limited English Proficient. There are currently 35

students enrolled in the Afternoon Academy program. The Edison Academy would expand the scope and capacity of the

program and offer a viable alternative pathway for this group of students. The Academy would allow for the exploration

of additional programming to attract and retain a larger number of students who are at‐risk of dropping out.

The Night School program serves approximately 200 students per year. Between 50‐70 students per year attain a High

School diploma through this program. This alternative path to graduation provides an invaluable service to at‐risk

learners who need an accelerated and alternate means to a diploma. Both the Afternoon Academy and Night School

programs face challenges in serving the targeted populations. The specific challenges and issues that will be addressed

by the implementation of the Edison Academy are as follows:

The funding for Afternoon Academy is finite with no guarantees beyond this fiscal year. When this funding is

depleted, the program will become a fee based service. Night School is such a tuition based program in which the

average student must pay $660. per semester to attend. Almost 70% of the students at BHS are low income

students who qualify for free/reduced lunch. The cost associated with the Night School program prevents many

students from attending. 100% of the students in the Afternoon Academy program qualify for free/reduced lunch,

and any tuition will be a prohibitive expense.

Many students in the Afternoon Academy program have a limited or interrupted educational history. This proposed

program will have the flexibility to accelerate credit accrual to help these students catch up and engage in an age‐

appropriate learning experience.

There is a lack of educational continuity for many of these youth due to the high rates of mobility of the student

population. Youth tend to move between various residences due to a multitude of issues stemming from family

dynamics and other various socio economic issues. Many students transfer from one inner city school to another

carrying forward the very issues that caused them to transfer to the alternative setting. These issues increase the

rates of drop out for our populations.

Concerns are presented with the unidentified or under‐addressed specific learning needs of specific populations

including English language learners, students with disabilities, teen parents, court ‐ involved youth, homeless

students and others. The wrap ‐ around services presented with the design of the Edison Academy are created to

support the individualized needs of each youth enrolled. Increasing the opportunity for student to engage in

authentic learning with connections to the community, to be able to do their homework during school with

additional supports, and then explore the real opportunities of work and / or community service learning will make

the learning experience valuable to the student.

Lack of parental involvement for the student populations represented tend to cause pose challenges for the youth

to value and commit to the educational process. Again the wrap around services presented in the Edison Academy

model will assist in fostering the intrinsic motivation that will engage students in the educational process.

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The inflexibility of traditional high school schedules pose many barriers to the student populations described. An

individualized and flexible schedule to meet the needs of all learners as outlined in the Academy will remove many

of the barriers of the traditional high school setting. Additionally, the traditional school year does not provide

opportunities to accelerate credit acquisition for older students who need to graduate school before they age out of

the school system. It is projected that youth who enroll in the Academy will do better in high school, complete high

school at a higher rate and continue on to college at a higher rate.

There is a lack of awareness and/or family support for post secondary education. Most students have a lack of

family role models who have completed high school or have entered into post secondary programs. The Academy

will assist the students in establishing the goal and believing in the possibility of entrance into college.

Economic issues require many students to work during traditional school hours thereby causing issues of truancy

and disengagement in the educational process. The proposed model of services would turn this barrier into a

positive by providing credit for work and / or community service learning.

The flexibility as outlined in the design and implementation of the Edison Academy is necessary in order to carry out the

objectives of the school. Students need to experience success to be accountable. The school’s primary responsibility is

to be student‐centered. A cooperative effort by family, students, community, and school is critical to meet the needs of

the individual. The program will focus on students individual academic, social, and emotional strengths. Students excel

in an environment where they are valued and challenged. Valuing differences is essential to success in a program such

as this. A collaborative process between school, community and student, and family offers an opportunity for students

to experience success in an educational setting. There is strong staff, parent, and community interest in this Academy as

is presented in the representatives of the committee who worked on the design of this school. The implementation of

this proposed school would allow for the creation of an innovative program that includes expanded electives as well as

career, and work programs designed to heighten the success of the students involved for their betterment as well as the

community at large.

Primary Partnerships

Community partners are an essential and integral component to the design and implementation of the Edison Academy.

The section below will highlight the partnerships and provide a brief description of their services.

I. Dual enrollment services will be offered via the following partnerships:

Jon. L. Jenmarc, Incorporated in conjunction with Fisher College has agreed to provide the Academy with a program entitled College Jump‐Start. This program is designed to offer seniors a means to earn undergraduate credit for course work. These credit courses would be offered free of all charge. Each course will carry 3 undergraduate credits from Fisher College, which may be transferred into any accredited college.

Masassoit Community College will offer distance learning opportunities to the student population. In addition to this service, the Accuplacer will be administered at the Academy via resources provided by Massassoit.

Bridgewater State University through their Continuing Education Department will assist in dual enrollment opportunities for the Edison Academy youth.

Catholic Charities have a Certified Nursing Assistant and a Certified Home Health Aide program. This agency is willing to have students enroll in either option at their location or will offer the courses at the Academy if the numbers of interested youth warrant the change in venue.

II. Work and community service partnerships will be offered through the following contacts:

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Stonehill College will provide supports and resources for the Community Service Learning component of the Academy’s service plan. Stonehill students will also complete community service work in the Edison Academy by providing additional supports in the classroom.

The Brockton Area Workforce Investment Board will assist in connecting employers with job seekers.

The Metro South Chamber of Commerce will foster connections in the community for paid and unpaid internships.

Youth Works, a component of the Brockton Area Private Industry Council, will provide workforce development services in to assist the youth in acquiring skills that will enable them to be productive members of the labor force and attain economic self‐sufficiency.

Commonwealth Corporation will offer technical assistance relating to academic credit for work and community service learning experiences.

Chartwells is the District food service provider. This organization has agreed to provide internship opportunities within the cafeterias of the schools.

Concord Foods will offer a limited number of internship opportunities due to the skill level required to work in their factory setting. Representation on the Edison Academy Advisory Board will be provided by an individual from this company as an alternate form of support.

Harbor One, a local banking facility, has agreed to accept interns at their locations. Additionally, they have agreed to offer extended hours at the on‐site banking location that is located within the building that will host the Edison Academy. This will foster the ability to increase the opportunity for youth interested in the field of finances to have supportive exposure to the career.

Community Bank

Good Samaritan

Signature Health Care is interested in offering internship experiences in the variety of opportunities that are presented in a medical health care facility.

Verizon

Comcast

Community Cable Access

III. Wraparound supports will be offered by the following partners:

Brockton Area Multi Services, Inc. (BAMSI) will offer counseling and other services via its role as the local Community Service Agency (CSA). BAMSI offers an array of services such as:

o community resources, information and support services o developmental disability services o family support and stabilization services o individual and family counseling o mental health services o and other such supports o mobile crisis intervention

Stonehill College through the office of Community Based Learning has agreed to provide college students who will volunteer to assist in the classrooms by providing individualized and small group supports to the learners.

Massassoit Community College has agreed to provide MCAS remedial supports to youth who would require this service.

Health Imperatives is willing to provide health related workshops, courses, informational materials and experiences.

IV. College Access and Planning Services

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The Massachusetts Educational Financing Authority (MEFA) will be utilized to offer college planning, saving and financing assistance. Students will create a portfolio using the new MyPlan for College Program sponsored by the Department of Elementary and Secondary Education and MEFA.

Massasoit Community College will administer the Accuplacer at the Academy. The purpose of ACCUPLACER tests is to provide students with useful information about their academic skills in math, English, and reading. The results of the assessment, in conjunction with information on academic background, goals, and interests, are used by academic advisors and counselors to determine appropriate course selection.

Health Imperatives is willing to offer classes on site that are designed to focus on various aspects of the health care industry. This agency has an existing curriculum that would be implemented. A core aspect of the curriculum is centered upon the utilization of guest speakers from the local hospitals who are currently employed in the field.

The partners listed above were chosen due to the ability and specialty of their service options. Through these

collaborative initiatives, a comprehensive model of services can be offered for youth, a level of comprehensiveness that

could not be offered without their supports.

Curriculum, Instruction, and Assessment

The focus of the curriculum at the Edison Academy will combine high expectations for every student utilizing a

competency‐based and standards‐aligned approach, a personalized learning environment, and opportunities to make

connections between classroom learning and the world outside the school.

The model for implementation is embedded in a performance based system with a supportive culture and effective supports. The Edison Academy provides curriculum, instruction, and assessment that are focused on knowledge, skills, and understandings. Students develop meaning and understanding at their own pace and graduate according to their demonstrated learning rather than seat time, age, or credit accumulation.

Curriculum

The competency‐based and standards‐aligned curriculum are designed to help facilitate rigorous and relevant understanding in the classroom by highlighting what is most essential in a discipline and supporting students in mastering the standards and provide a framework for teachers to authentically assess student work. Both the competencies and the prioritized standards are present in all aspects of curriculum design. The curriculum development begins with identifying what students need to know, understand, and be able to do for a course or subject. The scope and sequence is developed by identifying the appropriate competencies and state content standards students will learn in each course. Next, teachers develop curriculum maps, authentic assessments, unit lesson plans overviews, daily lesson plans and rubrics that will enable their students to meet the prioritized standards by demonstrating their knowledge, understanding and ability in the competencies.

The selection of appropriate materials and resources is driven by decisions about what students need to know, understand, and be able to do. The Edison Academy classrooms will utilize curriculum materials and resources drawn from a wide range of group identities and backgrounds to foster cultural respect and identity. The educational resources that are implemented in the traditional classroom setting will be enhanced with increased technological advances to foster 21st century skill development. This medium will be united with hands on real life engaging projects to instill the skill set required for future success. Traditional classroom exposure will be available for those youth who thrive and are more confident in this setting.

Data

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Accountability is imperative for all schools. It's not only important to employ standardized tests to measure student performance but it is imperative to track baseline data to measure student growth. Different measures of data need to be triangulated in order to assess competency of the standards. A diagnostic standards based assessment will be administered upon entrance to place students accordingly so as to meet their educational needs and secondly, for a method of tracking baseline data. Although assessments may vary, their measurements will adhere to state standards and speak to students' knowledge of the mandated curriculum. Data meetings will analyze these data with all teachers so teachers will be begin to analyze trends in areas that will be deemed as red areas or truly under ‐performing areas. The process by which teachers are involved under a trained data facilitator will ensure their commitment data driven instruction. We will set a culture of data use the invites participation by those who are in the classroom working with students. True data driven instruction involves buy in from educators and a forum with which to look at data collaboratively. Triangulating these data will foster a deeper understanding of student achievement combined with instructional practices. For example, assessing data in which a teacher assesses student work with an advanced rating on a particular concept when they haven't mastered it on a standardized test will challenge the teacher to become more reflective in assessment. So the focus... data driven instructional practices that are intentional and baseline data that tracks student growth, the latter is really a productive way to look at previously under ‐performing students. We know they may test low compared to others in the state and district but their achievement in terms of a growth model is very telling.

Instructional Practices Edison Academy will implement project‐based learning experiences as a core methodology of instruction. Students will

work in teams to explore real‐world problems and create presentations that include culminating projects to

demonstrate what they have learned. Compared with learning solely from textbooks, this approach has many benefits

for students, including:

• Deeper knowledge of subject matter;

• Increased self‐direction and motivation;

• Improved research and problem‐solving skills.

The project based learning opportunity will be curriculum driven and standards based. Within this framework, the

learning experience involves questioning, planning, scheduling, monitoring, assessment and evaluation.

The process will be initiated with the “essential” question. Students guided by teachers will capture a real‐world topic

and begin an in‐depth investigation of the issue. The topic will be relevant to the student population. In order to

accomplish this attention to an authentic concern, students will be engaged in the brainstorming process. Engaging

them in the development of the essential question facilitates the development of a real world concern and ensures the

learners “buy in” on the project.

The planning phase will address which content standard will be addressed while answering the question. Students will

be actively involved and engaged in the questioning, planning and project building process.

Scheduling occurs with the teachers and students designing a timeline for the project components. Key benchmarks will

be denoted within the guidelines of this phase.

Monitoring of the project is utilized to facilitate and mentor the process. A rubric will be designed to guide this process

which will, in turn, be utilized as an assessment tool. It will also assist the student in understanding what their

expectations are and will serve as a guide for the overall project. The rubric will focus on measuring the objectives,

providing a range to rate performance, and contain specific performance characteristics arranged in levels indicating the

degree to which the standard was met.

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It is essential that the assessment process be authentic and determines whether learners are able to demonstrate the

instructional objectives established by the completion of the project. Scaffolding the project so that it builds up to a

final assessment that represents a blend of all the content covered in the project ensures that the learners have

improved over time and achieved the instructional objectives. The rubric will serve a different role in various phases of

assessment. During the pre‐assessment phase, the rubric will be utilized to clarify expectations with the learners. As a

result, the students can perform a self‐assessment of his / her work throughout the project. During the assessment

phase, the rubric will assist the instructor to remain focused on the preset standards of excellence and objectively assess

the student. During the post assessment phase, the students will be provided with a scored rubric with clear

explanation of their grade with clear delineations of their strengths and areas of limitations.

In the evaluation process, reflection by the youth individually as well as by the group will be incorporated into the

process. Discussion will occur as to what worked well and what could have or should have been changed. This dynamic

process will foster new inquiries and therefore new projects.

The following guidelines and criteria will be utilized evaluating the effectiveness of problem‐ and project‐based learning

implementation in the Edison Academy:

Allows for a variety of learning styles

"Real" world oriented ‐ learning has value beyond the demonstrated competence of the learner

Risk‐free environment ‐ provides positive feedback and allow choice

Encourages the use of higher order thinking skills and learning concepts as well as basic facts

Utilizes hands‐on approaches

Provides for in‐depth understanding

Accessible for all learners

Utilizes various modes of communication

Assessment is congruent with instruction, i.e. performance‐based

Students are responsible for their own learning

Students have ownership of their learning within the curriculum

Projects promote meaningful learning, connecting new learning to students' past performances

Learning utilizes real time data ‐ investigating data and drawing conclusions

The learning process is valued as well as the learning project

Learning cuts across curricular areas ‐ multidisciplinary in nature

Teacher is a facilitator of learning

Student self‐assessment of learning is encouraged

Work based learning will serve as a key innovation of the school. Work based learning occurs when a student is actively involved in a work setter, whether paid or unpaid, and his/her duties and responsibilities have been carefully structured to offer a learning component. The learning that takes place in a work place can be substantial and empowering. However, not all jobs are sufficiently learning –rich to warrant formal inclusion in a student’s academic program. When a work experience offers a continuing opportunity for personal growth and skill gain, and when identified adults at the workplace ensure that continual learning occurs on the job, then the experience may be appropriate for inclusion in the school experience. For this to be the case, the learning must also be well documented and the source of reflection for students. A well structured work experience of this sort is credit worthy. Edison will refer to such credit worthy work experiences in which our students participate as internships, whether paid or not, and whether or not the school brokered the placement. A work experience will only be characterized as an Edison internship if there is a written agreement between the work site and the Academy.

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Brockton Public Schools have developed a set of guidelines for transforming work experience into a credit worthy internship. The District’s guidelines are attached as an Appendix. It sets forth a number of student products that can be used to capture the learning that is occurring at the site, and to enable the student to reflect on the experience in order to capture the structured learning that is taking place. The guidelines indicate that the student and teacher will develop a plan for the internship that addresses the various student products that will need to be created over the course of the internship in order for the student to earn credit from the experience. In order for credit to be offered, certain minimum elements must be present:

The student must have a sponsor who will work in conjunction with the Edison Academy Workplace Coordinator to award academic credit

The sponsor and Workplace Coordinator will determine what the expectations for the work experience are, and the student and sponsor with the Workplace Coordinator will review them before the start of the work or community service

A written plan reflecting that set of requirements will be created so that the student is clear about expectations

An expectation of this model is that the student and sponsor with the Workplace Coordinator will have regular and frequent meetings

Students must perform the work assigned by their sponsor As is the case of project based learning (PBL), work based learning also offers the following benefits for youth:

Deeper knowledge of subject matter infused into the internship experience

Increased self direction and motivation

Improved research and problem solving skills The work based learning experience will be monitored by the Workplace Coordinator in conjunction with staff from the workplace. The Workplace Coordinator will make an assessment of the duties and responsibilities of the internship and will identify and document the connections between the academic program of the student and the work experience. The work based learning experience, like PBL, will involve questioning, planning, scheduling, monitoring, assessment and evaluation. The Workplace Coordinator will use several tools to monitor students’ internships. One significant tool is the Massachusetts Work‐based Learning Plan (WBLP), which is an assessment tool used across the state to measure skill gain by youth during brokered work experiences. The WBLP is included in the Appendix section of this document. It was developed by the Massachusetts Department of Elementary and Secondary Education (DESE), and has been widely used in recent years. It is a rubric that assists students to understand what the expectations of the work site are, and will serve as a guide for the overall project. The rubric will focus on measuring the objectives, providing a range to rate performance, and contain specific performance characteristics arranged in levels indicating the degree to which the standard was met.

The community of Brockton and the surrounding towns has four primary industry availabilities for workforce development and employment. The four categories are: health care, banking and finance, communications, and the food service industry. There are three major hospitals within a five mile radius as well as a magnitude of nursing facilities. In the nearby towns, there are an additional two hospitals. Within the city of Brockton itself, there are twenty two banking branches that service the community needs. The food service industry offers a magnitude of employment opportunities some that are embedded within the health care facilities. In addition to these placement opportunities, there are a multitude of restaurants of varying scale, function facilities, and higher education colleges that also house food services. Communications are imbedded in all

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aspects of community development. Due to the abundance of these employment opportunities, the program’s credit for work and service initiative will focus the curricula and program design on these four major avenues. Academy students who are participating in work experience or a community service program with sufficient hours may be eligible for academic credit for their work/service. In order to receive credit, students must have a sponsor who is approved to award academic credit by the Academy, and they must perform the work assigned by their sponsor. The curriculum will be designed so that students will learn all aspects of the industry including the employability skills. An expectation of this component is that the student and sponsor will have regular and frequent meetings, either during regular class time or during a scheduled meeting outside of school. Additionally, the student must demonstrate academic progress in order to maintain placement in the workforce development opportunity.

Assessment

The Academy will utilize assessments that allow students to demonstrate their understanding of the prioritized standards through competencies. Assessments will be developed to measure the learning objectives identified, which are directly linked to the competencies and prioritized standards. In all activities, products and performances will be assessed using the rubrics developed for the competencies and projects.

The students will be assessed, as much as possible, on authentic products and performances such as applying knowledge and skills learned in their courses to meaningful problems that they may encounter in their life, and then to defend their processes and solutions. Authentic assessments ask students to discuss, perform, write, evaluate, analyze, and create artifacts that demonstrate and extend their learning of content standards through the competencies as they complete their task.

Every student will be required to create a Portfolio that contains his or her accumulation of significant work for each course and content area. The Portfolio will be a document designed to engage the student in reflection on his or her learning, to demonstrate his or her progress, and as a body of work to show academic growth. The Portfolio will also serve as a formative assessment for teachers to track and assess student progress in the prioritized standards and competencies. Additionally, the Portfolio will be utilized, if need be, for youth to earn a Massachusetts Competency Determination should he/she fail to pass the MCAS. The Appendix section contains the checklists that will be utilized for filing for an English language arts or mathematics appeals.

It is important to regularly assess students because learning happens on a continuum. Continuous assessment is crucial in providing feedback to the teacher on the effectiveness of classroom instruction, and for teachers and students to know how well the students are doing. Frequent assessment also allows students to have multiple opportunities to demonstrate their learning. This is valid for learning that occurs in the classroom setting or in the workplace environment.

Promotion and Graduation Requirements

Student’s individual graduation plan will be determined at the point of entry. Based on school records and transcripts

from previously attended schools, student will receive transfer credit from other public and private school programs.

After determining the individual graduation plan, the student will be enrolled in the appropriate courses and support

classes. The year of graduation will be determined by the student’s academic progress and completion of the Edison

Academy requirements. See Graduation Planner.

Supportive Environment

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The Edison Academy recognizes and respects the numerous challenges that many of our youth bring to their educational experience. Given that, a strong supportive environment will be established to provide the necessary assistance to assist the youth in channeling their challenges into a successful experience. The supports will be provided through staffing positions within the Academy and through the myriad of community partnerships. The following model, as adapted from the Center for the Study and Teaching of At‐Risk Students (C‐STARS) will be implemented at the Edison Academy.

The structural components are:

Case Manager – holds the position of overall coordinator; responsibilities include identifying at‐risk students and referring them to the inter‐professional case management team, facilitating meetings and mentoring and advocating

Inter‐professional Case Management Team – includes at least the case manager, a social worker and a health service professional ‐ the team executes the seven functional components of this model.

Comprehensive Service Network – includes a range of local services that agree to work with the case manager and case management team to deliver specific services as needed by students

The functional components that will guide the case management team are:

Assessment – identify the causes of targeted student’s difficulties

Development of Service Plan – determines a coordinated service plan involving coordinated short‐term and long‐range services delivered in and out of school

Brokering – establish connections between students and those services that cannot be offered through the school

Service Implementation and Coordination – firstly, deliver services to students; secondly, ensure that services are actually working together for the student’s benefit

Advocacy – help students and/or family negotiate bureaucracies and facilitate communication between students and service providers

Monitoring and Evaluation – track services delivered to students, and monitor emerging needs in order to make swift adjustments as they become necessary

Mentoring – one member of the case management team becomes the “primary professional” who follows through with the student on a one‐on‐one basis, regardless of the number of specialists involved in the services

The Edison Academy supervisors may chose to redefine job descriptions to designate existing school personnel as case managers and redefine school procedures. Evaluation is a key component of this model, and elaborate and systematic evaluative methods are recommended by C‐STARS. Using such methods, it was found that school attendance, performance, and behavior of students all improved in the period during which the model was implemented.

Future Focus

The Edison Academy will intentionally focus on students’ futures through awareness, exposure, and preparation

opportunities, and by providing transitional experiences for students through their work or internship

experiences. This involves a sequence of civic, career and college exploration activities and opportunities that

are embedded in advisories, classroom activities, and out‐of‐school Edison Academy.

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INTAKE AND ADMISSION POLICY AND PROCEDURES

I. INTRODUCTION

A detailed selection/admission process is necessary in a program in which there are more applicants than

openings. In the case of the Edison Academy, this is particularly relevant given the nature of the program

offered which aims to serve a particular student population. This process allows for the identification of

applicants that may most benefit from this unique educational opportunity. All applicants to the Edison

Academy will be evaluated using the procedures and selection criteria contained in this Admissions Policy.

II. EDUCATIONAL OPPORTUNITY

The Edison Academy does not discriminate in its admission, access, services, and treatment on the basis of race,

ethnicity, sex, religion, national origin, sexual orientation, veteran status, marital and living status,

homelessness, or disability. Any under credited youngster between the ages of 16 and 21 years old who has not

experienced success in the traditional education setting and wants to re‐engage in their education has the right

to apply and be considered for admission.

Information on Limited English Proficiency, disability and/or homelessness submitted voluntarily by the

applicant, for the purpose of receiving assistance and or accommodations during the application and admission

process will not affect the applicant’s admission to the Edison Academy.

Applicants who voluntarily identify themselves or who are identified as individuals with Limited English

Proficiency will be assisted by an interpreter who will help them in completing forms and assist them throughout

the application/admission process.

Applicants who voluntarily identify themselves as having a disability will receive reasonable accommodations. EA

will provide for reasonable accommodations to assist the applicant throughout the application and admission

process.

Applicants that identify themselves as homeless will be made aware of the federal policy that requires the

school to refer them to the district homeless liaison and of the services and support they are entitled.

The Edison Academy will follow an open admission criteria regarding residence status. No student will be given

priority for admission on the basis of residence.

III. ELIGIBILITY

The Edison Academy admits male and female youth who are over‐aged and/or under‐credited for grade level

high school between the ages of 16 and 21 years old. The EA is mainly oriented to serve individuals whose

secondary educational process has been truncated for a variety of reasons and who want to make the serious

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commitment to re‐engage in their education. The EA makes available to these individuals a rich educational

program which includes free‐of‐charge structured learning time and wraparound services designed to provide

individuals with the personalized support required to have the opportunity to earn a high school diploma and to

obtain career training/education within the fields of food production, health related services, financial

education, and communication.

IV. ORGANIZATIONAL STRUCTURE

The Edison Academy is an innovative local public school located in Brockton, Massachusetts where over aged, under

credited students between 16 and 21 years old can earn a high school diploma with the added benefit of obtaining

career training in four different areas. Edison Academy is accredited by the XXXXXXXXXXXXXXXXXXXX. (Chapter

references here).

The Superintendent of Schools will have the overall responsibility to supervise the administration of the policies and

procedures required to admit end enroll applicants in conformity with this Admissions Policy. The principal of the

Edison Academy is delegated by the superintendent to implement the specific details of the Admissions Policy.

The Edison Academy will have an Admissions Committee whose members will be appointed by the EA principal. The

Committee will consist of the principal, Assistant Principal and the following staff members: the Adjustment

Counselor, the Case Manager, and the guidance counselor.

Responsibilities of the Admissions Committee include:

A. Determination of standards for admission B. Development and implementation of procedures C. Procession application D. Ranking students E. Acceptance of students according to the procedure and criteria in the admission policy F. Establishment and maintenance of a waiting list of acceptable candidates

The Edison Academy principal is responsible for disseminating information about the program the school offers

through assemblies and press releases, postings on the school and school district website and for collecting and

processing applications for students.

V. RECRUITMENT ACTIVITIES

A. The Edison Academy Principal (or designee) will organize and implement a number of recruiting activities. These activities will include information about the program including selection/admission criteria,

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academic courses, wraparound services, career exploration/training opportunities, special education/bilingual support resources.

1. Brochures and other printed materials: These will be distributed through public service agencies in the local and surrounding communities twice a year in the months of May and November.

2. Information Sessions: Two large information sessions will be scheduled in the months of June and December at the Edison Academy. These sessions will be advertised through local newspaper, community cable access, and fliers distributed throughout public agencies.

3. Individual Information sessions: Potential applicants who inquire about the program throughout the year at a time other than the one schedule for information sessions will be scheduled for an individual/small group information session with the guidance counselor.

4. Open House:

5. EA Website/District Website: all the above information will be published in the EA website xxxxxxxxxxxxxxx and the district website www.brocktonpublicschools.org under Schools> Edison Academy

VI. APPLICATION PROCESS

PROCEDURES FOR FALL, SPRING, AND SUMMER ADMISSION

Application process will take place at the beginning of each semester within the first two weeks during the months

of June, August and December each year. Information about the application process, including timeline, paper work

requirements, and location for dropping off applications; will be in the form of adds in the local newspaper and

cable community access, and in the distribution of posters and brochures throughout the local and surrounding

communities. Only complete applications will be reviewed by the Edison Academy Admissions Committee.

Phase#1 Preliminary Application:

Universal Screening: All potential applicants will answer a short questionnaire which will be available at the

Edison Academy administration and guidance office throughout the year. The first part of the questionnaire

(Appendix XXX) will be in the form of a check list that will spell out the criteria for initial selection to the

program. Through this process applicants will have the opportunity to evaluate if they match and thus have the

ability to benefit from its program.

Initial Criteria for Admission: The following criteria will serve as a guideline for the initial selection of

candidates into the Edison Academy.

An applicant can be a potential candidate for admission into the Edison Academy if he/she follows within the

following criteria:

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1. Be between 16 to 21 years old.

2. Have “aged out” of system and /or be an under credited high school student.

3. Have not experienced success in the traditional system.

4. Have the desire to complete his/her education.

5. Be available and committed to attend school between 2:30 and 8:30 P.M. from Monday through Friday.

6. Be available during the summer (July and August) to complete non‐paid/paid internships and to attend

school.

7. Be able to commit to complete a two year program

Phase #2: Required Documentation:

Applicants matching the above criteria will be able to continue the application process by moving into the

second part of the questionnaire. This section will ask for personal, demographic, and academic information

(perhaps we need to spell this out or just refer to Appendix). In addition, it will provide the applicant with a list

of documents that need to be submitted along with the completed questionnaire which include:

a) school records

including transcripts

Attendance and disciplinary reports, and

b) two recommendations attesting to the desire and ability of the candidate to commit to the program

offered by the Edison Academy.

Note for us: (to keep in mind: No one school records criterion will exceed 50% of the total). Applicants will be

urged to submit (mail/drop off) the completed questionnaire along with the required documentation to the EA

guidance office within the given Fall/Spring admissions timeline.

Phase #3: Selection of Candidates:

The EA Admissions Committee will review all completed applications and will generate a list of potential

candidates who truly match the AE guidelines for initial selection for admission criteria. All pre‐selected

applicants will receive a letter and a phone call indicating they have been pre‐selected for admission into the EA.

The letter will include the time and date for further screening including testing and a one hour in‐depth

interview. Applicants will be able to cancel and re‐schedule these dates with a minimum of 48 hour notice.

Applicants who do not show up for testing or their interview will lose their status of pre‐ selected and will have

to re‐apply for the next semester.

( Note for us: for later in the process: Only if the number of student’s complete applications/acceptances

exceeds the seat availability the Admissions Committee will consider scholastic achievement, attendance,

composite of discipline/conduct records, and recommendations)

Phase #4: Screening

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Phase two of the EA admissions process requires a comprehensive screening to determine the applicant’s

personal needs, career, and educational goals (do we also want their reading level???). The objective is to

determine how those needs can be served and who/what (individual or structure) can responsively serve them

within the EA structural components (Inter‐professional Case Management Team – Comprehensive Service

Network). On this basis the intake screening identifies the candidate’s home‐living situation/status, career goal,

career exploration pathway/experiences needed to help the applicant meet his/her career goal. It also helps to

determine whether or not the applicant’s expectations and those of the Edison Academy are compatible; this, in

turn, determines whether the candidate’s own valued outcomes can be responsively delivered.

A. IN DEPTH‐INTERVIEW: Each candidate will be interviewed by a Screening Committee comprised by the EA

case manager, guidance counselor, and adjustment counselor. This interview will help to personalize the

intake process. The information collected during the interview will help determine the student’s needs,

required services, potential responsible agents, and ultimately to generate the Student Individual Success

Plan.

The interview will aim to create a profile of the student in the following areas:

Personal: with the goal of identifying strengths and weaknesses at the personal, physical, educational, and

financial level.

Inter‐personal: with the goal of identifying strengths and weaknesses related to student’s family and school

history and his/her social‐personal relationships.

Intra‐personal: with the goal of identifying strengths and weaknesses related to student’s self‐ awareness at the

emotional and psychological level.

Procedure: Student will be interviewed, in private, in a designated room, by the EA Screening Committee at the

Edison Academy. Committee members will share their notes, compare their checklists, and review the students’

required documentation.

B. TESTING:

Guide for Evaluation, Eligibility and Placement of Students with Disabilities and English Language Learners

This is a guide to describe evaluation, eligibility, and placement procedures for students with disabilities attending Edison Academy. It will also describe the programs and services for English Language Learners.

Students with Disabilities Procedural Safeguards

Procedural safeguards are rights extended to parents and students to assure that they are informed about how decisions are made regarding their children.

Pre‐referral

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The pre‐referral process begins when the parent, student or any school personnel suspects that a student has a disability. Referral occurs after observations of the student’s needs have been documented; attempts to correct the problem have been made and the Instructional Support Team (IST) has held a conference with the student and parent to review the results of their efforts

The IST will submit the following to the Special Education liaison for review. Previous testing information (MCAS, Benchmarks, SAT’S) Schedule Transcript Credits to date Attendance Discipline Report Existing Behavior Intervention Plan Teacher Reports Observation report Classroom Accommodation List

Referral

If the IST team agrees that the student should be evaluated, the Special Education Liaison will send out an evaluation consent form to the parent for signature. The Special Education Liaison will change the status of the student in Infinite Campus to reflect that the student is in the process of an evaluation and will add the appropriate SPED flag to the student’s record. Edison Academy will then conduct the appropriate evaluations.

Evaluations

The evaluations will consist of individual testing based on the suspected area of disability, observation of the student, a review of records, and gathering information from the family. These evaluations will be completed by qualified professionals who meet standards for certification with the Massachusetts Department of Secondary and Elementary Education in special education.

Eligibility

Within thirty days of receipt of signed consent, the evaluations will be completed and an initial team meeting will be held. The team is comprised of representatives from Edison Academy, the parent and the student. The role of the team is to use all the evaluations, observations, and reports to determine if the student has a disability and if that disability is the reason that the student is not making effective progress.

Every three years, the team must establish continued eligibility for an Individualized Education Program for those students who are already receiving services via an (IEP). The Special Ed. Liaison will monitor students due for a reevaluation utilizing Easy IEP’s “projected eligibility meetings” feature. (Please refer to the eligibility flowchart attached.)

Should the student be found “not eligible” to receive specialized instruction via an IEP, the Special Ed. Liaison will make the necessary corrections in Easy IEP and Infinite Campus.

Special Education Process Guide Developing an Individualized Education Program

If found eligible, an IEP will be developed at the team meeting. The IEP will describe the student’s current levels of educational performance. Goals and objectives will be written to meet the student’s educational needs and will be reviewed annually at a team meeting.

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Annual Review

Each year, students’ Individualized Education Programs must be reviewed to update goals and review current performance levels. The Special Education liaison will collect all relevant information to report to the “team” to update the IEP. The new IEP will be generated and provided to the parent within five days of the team meeting.

Process for Registering Students with IEPs

The Registrar will send the SPED request form to the Brockton High School SPED office. The Special Ed. Dept. Head will

o determine if the Individualized Education Program is implementable at Edison o work with the registrar or their designee to build a schedule that meets the unique needs of the student o the Dept. Head will update Infinite Campus and Easy IEP to reflect the current placement and

“enrollments” in IC o distribute the IEP At‐A‐Glance to all stakeholders o hold a team meeting if necessary

Organizational structure

Students with disabilities will participate in the same curricula as their typically developing peers. Students will be

offered academic support classes to provide additional time for gap‐bridging and closing activities. Some examples of

gap‐bridging are: pre‐teaching and re‐teaching content material, extra time to complete assignments, direct instruction

in executive functioning, chunking long‐term projects into manageable pieces, and access to assistive technology. Gap‐

closing activities require more intensive interventions in reading, written language, and math.

Transitional planning

Recognizing the need for students with disabilities to engage in effective transition planning, the Individuals with

Disabilities Education Act (IDEA) requires that transition planning be part of the Individualized Education Program (IEP).

Beginning no later than the first IEP developed when the eligible student is fourteen; the Team considers the student's

need for transition services and documents this discussion. If appropriate, the IEP includes a statement of needed

transition services. Edison Academy will maintain documentation of a full discussion of the student's transition needs,

whether or not such discussion identifies needed transition services for the IEP. Such documentation must be reviewed

and updated annually thereafter. Students must be invited to all educational meetings and allowed to participate

actively when transition planning is discussed.

English Language Learners

The Edison Academy has a diverse student population and currently services students from a variety of countries, including Angola, Cape Verde, Haiti, Portugal, and several Spanish‐speaking countries.

Massachusetts general laws Chapter 71A outlines these new requirements. In the Edison Academy School, English language learners re‐ceive sheltered instruction in structured English immersion classrooms. Structured English immersion is a program model whereby all curriculum materials and instruction are in English, and native language maybe used for clarification purposes. Immersion classrooms with native speaking teachers are available for Cape Verdean Creole and Spanish speaking students. Immersion classrooms with Haitian Creole, Portuguese speaking, and low incident populations provide for native language support when necessary. Sheltered Instruction is a methodology in which content concepts and skills are addressed while simultaneously attending to language development. Specific instructional approaches, such as comprehensible input, interaction, building background, and cognitive strategies, are at the foundation of Sheltered Instruction.

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The Edison Academy assesses all limited and non‐English speaking students to determine their proper placement and classification in the immersion or bilingual programs. Students are assessed to determine proper grade placement and also to determine the need for additional and specific types of academic support. Most of the students entering the immersion and bilingual programs have attended school in their country of origin can be placed at the appropriate grade level, and need only to maintain their academic development while they develop their English proficiency. Such students will usually exit department programs in three years or fewer.

Some students enter the bilingual and immersion programs with very limited education and academic skills. These students may have had limited or interrupted formal schooling experiences. The development of basic literacy skills, as well as promoting academic competency and English language development, is a particular challenge with this population. The development of academic language may take longer with this group of students given the lack of academic background in their first language.

The Edison Academy, therefore, takes into account the academic profile of each student. Progression through the Edison Bilingual Program may vary for students based on their academic profiles. Title VI of the federal Civil Rights Act does not permit time limitation of services for English language learners and requires that ELLS be provided language support services until they are proficient enough in English to participate meaningfully in the district's education program.

All students receiving bilingual or immersion services are assigned a step and profile classification. The initial classification is accomplished by classroom teachers, counselors, and ESL teachers. Staff uses a variety formal and informal assessments, including the Massachusetts English Language Assessment‐Oral (MELA‐0), the Massachusetts English Proficiency Assessment (MEPA), and the Language Assessment Scales (LAS R/W), to assist in determining step classifications. New students will be classified in accordance with the entry classification process. Subsequent classifications of all students will be the responsibility of the Language Assessment Teams (LAT), which are assembled in each building housing a program for English language learners.

Definition of a Student of Limited English‐Speaking Ability

(1) A student who was not born in the United States and whose native tongue is a language other than English and who is incapable of performing ordinary class work in English and/or

(2) A student who was born in the United States of non English‐speaking parents and who is incapable of performing ordinary class work in English.

Other terms used for children of limited English‐speaking ability:

Bilingual Student English Language Learner (ELL) Limited English Proficient (LEP)

Non English Speaker (NEP) English as a Second Language (ESL) Linguistic Minority Student. (LM)

BILINGUAL EDUCATION DEFINITION OF TERMS

ELL English Language Learner

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ESL English as a Second Language (L2)

FLEP Former Limited English Proficient

High incidence Program usually having 20 or more of one language group enrolled in a school district or schools

Integration In the context of Chapter 71 A, integration means students from the immersion and bilingual classrooms are engaged in meaningful learning activities with their peers

LEP Limited English Proficient‐students who have a non‐English language background

Low Incidence

Fewer than twenty LEP students of one language group.

Native Language (L1 or NL) First language of the learner

Second Language (L2) Second language of the learner

SE1‐ Structured English Immersion – a program model whereby instruction and materials are in English and native language is used for clarification purposes

S1 Sheltered Instruction — a methodology through which the development of language and academic content skills are promoted simultaneously

TBE Transitional Bilingual Education

Waivers

Chapter 71A provides for waivers based on parent request under certain circumstances, assuming that the parent annually applies by

visiting the student's school and by providing written informed consent.

For students under the age of 10, with parental consent, waivers are allowed under the following conditions:

The student has been placed in an English language classroom for at least 30 days prior to the parent's application for a waiver

Documentation by school officials in no less than 250 words that the student has special and individual physical or psychological

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needs, separate from lack of English proficiency, that require an alternative course of educational study and inclusion of such documentation in the student's permanent school record

Authorizing signatures on the waiver application of both the school superintendent and the school principal

For students over the age of 10, with parental consent, allows waivers when it is the informed belief of the school principal and educational staff that an alternate course of educational study would be better for the student's overall educational progress and rapid acquisition of English

Allows students receiving waivers to be transferred to bilingual programs or 'other generally recognized educational methodologies required by law.'

Requires individual schools in which 20 students or more of a given grade level receive a waiver to offer a bilingual or other type of language support program; in all other cases, students with waivers must be permitted to transfer to a public school in which such a program is offered.

Structured English Immersion and Bilingual Education Program Entry and Criteria

Registration

The Parent Information Center will refer all students whose first language is not English to the Brockton Office of Bilingual and ESL Services.

Home Language Survey

The Parent Information and Student Registration Center established registration procedures, which ensure that a home language survey is completed on all students entering the Brockton Public Schools. The survey asks families to identify the language(s) used by the student with siblings, parents, and friends. Whenever possible, the home language survey should be completed by personnel at the Parent Information Center. If for any reason Parent Center personnel cannot complete the Home Language Survey, the parent will be referred to the appropriate community liaison for completion of the survey form.

Initial Placement of Limited English Proficient Students

After the home language survey has been completed, and a student has been registered and identified as an English language learner, the student will be assessed for appropriate placement within the structured English immersion program. At this point, parents must be informed of their right to request a waiver for alternate programs, including bilingual education or general education placement. All parents will be provided with a program booklet on the programs available for English language learners.

A parent wishing to withdraw his/her child from programs for English language learners is requested to have a conference with the Director of Bilingual/ESL Services to review the placement recommendation. If the parent does not agree with the recommendation, she/he must sign a waiver form in order for the child to exit the program. MGL 71A states:

Such informed consent shall require that said parents or legal guardian personally visit the school to apply for the waiver and that they there be provided a full description in a language they can understand of the educational materials to be used in the different educational program choices and

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all the educational opportunities available to the child. If a parental waiver has been granted, the affected child may be transferred to classes teaching English and other subjects through bilingual education techniques, such as two‐way bilingual programs, or other generally recognized educational methodologies permitted by law. Individual schools in which 20 students or more of a given grade level receive a waiver shall be required to offer such a class; in all other cases, such students must be permitted to transfer to a public school in which such a class is offered.

Initial Placement Procedures

1. The initial placement of the student shall be determined by the Department of Bilingual/ESL Services administration in collaboration with the Department of Guidance Services. This initial placement is subject to review by the Language Assessment Team (LAT) once the student begins attendance at a school. Assessment results will be reported to the Department of Bilingual/ESL services to ensure that placement is based on estab‐lished placement criteria and ensure compliance with all procedures and laws. All documentation regarding placement and compliance will be placed in the student's cumulative folder and a copy is to be sent to the Department of Bilingual/ESL services program office.

2. If a student enrolls between regularly scheduled Language Assessment Team (LAT) meetings, the bilingual guidance or adjustment counselor and classroom teacher will meet to assign the student an initial step placement. The LAT will then collaboratively reevaluate the student' step at the next LAT meeting.

3. If a student has been assessed and classified as limited English proficient (LEP), and the student's native language is Spanish, Cape Verdean, Portuguese, Haitian Creole, or some other language for which the school district has an established program for English language learners, the student will be assigned to the appropriate classroom within the level and school that has available space. Elementary low incidence students will be placed into a structured English immersion program in the north or south zone, depending on where they reside within the district.

4. The school district shall notify, in writing, the parents or legal guardian of a limited English proficient student of the programs for English language learners that are available within the district, and shall recommend a specific program for that student. Such notice shall be sent by mail no later than 10 days after the enrollment of the student in the school district.

5. If a placement is deemed as inappropriate by school personnel and evaluation of English language development or language dominance is required, the City‐wide Assessment Coordinator will assess the student using the appropriate assessment instrument(s).

6. When a waiver request is filed by the parents, the school administration shall follow the procedures established in the Parent Exception Waiver Manual.

Assessment of Placement : Assessment for placement in programs for English language learners will be accomplished by a bilingual counselor or SEI/bilingual teacher who is fluent in the child's native language. The

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bilingual counselor will have the responsibility for coordinating the assessment. Low incidence students will be assessed by a designated ESL or SO teacher. If a student is referred by school personnel for determination of appropriateness of previous placement, the City‐Wide Assessment Coordinator may assess English language development through a variety of measures. The following is a list of program personnel included in the assessment or coordination of the assessment of limited English speaking students:

Edison Academy

Bilingual Department Head

Bilingual Guidance Counselor

Resource Room Coordinator

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Language Assessment Team

Each school building serving English language learners will have a Language Assessment Team (LAT) that will be responsible for the classification and placement of each English language learner. Once a student receives the initial classification as a result of the placement assessment, subsequent classifications will be accomplished by the LAT using a weighted system based on teacher recommendation, student performance, results of the MELA‐0, reading tests, LAS R/W, MEPA,* additional formal and informal school‐based assessments, and length of time spent in department programs.

All SEI, bilingual, and adjustment/guidance counselors are members of the Language Assessment Team (LAT), as well as building principals, Reading Resource Specialists, and other educational staff working with students. At Edison Academy, the team will be chaired by the Bilingual Department Head. The LAT meets in October and April to discuss issues relating to the progress of students in department programs. Once the schedule of meetings is determined, it is sent to the Director of Bilingual/ESL Services. The Director or the Department Head will plan to attend LAT meetings at each of the schools housing programs for ELLS, if necessary. During the month of April, the

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Language Assessment Team will review the classification of each ELL student in their building and assign new classifications as necessary. The names of any students recommended for integration will be forwarded to the Parent Information Center. The PIC will then inform parents of their school choices within the regular education program for the following school year.

At any point between regularly scheduled LAT meetings, the assignment of new classifications can be accomplished by a consensus of the LAT members within the school building. Individual members of the team may review the data on any student and make a recommendation for a classification review to the LAT chairperson. The LAT chairperson may assign a new classification to a student only after receiving a consensus of the members through a group meeting or by contacting each member of the LAT. This process allows for students who progress more rapidly in their development of English proficiency to be reclassified (if necessary) prior to the scheduled meetings of the LAT.

Appeal Process

Any member of the LAT can appeal to the LAT chairperson if she/he is in disagreement with a classification assignment of a student.

Appeals should be submitted to the LAT chairperson with a rationale as to why there is a disagreement. All appeals should be reviewed by

the LAT, which will render its decision after reviewing the appeal and any additional data or information that may have a bearing on the

assigned classification. Issues that cannot be resolved by the LAT at the building level shall be referred to the Edison principal and the

Director of Bilingual/ESL Services.

• NOTE: The assessment instruments (MELA‐0 AND MEPA) are for reference purposes only when assigning a step

classification.

Assessment Instruments

The following tests are used for the assessment of language dominance, oral proficiency, and reading and writing skill levels. The assessment results from any of the instruments indicated below are to be used as resources and guides by the LAT when making decisions for step classification, retention, or exiting department programs. In addition, results of district, state, and school based assessments should also be used in providing additional information on the academic performance of the student. Teacher recommendation and student performance should be given strong consideration in all decisions regarding classification issues.

Grade Test Levels Determined For

PreK‐12 MELA‐0 English Oral Language Proficiency

3‐12 MEPA English Reading and Writing Development

Bilingual Syntax Measure (BSM) is used to determine levels of English language proficiency and fluency and can be used for initial placement into programs for English language learners. In addition, it can be used to determine language dominance for Spanish speakers. The BSM requires a skilled and trained administrator who is also highly proficient in English.

The Bilingual Verbal Ability Test (BVAT) is designed to help in developing entry and exit criteria in bilingual education, to facilitate appropriate program placement and planning, and to assess a bilingual student's academic readiness. The BVAT will be administered by trained department staff member or the City‐Wide Assessment Coordinator accompanied by speaker of the student's native language. The BVAT is particularly appropriate for assessing the academic potential or scholastic aptitude of bilingual students during their initial 5 or 6 years of learning English and provides 2 scores – English

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only proficiency and bilingual verbal ability.

Massachusetts English Proficiency Assessment (MEPA) is an annual assessment that is required by the Department of Education and is administered by the Department of Bilingual ESL Services to all ELLs, in grades 3‐12. The MEPA measures those English language skills in reading and writing necessary for functioning in an English monolingual academic environment. The MEPA is not an achievement test, in the strictest sense, and does not measure achievement in course content.

Massachusetts English Language Assessment‐Oral (MELA‐0) is an observation scale that is completed twice a year by a student's classroom teacher in grades K‐12. The six point matrix is used to assess a student's oral English language proficiency in both formal and informal settings. The rating scale measures comprehension, vocabulary, fluency, pronunciation, and grammar.

All or a combination of the above mentioned assessment instruments, can be used by the Language Assessment Team when making decisions regarding integration of English language learners or the continuation of SEI Bilingual and ESL services.

Depar tment o f B i l i ngua l Se rv i c e s S tep C la s s i f i c a t i on o f Eng l i s h Language Lea rne r s

All students enrolled in a program for English language learners will be assigned a step classification in addition to the initial profile classification. While the profile classification does not change after the initial assignment, the step classification continues to change according to the progress of the student's English language proficiency.

Each ELL student must be reviewed during the month of April to assess the student's progress and to determine

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whether or not a new classification can be assigned. Any student referred by her/his teacher can be reclassified at any of the scheduled meetings of the LAT. Students who are on the step 4 classification, however, can only exit the program for ELLS at the end of a semester. If a student is mainstreamed at the end of the first semester, student should be placed in a general education classroom at the same school until the end of the academic year. Any student who exits a program prior to three years must have the written approval of the Director of Bilingual/ESL Services and the parent or guardian of the student.

All students, regardless of step classification, should have opportunities for integration activities with general education students. Such integration activities might include immersion students going into "age" appropriate general education classes, or students who speak only English going into immersion classes for instruction using world languages or English. Step 4 students should be given opportunities to experience academic coursework in general education classrooms prior to exiting programs for English language learners. These are the recommended models of integration. "Homeroom" or specialist integration time is not considered adequate to meet integration criteria for program models. Integration is a two way process that involves students, teachers, administrators, support staff, and parents as a community of learners. Through the integration of all the resources within our schools and community, we can provide students positive multicultural educational opportunities.

Exit Procedures for English Language Learners (TALK TO J. PINHEIRO)

Language Assessment Teams will monitor the transition of LEP students between levels, grades, schools and programs based on the following guidelines:

A. Each student in a program for English language learners will be evaluated annually for English proficiency and content skills. Students in grades 3 ‐ 12 who will be assessed annually in English reading and writing skills using the Massachusetts English Proficiency Assessment (MEPA). Oral language assessment (MELA‐0) will be administered by the classroom teacher twice annually. These results will be documented on the Step classifi‐cation record, which will be maintained by the SEI or Transitional Bilingual Education teacher. A copy of the class results will be given to the Department of Bilingual ESL Services each November and May. The results will be maintained in a database by the department.

B. Each school year, the Language Assessment Team will make written recommendations for the next year's placement for ELL students based on placement criteria. The placement procedures GUIDELINES. Recommendations will be documented in each student's cumulative folder with a copy sent to the Department of Bilingual/ESL Services. Whenever appropriate, parents/guardians will be notified as their child

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is making adequate progress in the Step Program.

C. Chapter 71A and Title VI require that Limited English Proficient students are entitled to language support services until they are proficient enough to participate meaningfully in the district's general education programs. Districts cannot limit the time necessary for language services for those students who are not yet able to meaningfully participate in the district's programs.

D. The Language Assessment Team and the Director of Bilingual/ESL Services will ensure that each student in programs for English language learners is appropriately placed and monitored. Copies of such meetings will be placed in the student's folder.

E. A student will normally be fully integrated into the general education program after documented successful partial integration, the recommendation of LAT, and parent/guardian approval. The movement of special education students will be considered on an individual basis at IEP meetings. Full integration should generally occur only at the end of a semester or at the beginning of the school year.

F. Students exiting a program for English language learners will be monitored for a period of two years by the City‐wide Assessment Coordinator or by other designated department personnel.

Exit Criteria

1. Language Assessment Team Recommendation

2. Assessments:

MEPA – Reading and Writing Proficiency (Massachusetts English Proficiency Assessment)

LAS ‐ Reading/Writing Proficiency (Language Assessment Scales)

MELA‐ 0 ‐ Oral Language Proficiency (Massachusetts English Language Assessment – Oral)

BVAT – (Bilingual Verbal Ability Test)

Criterion Reference Testing

District/State Testing (Iowa, MCAS)

Student Portfolios including writing samples

Reading Assessments (DRA, running records, etc.)

Other assessments as needed by the LAT to assist in making their decision

3. Requirements:

Student should not be more than two years below grade level in reading in English.

Whenever possible, student should have had a successful partial integration in at least one class in the general education program.

Student should have a good working knowledge of English, be able to do "regular school work in English", and be

able to "participate meaningfully in the district's programs"

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APPENDIX

Application

Required Documentation Checklist

Recommendation Form

Academic Behavior Success Plan

Weekly Progress Note

Credit for Work Service

Massachusetts Work‐Based Learning Plan

ELA MCAS Portfolio Checklist

Math MCAS Portfolio Checklist

Science MCAS Portfolio Checklist

Edison Academy School Calendar

Program Schedule

Academic Calendar School Closings

Individualized Graduation Planner

Edison Academy Needs Assessment

City of Brockton Interagency Permission to Share Information

Edison Academy Program Application

If you answer yes to all of the following questions, you may be eligible for the Day & Evening School Program:

Between 16 and 21 years old ? Yes_____ No_____

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Aged out and under credited high school student? Yes_____ No_____ Have left high school before graduation OR at risk of dropping out? Yes_____ No_____ Have less than senior standing OR are behind in high school credits? Yes_____ No_____ Be available to attend school between 2:30 and 8:30 from Monday-Thursday? Yes_____ No_____ Be available to attend summer school (July and August)?

If you have answered YES to ALL of the questions above, fill out the form below and either mail or fax to: Massasoit Community College

One Massasoit Boulevard Brockton, MA 02302 Attn: Gateway to College

Fax #: (508)427-1271

Once the preliminary application is received and you are found eligible, information will be mailed to you regarding registration for the next Information Session.

Today’s Date: ____________/____________/____________ Name: ____________________________________________________ ate of Birth: _______/______/_______ (Last Name) (First Name) MI Street Address: ____________________________________ City: ___________________ State: ______ Zip:__________ (P.O. Box, Street, Avenue, Apt. #, etc.) Phone: (______) ______________ Cell Phone: (_____)______________ E-mail Address: _______________________ High School Last/Currently Attending: ___________________________________ Last Grade Completed: _______ Did you drop out? Yes____ No____ Did you pass: 10th Grade Math MCAS exam Yes____ No____ Do you have your GED? Yes____ No ____ 10th Grade English (ELA) MCAS exam Yes____ No____ 10th Grade Science MCAS exam Yes____ No____

How did you hear about Gateway to College? (Please check one) Newspaper____ Website____ Radio_____ Friend____ Gateway Student____ (name) __________________ Agency____ (name) ____________________ Guidance Counselor____ (name) ____________________ Other____ (name)____________________

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Edison Academy

Application Checklist for Registration

________ Proof of Residency

Please bring three (3) documents to prove you are a resident of Brockton.

The first must be one of the following:

1. Copy of deed and most recent mortgage payment

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2. Copy of lease and most recent rent payment

3. Legal affidavit from landlord and most recent rent payment

4. Section 8 agreement

The second is a recent utility bill or work order (gas, oil, electric or home

telephone).

The final item is proof of your identity such as a driver's license or passport.

In addition you must provide:

1. Your child's birth certificate or passport

2. Up to date health and immunization records

3. Court documentation if your child lives with a legal guardian

If you have your child's records, please bring them when you register. Otherwise you will be

asked to sign a release to obtain the following:

1. ________ Copy of Academic Records, Previous testing/assessment information (MCAS, IOWA, MEPA, MELO‐A, Benchmarks, SAT’S)

2. ________ Official Transcript 3. ________ Copy of Attendance Record 4. ________ Copy of Discipline Report 5. ________ Existing Functional Behavior Assessment and/or

Behavior Intervention Plan (If Applicable) 6. ________ Copy of an Individualized Education Plan (If Applicable) 7. ________ Copy of a 504/Classroom Accommodation List (If

Applicable) 8. ________ Health Record Health Record 9. ________ Immunization Records Immunization from 10. ________ Assessment of Needs and Services (After registration??) 11. ________ Essay

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12. ________ Two recommendation Letters; one from a Principal & one from a Guidance Counselor

Edison Academy

Recommendation Form

(Two Recommendations from School Personnel are Required)

Today’s Date:

Applicant Name:

D.O.B.:

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Name and School Title of person completing this Form:

Please describe the barriers that have kept this student from being successful in school.

Please explain why you think this student could be successful in the Edison Academy Program.

Edison Academy Academic and Behavior Success Plan

The Day/Evening School Program seeks to teach our students in a safe, supportive environment the knowledge, skills, values, and behaviors necessary to become responsible and productive members of a diverse society. Instruction focuses on enabling students to demonstrate the literacy skills of reading, writing, speaking, and reasoning and preparing them to participate actively as citizens in a technologically advanced society. In order to provide such a place for our students, we require you, in turn, to agree to the terms of the contract prescribed below. I will agree to the following academic goals:

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* To attend school daily and on time. I have read and understand the school attendance policy. * To attend all classes regularly and on time. I have read and understand the school disciplinary policy. * To give my best effort in all my classes.

(Check all that apply) * To meet with my guidance and/or adjustment counselor regularly. ______ * To demonstrate consistent acceptable behavior throughout the school day. * To submit a completed weekly progress notice to the principal. * To attend meetings every 4 weeks with the principal to assess progress. * Other Additional Academic Supports Odyssey Lab support available during the school day in the Access Center, AIRC. Meet with academic teachers @ 2:30 pm prior to each school day. Student Signature Parent/Guardian Statement of Support I understand that I must support and cooperate with the school staff to reinforce provisions outlined. I will also reinforce and encourage my child to uphold the contract and to strive to succeed academically. In addition, I will notify school personnel of any issues or concerns that involve my child. ____________________________ Parent's Signature Date ____________________________ School Official's Signature Date

Achieve the following specific academic goals: Date Math English History Science Elective(s)

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Edison School

STUDENT WEEKLY PROGRESS NOTICE

Student: Week Ending: Subject

Teacher Current Average

Comments on behavior, homework, class work, participation, assessments, upcoming assignments, etc.

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Student’s Comments Principal’s Comments Parent’s Comments

BROCKTON PUBLIC SCHOOLS

CREDIT FOR WORK & SERVICE INITIATIVE ‐ SUMMARY STUDENT PRODUCTS AND TEACHER ASSESSMENT TOOLS

[This set of materials about students earning academic credit for work and community service experience was adapted from curricula created by Brockton Public Schools staff members Kathleen M. Quigg & Donna Burrill, hired for the Multiple Pathways pilot effort in the spring of 2009, and was funded by the Brockton Working for All Youth initiative with US Dept. of Labor funds.]

Brockton Public Schools students participating in work experience or a community service program with sufficient hours may be eligible for academic credit for their work/service. In order to receive credit, students must have a sponsor, typically a teacher or guidance counselor of the BPS, approved to award academic credit by the Brockton Public Schools. The sponsor will assist in the development of a Student Work Plan (see template attached) which sets forth the expectations for the award of academic credit. Additionally, the student and his/her sponsor will work closely with the work or service site to develop a shared understanding of the student work plan. Ideally, a representative of the work site will enter a short memo of understanding

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(“MOU”) with the BPS and the student, reflecting its willingness to support the student’s learning process on the job. Sample MOU is attached.

Below are set forth the possible tasks and student products that would justify the award of credit. The sponsor will determine which are necessary, and the student and sponsor will review them before the start of the work or community service. A written plan reflecting that set of requirements will be created (see page 5). An expectation of this model is that the student and sponsor will have regular and frequent meetings, either during regular class time or during a scheduled meeting outside of school.

The amount of credit that can be earned by students participating in work or community service will vary, depending upon the nature of the experience. For example, students participating in the BPS Summer of Work & Learning can earn 3 credits for that summer program, based upon the fact that the program lasts for 5 weeks, offers 125 hours to the student (100 hours of which are paid), and is a highly structured learning experience with curricula, some traditional instruction, work and college readines skills, evaluation of skill gain using the Massachusetts Work‐based Learning Plan, and the creation of a polished final product. As a basis for comparison, students typically earn 3 credits for a 90 hour course during the regular school year, so 3 credits is a reasonable amount for this particular 125 hour summer program. Students must:

elect to earn credit in advance

have a sponsor (who can be their team leader in that program)

agree to a plan that defines the products that they must produce

ACADEMIC ASSESSMENT: 4 Possible Elements (more details below)

1. BPS Student Work & Learning Portfolio ‐ Class work and Quiz credit Student Class Work/Teacher Facilitation and Evaluation

Portfolio Outline Attached

2. Reflection Essay‐Test Credit Student Created/Teacher Evaluation

Requirements Attached

3. PowerPoint Presentation‐Test Credit Student Created/Teacher Evaluation

Requirements Attached

4. Capstone Project‐Final Project Grade

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Student/Employer Created/Teacher Facilitation and Evaluation

Expectations and Requirements Attached

WORK PERFORMANCE ASSESSMENT (for Work and Community Service)

Massachusetts Work Based Learning Plan WBLP Employer/Teacher/Evaluation

WBLP Attached

Here are more details about the four possible student products for academic assessment:

1. BPS STUDENT WORK & LEARNING PORTFOLIO

The portfolio is a compilation of products created by the student. It is created over the course of the work or service experience, with possible daily, weekly and monthly elements and contributions, at the discretion of the sponsor. The purpose of the portfolio is for the student to document, reflect upon and analyze his/her work experience in order to improve his/her employment skills and to make informed career decisions. It is strongly recommended that most of the portfolio be created electronically, and that documents be saved in a student electronic file as well as printed as hard copy. The portfolio may be created during class time or, at teacher discretion, during the student’s own time. It will be reviewed and graded by the Sponsor.

The portfolio will include:

GENERAL CONTENT: Employer Contact Information

Student Schedule

Expectations of Students at School and at Work

Student Safety Guidelines at School and at Work

Parent Permission Participation Form

Media Release

Field Trip Permission Forms

Medical Insurance Forms

ACADEMIC CONTENT: Microsoft Office/Word, Excel/PowerPoint/Publisher/Photoshop Functions and Use

Attendance log for school and work/Microsoft Excel or Word Chart or Graph

Daily worksite activities log/Microsoft Word‐MW

Weekly Written Reflection based on Logs/MW/Open Response

Weekly Oral Presentation based on Reflection‐no electronics

Weekly Career Maps/Exploration of Careers within the students Field of Work

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Monthly Career Plans based on Maps and other future career interests

Record of Payroll /Student Wages/Taxes/Raises/Microsoft Excel or word Chart or Graph

Tax and Employment Package IRS, W4, W2, I9, 1040EZ

Teen Safety OSHA

MA Child Labor Laws

Resume

Cover letter

2. REFLECTION ESSAY

REQUIREMENTS: Once per quarter the student will write an essay about his/her work or service experience. Weekly open response Reflections will be used to outline and format the essay. (See Manual‐Academic Content) All BPS essay writing guidelines will be used for grading as well as the BPS English Writing Rubric.

3. POWERPOINT PRESENTATION/TEST GRADE

Students will create six PowerPoint slides to represent their quarterly essay and make a presentation to their sponsor once per quarter. The BPS Oral Presentation Rubric will be used for grading.

REQUIREMENTS:

Slide 1 ‐‐ Cover Slide/Introduction

Slides 2, 3 and 4 ‐‐ Content Slides

Slide 5 ‐‐ Graph or Chart/Analyze Content

Slide 6 ‐‐ Summary

4. CAPSTONE PROJECT (FINAL GRADE)

A Capstone Project may be created by the student using a variety of media, text and technology. This culminating event should be informative and content‐rich. The student and sponsor shall consult about the contents of the Capstone project, and the sponsor will assist the student in making sure that the presentation is comprehensive and high quality. Employers, family members, school and community members may be invited to view a display of Capstone Projects at the end of the experience.

Key Elements of a strong Capstone Project:

Brochure ‐‐ Student photos and text depicting work activity/tasks/ interaction with sites, employer and co‐workers

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Interview of Employer/Student‐created questionnaire/Ten questions ‐ teacher approved

Video/Participation in class created video‐all worksites

Display of Student Manual/Reflection Essays/PPTS

BROCKTON PUBLIC SCHOOLS ‐ CREDIT for Work or Community Service

STUDENT WORK PLAN

Name: __________________ ___________________ ______ Id. # _____ Last First Middle BPS School ____________________ Grade: ___ Guidance Counselor _____________ Sponsor for plan: _____________________________ Brief description of planned Work Experience or Community Service Project: __________________________________________________________________________

__________________________________________________________________________ Location of project: _____________ Possible credit upon satisfactory completion: __________ Supervisor at site: ___________________________ phone at site: ___________________

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Start date of Project: _________________ End date of Project: _____________ Schedule of days and hours of work: __________ Total hours to be served: _________ Plan for Student Products Required for Academic Credit (must be filled in before signing). Note that not all products are required (except MA WBPL), the sponsor will identify those that are: Product Required

(yes or no) Frequency Schedule/Due Date Notes

BPS Student Work & Learning Portfolio

Possible components: Daily Log Weekly written reflection Monthly Career Plan All required documents by last day of plan

Reflection Essay

PowerPoint Presentation

Capstone Project

Massachusetts Work Based Learning Plan WBLP

Required for all Plans

2 reviews are required (pre and post)

1. 2.

Signatures:

Student Participant: ____________________________ Date: ________

Sponsor: ___ _____________________________________ Date: ________

MEMORANDUM OF UNDERSTANDING

ACADEMIC CREDIT FOR WORK

Student: __________________

School or Program: ___________________________

Work Site: _________________________

This memorandum describes the mutual understanding of the Brockton Public Schools (the District) and

______________________________ (name of organization), hereafter referred to as the Work Site, regarding the work

experience of the student named above. The District and the Work site both recognize that work and/or community

service can provide a rich opportunity for student learning, when the duties and responsibilities of the job have been

properly designed. Both parties agree that this particular work or service experience offers substantial structured

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learning time, giving the student the opportunity to master new skills and to learn about the industry sector of which the

Work Site is a part. As a result, it is understood that the student will be able to earn academic credit for this work.

The Parties acknowledge that the key elements of the experience that will justify the award of credit will be reflected in

the “Student Work Plan,” which will also identify the person who will serve as the adult sponsor of the experience,

typically a teacher or guidance counselor of the District. The student, with the support of his/her sponsor, will be

responsible for the completion of those products entitling him/her to earn academic credit for the work.

The Work Site is pleased to partner with the District to facilitate the award of credit to this student upon his/her

satisfactory completion of the number of hours of work set forth in the student’s Work Plan. The Work Site will

designate a contact person to confirm that the hours have been served, to assist with the award of credit. Under this

agreement, the Student will be assigned useful duties by the Work Site that will assist him/her to gain skills for future

employment, while learning about the industry of which the Work Site is a part. The Work Site will also evaluate the

student to determine if he/she is demonstrating skill gain, further described below.

It is also agreed that the work experience provided the intern(s) will be conducted in a safe and sanitary working

environment.

Name of BPS Sponsor (teacher/guidance counselor/coach) __________________________

Supervision:

A supervisor will be present at the work site during the entirety of the time the student is at work. There will also be a

contact person identified for this program, who may or may not be the same as the supervisor, with whom the student

shall communicate in the event of any emergency or need to change scheduled hours.

Name of Supervisor/Contact person at site: ______________________________

Phone: __________________________ Email: _____________________________

Evaluation:

The parties will work together to ensure that the student’s performance will be evaluated twice by the Work Site

supervisor, with the assistance of the sponsor, using the Massachusetts Work‐based Learning Plan, once near the

beginning of his/her internship and again near the end, so that the impact of the experience can be measured.

Work Activities:

The job description and duties for the participating Student will be described generally in the space provided in the

Massachusetts Work‐based Learning Plan.

Schedule:

The student will start work on ______________________ , and will generally work a minimum of _______ hours per

week, for __________ weeks. For purposes of the award of academic credit, the Parties agree that the student must

complete at least _____ hours on the job.

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Intended duration of work experience (for credit purposes only, since it is understood that in some cases, the student

will continue working at the site after the end of the period defined for credit): _________________________

The parties acknowledge their mutual understanding here: Brockton Public Schools: Work Site: ____________________________ _____________________________ Superintendent or his designee Name ____________________________ _____________________________ Title Title Date: _______ Date: _______

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ELA MCAS Portfolio Checklist

Five written work samples with:

1. title student’s name and date it was produced 2. independent revisions by the student 3. indication of the type and frequency of the assistance provided to the student during the writing process

Student analyzes, interprets, compares or contrasts, or discusses the meaning of a work of

nonfiction

Student analyzes, interprets, compares or contrasts, or discusses the meaning of a work of

fiction

Student analyzes, interprets, compares or contrasts, or discusses the meaning of a Poetry

OR drama

One composition or essay‐Identifying and discussing a theme in literature &/or connect the

literary theme to personal life

One composition or essay‐on a topic that the student chooses. Decide on:

1. Reflective

2. Persuasive or

3. Creative

The following can be incorporated into the above writing samples or done separately.

Vocabulary (words used correctly; literal/figurative meaning).

Grammar and Usage (sentence structure and language conventions).

Mechanics (punctuation & spelling).

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Math MCAS Portfolio Checklist

The DESE stipulates that each work sample must have:

At least four examples or problems solved correctly by the student that demonstrate all aspects of each learning standard,

A score (% accurate) given by the teacher for each work sample,

Written evidence of the student’s thinking and problem‐solving, indicating the process used to solve each problem (i.e., “show all work”),

A clear indication of the type(s) and frequency of assistance (% independence and any accommodations) provided to the student by the teacher.

Worksheets will be provided that cover all strands of the MCAS and at minimum the

following standards:

Number Sense and Operations: 10.N.1 and 10.N.2

Patterns, Relations, and Algebra: 10.P.2, 10.P.4, 10.P.5, and 10.P.7

Geometry: 10.G.1, 10.G.2, 10.G.3, 10.G.4, 10.G.5, 10.G.6, 10.G.7, 10.G.8, 10.G.9, 10.G.10

and 10.G.11

Measurement: 10.M.1, 10.M.2, and 10.M.3

Data Analysis, Statistics, and Probability: 10.D.1, 10.D.2

All worksheets will be pre‐labeled with the topic covered and the associated strand and

standard – e.g.

The Associative, Commutative and Distributive Properties

Number Sense and Operations

10.N.1

Please check off the completed work samples as applicable to your class.

umber Sense Patterns/Relations Geometry Measurement Data Analysis

10.N.1 10.P.2 10.G.1 10.M.1 10.D.1

10.N.2 10.P.4 10.G.2 10.M.2 10.D.2

10.P.5 10.G.3 10.M.3

10.P.7 10.G.4

10.G.5

10.G.6

10.G.7

10.G.8

10.G.9

10.G.10

10.G.11

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SCIENCE, ENGINEERING, TECHNOLOGY COMPETENCY CHECKLIST GRADES 9 - 12

I. Content Standards

(Suggested learning activities related to the high school Technology/Engineering learning standards are listed on

1. Engineering Design Central Concepts: Engineering design involves practical problem solving, research, development, and invention/innovation, and requires designing, drawing, building, testing, and redesigning. Students should demonstrate the ability to use the engineering design process to solve a problem or meet a challenge. E M F 1.1 Identify and explain the steps of the engineering design process: identify the

problem, research the problem, develop possible solutions, select the best possible solution(s), construct prototypes and/or models, test and evaluate, communicate the solutions, and redesign.

1.2 Understand that the engineering design process is used in the solution of problems and the advancement of society. Identify examples of technologies, objects, and processes that have been modified to advance society, and explain why and how they were modified.

1.3 Produce and analyze multi-view drawings (orthographic projections) and pictorial drawings (isometric, oblique, perspective), using various techniques.

1.4 Interpret and apply scale and proportion to orthographic projections and pictorial drawings (e.g., ¼" = 1'0", 1 cm = 1 m).

1.5 Interpret plans, diagrams, and working drawings in the construction of prototypes or models.

2. Construction Technologies Central Concepts: The construction process is a series of actions taken to build a structure, including preparing a site, setting a foundation, erecting a structure, installing utilities, and finishing a site. Various materials, processes, and systems are used to build structures. Students should demonstrate and apply the concepts of construction technology through building and constructing either full-size models or scale models using various materials commonly used in construction. Students should demonstrate the ability to use the engineering design process to solve a problem or meet a challenge in construction technology. E M F 2.1 Identify and explain the engineering properties of materials used in structures

(e.g., elasticity, plasticity, R value, density, strength). 2.2 Distinguish among tension, compression, shear, and torsion, and explain how they

relate to the selection of materials in structures. 2.3 Explain Bernoulli’s principle and its effect on structures such as buildings and

bridges. 2.4 Calculate the resultant force(s) for a combination of live loads and dead loads. 2.5 Identify and demonstrate the safe and proper use of common hand tools, power

tools, and measurement devices used in construction. 2.6 Recognize the purposes of zoning laws and building codes in the design and use of

structures.

3. Energy and Power Technologies—Fluid Systems Central Concepts: Fluid systems are made up of liquids or gases and allow force to be transferred from one location to another. They can also provide water, gas, and/or oil, and/or remove waste. They can be moving or stationary and have associated pressures and velocities. Students should demonstrate the ability to use the engineering design process to solve

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a problem or meet a challenge in a fluid system. E M F 3.1 Explain the basic differences between open fluid systems (e.g., irrigation, forced

hot air system, air compressors) and closed fluid systems (e.g., forced hot water system, hydraulic brakes).

3.2 Explain the differences and similarities between hydraulic and pneumatic systems, and explain how each relates to manufacturing and transportation systems.

3.3 Calculate and describe the ability of a hydraulic system to multiply distance, multiply force, and effect directional change.

3.4 Recognize that the velocity of a liquid moving in a pipe varies inversely with changes in the cross-sectional area of the pipe.

3.5 Identify and explain sources of resistance (e.g., 45º elbow, 90º elbow, changes in diameter) for water moving through a pipe.

4. Energy and Power Technologies—Thermal Systems Central Concepts: Thermal systems involve transfer of energy through conduction, convection, and radiation, and are used to control the environment. Students should demonstrate the ability to use the engineering design process to solve a problem or meet a challenge in a thermal system. E M F 4.1 Differentiate among conduction, convection, and radiation in a thermal system

(e.g., heating and cooling a house, cooking). 4.2 Give examples of how conduction, convection, and radiation are considered in the

selection of materials for buildings and in the design of a heating system. 4.3 Explain how environmental conditions such as wind, solar angle, and temperature

influence the design of buildings. 4.4 Identify and explain alternatives to nonrenewable energies (e.g., wind and solar

energy conversion systems).

5. Energy and Power Technologies—Electrical Systems Central Concepts: Electrical systems generate, transfer, and distribute electricity. Students should demonstrate the ability to use the engineering design process to solve a problem or meet a challenge in an electrical system. E M F 5.1 Explain how to measure and calculate voltage, current, resistance, and power

consumption in a series circuit and in a parallel circuit. Identify the instruments used to measure voltage, current, power consumption, and resistance.

5.2 Identify and explain the components of a circuit, including sources, conductors, circuit breakers, fuses, controllers, and loads. Examples of some controllers are switches, relays, diodes, and variable resistors.

5.3 Explain the relationships among voltage, current, and resistance in a simple circuit, using Ohm’s law.

5.4 Recognize that resistance is affected by external factors (e.g., temperature). 5.5 Compare and contrast alternating current (AC) and direct current (DC), and give

examples of each.

6. Communication Technologies Central Concepts: Applying technical processes to exchange information can include symbols, measurements, icons, and graphic images. Students should demonstrate the ability to use the engineering design process to solve a problem or meet a challenge in a communication technology. E M F

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6.1 Explain how information travels through the following media: electrical wire, optical fiber, air, and space.

6.2 Differentiate between digital and analog signals. Describe how communication devices employ digital and analog technologies (e.g., computers, cell phones).

6.3 Explain how the various components (source, encoder, transmitter, receiver, decoder, destination, storage, and retrieval) and processes of a communication system function.

6.4 Identify and explain the applications of laser and fiber optic technologies (e.g., telephone systems, cable television, photography).

6.5 Explain the application of electromagnetic signals in fiber optic technologies, including critical angle and total internal reflection.

7. Manufacturing Technologies Central Concepts: Manufacturing processes can be classified into six groups: casting/molding, forming, separating, conditioning, assembling, and finishing. Students should demonstrate the ability to use the engineering design process to solve a problem or meet a challenge in a manufacturing technology. E M F 7.1 Describe the manufacturing processes of casting and molding, forming, separating,

conditioning, assembling, and finishing. 7.2 Identify the criteria necessary to select safe tools and procedures for a

manufacturing process (e.g., properties of materials, required tolerances, end-uses).

7.3 Describe the advantages of using robotics in the automation of manufacturing processes (e.g., increased production, improved quality, safety).

II. Steps of the Engineering Design Process

Students should be provided opportunities for hands-on experiences to design, build, test,

and evaluate (and redesign, if necessary) a prototype or model of their solution to a problem. Students should have access to materials, hand and/or power tools, and other resources necessary to engage in these tasks. Students may also engage in design challenges that provide constraints and specifications to consider as they develop a solution to a problem. Steps of the Engineering Design Process* 1. Identify the need or problem 2. Research the need or problem

Examine current state of the issue and current solution(s) Explore other options via the Internet, library, interviews, etc.

3. Develop possible solution(s) Brainstorm possible solution(s)

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Draw on mathematics and science Articulate the possible solution(s) in two and three dimensions Refine the possible solution(s)

Steps of the Engineering Design Process (cont.) 4. Select the best possible solution(s)

Determine which solution(s) best meet(s) the original requirements 5. Construct one or more prototypes and/or models

Model the selected solution(s) in two and three dimensions 6. Test and evaluate the solution(s)

Does it work? Does it meet the original design constraints?

7. Communicate the solution(s) Make an engineering presentation that includes a discussion of how the solution(s)

best meet(s) the needs of the initial problem or need Discuss societal impact and tradeoffs of the solution(s)

8. Redesign Modify the solution(s) based on information gathered during the tests and

presentation *The Engineering Design Process is also listed under the first content standard of the Engineering Design subtopic in this course.

III. Mathematical Skills Students are expected to know the content of the Massachusetts Mathematics Curriculum

Framework, through grade 8. Below are some specific skills from the Mathematics Framework that students in this course should have the opportunity to apply: Construct and use tables and graphs to interpret data sets. Solve simple algebraic expressions. Perform basic statistical procedures to analyze the center and spread of data. Measure with accuracy and precision (e.g., length, volume, mass, temperature,

time) Use both metric/standard international (SI) and U.S. Customary (English) systems

of measurement. Convert within a unit (e.g., centimeters to meters, inches to feet). Use common prefixes such as milli-, centi-, and kilo-. Use scientific notation, where appropriate. Use ratio and proportion to solve problems.

The following skills are not detailed in the Mathematics Framework, but are necessary for a solid understanding in this course: Determine the correct number of significant figures. Determine percent error from experimental and accepted values. Use appropriate metric/standard international (SI) units of measurement for mass

(kg); length (m); time (s); power (W); electric current (A); electric potential difference/voltage (V); and electric resistance ().

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Use the Celsius and Fahrenheit scales.

WHAT IT LOOKS LIKE IN THE CLASSROOM

Assessment Strategies

Students can research building codes and zoning laws in the community, then each can write a detailed informational report.

Students can compare construction efficiency for various house designs, evaluating the advantages and disadvantages of each design (e.g., ranch vs. colonial, lumber vs. steel framework). They can then create a chart illustrating the differences.

Students can create an engineering presentation illustrating the design and efficiency of the prototype, using appropriate visual aids (e.g., charts, graphs, presentation software). The presentation should include any other factors that impact the design of the house (e.g., site, soil conditions, climate).

Students will use a rubric to assess design specification, heat efficiency, and final prototype of the design challenge.

Engineering Design Learning Standards

High School 1.2 Understand that the engineering design process is used in the solution of problems

and the advancement of society. Identify examples of technologies, objects, and processes that have been modified to advance society, and explain why and how they were modified.

1.3 Produce and analyze multi-view drawings (orthographic projections) and pictorial drawings (isometric, oblique, perspective), using various techniques.

1.4 Interpret and apply scale and proportion to orthographic projections and pictorial drawings (e.g., ¼" = 1'0", 1 cm = 1 m).

1.5 Interpret plans, diagrams, and working drawings in the construction of prototypes or models.

Construction Technologies Learning Standards

High School 2.1 Identify and explain the engineering properties of materials used in structures

(e.g., elasticity, plasticity, R value, density, strength). 2.6 Recognize the purposes of zoning laws and building codes in the design and use of

structures.

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Energy and Power Technologies—Thermal Systems Learning Standards High School 4.2 Give examples of how conduction, convection, and radiation are considered in the

selection of materials for buildings and in the design of a heating system. 4.3 Explain how environmental conditions such as wind, solar angle, and temperature

influence the design of buildings.

Suggested Learning Activities for High School Technology/Engineering Learning Standards

1. Engineering Design

Create an engineering design presentation using multimedia, oral, and written communication. (1.1)

Choose the optimal solution to a problem, clearly documenting ideas against design criteria and constraints, and explain how human values, economics, ergonomics, and environmental considerations have influenced the solution. (1.1)

Visit a local industry in any area of technology and describe the research and development processes of the company. (1.1, 1.5)

Have students utilize library/Internet resources to research the patent process. (1.1, 1.2, 1.5)

Create pictorial and multi-view drawings that include scaling and dimensioning. (1.2, 1.3, 1.4, 1.5)

Create plans, diagrams, and working drawings in the construction of a prototype. (1.2, 1.3, 1.4, 1.5)

2. Construction Technologies

Demonstrate the transmission of loads for buildings and other structures. (2.1, 2.2, 2.6)

Construct a truss and analyze to determine whether the members are in tension, compression, shear, and/or torsion. (2.1, 2.3, 2.4, 2.5)

Given several types of measuring tools and testing tools, give students a challenge and have them evaluate the effectiveness of a tool for the given challenge. (2.2)

Construct and test geometric shapes to determine their structural advantages depending on how they are loaded. (2.3, 2.5, 2.6)

Using a chart from the state building code, students should be able to correctly use the stress-strain relationship to calculate the floor joist size needed. (2.4, 2.6)

Design and conduct a test for building materials (e.g., density, strength, thermal conductivity, specific heat, moisture resistance). (2.4, 2.5)

Calculate the live load for the second floor of a building and show how that load is distributed to the floor below. (2.5, 2.6)

Identify ways to protect a watershed (e.g., silt barriers, hay bales, maintenance of watershed areas). (2.5)

3. Energy and Power Technologies—Fluid Systems

Demonstrate how appropriate selection of piping materials, pumps, and other materials is based on hydrostatic effects. (3.1, 3.5)

Demonstrate how a hydraulic brake system operates in an automobile. (3.1, 3.5) Design a private septic system while considering the type of soil in the leach field.

(3.1, 3.4) Identify similar and differing elements of a public sewer system and a private

septic system. (3.1, 3.4)

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Explain engineering control volume concepts as applied to a domestic water system. Does the amount of water entering a residence equal the amount of water leaving the residence? (3.5)

Design an airfoil or spoiler to demonstrate Bernoulli’s principle. (3.3) Create a hydraulic arm powered by pistons that is capable of moving in three

dimensions. (3.4) Have students do a simple calculation with velocity and cross-sectional pipe size.

Velocity times cross-sectional area is a constant. As the pipe size changes, the velocity will have to change as well. For example, if the pipe changes from a 2-inch diameter to a 1-inch diameter, the velocity will quadruple. (3.5)

4. Energy and Power Technologies—Thermal Systems

Create a model (e.g., the multi-layer wall of a building) to test the concept of conduction, and compute heat losses. (4.1, 4.2, 4.4)

Design and build a hot water solar energy system consisting of a collector, hoses, pump (optional), and storage tank. After the system has been heated, calculate the heat gains achieved through solar heating. (4.1)

Design and build a model to test heat losses through various materials and plot the results. (4.2, 4.5)

Design and build a solar cooker for various food substances. Each student should design a solar cooker for her or his specific food. (4.1, 4.2)

Design an awning for a business based upon seasonal changes and the angles of the sun. (4.2)

5. Energy and Power Technologies—Electrical Systems

Design and create an electrical system containing a source, a switch, and multiple loads. Be able to measure the voltage and current at each load. (5.2)

Design and create an electrical system with either motors, all operating at different speeds, or lamps, all operating at different intensities. (5.2, 5.3)

Create schematics for series, parallel, and combination (series-parallel) circuits, and construct each type of circuit from its schematic. (5.4)

6. Communication Technologies

Give an example of each of the following types of communication: human to human (talking), human to machine (telephone), machine to human (facsimile machine), and machine to machine (computer network). (6.4)

Create prototypes for the following specific types of communication: human to human (e.g., talking, telephone), human to machine (e.g., keyboard, cameras), machine to human (e.g., CRT screen, television, printed material), machine to machine (e.g., CNC, internetworking). (6.2, 6.3, 6.4)

Define size and focal length for a lens and explain their applications in light theory. (6.5)

Research a communication technology and the impact that lasers or fiber optics have had on that technology. (6.4, 6.5)

7. Manufacturing Technologies

Design a system for mass producing a product. (7.1, 7.2) Design, build, and program a robotic device capable of moving through three axes. (7.3)

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Edison Academy School Calendar

The Edison Academy will run on a trimester system. The required 990 hours will be achieved in the following manner:

Semester # Hours per Week # of Weeks Total

Fall 24 16 384 Spring 24 16 384 Summer 25 4 100

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Structured Learning Time Breakdown

Classroom Time 868 Work and Learning 122 Total Hours 990

Sample Schedule Fall and/or Spring Semester

Time Period Monday Tuesday Wednesday Thursday 2:30-4:00 1 English English English English 4:00-5:30 2 Algebra Algebra Geometry Geometry 5:30-6:30 3 Academic

Support Advisory Academic

Support Advisory

6:30-8:30 4 Career Skills or Elective

US History Or Elective

Health and Wellness or Elective

Biology or Elective

Sample Summer Schedule

Time Period Monday Tuesday Wednesday Thursday Friday 7:30-9:30 1 Core

Subject Core Subject

Core Subject Core Subject Core Subject

9:35-11:35

2 Core Subject

Core Subject

Core Subject Core Subject Core Subject

11:45-12:45

3 Academic Support

Advisory Academic Support

Advisory Work and Learning

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Other courses to be offered on a variable schedule:

World History

Civics and Government

American Legal System

Art History

Music History

Algebra 2

Chemistry

Spanish

Humanties Units that will run over a 8 week session that will include topics such as:

Civil Rights Movement

The Immigrant Experience

20th Century Warfare

Industrialization and Technology

The Global Economy and Emerging Markets

Mini-Science Units

Sustainable housing Cloning Rights to genetic information alternative power sources pollution waste treatment and storage water purification extreme weather dark energy/dark matter string theory satellites weapon systems space travel deep ocean environments

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Day and Evening Program Schedule

Academic School Year 2012‐2013

HR/Advisory 2:30‐3:00 Monday Tuesday Wednesday Thursday

Period 1 3:00‐4:00 Period 2 4:00‐5:00 Lunch 5:00‐5:30 Period 3 5:30‐6:30 Period 4 6:30‐8:30

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Brockton Public Schools Day and Evening School Program

2012-2013 Academic Calendar Semester One Classes Begin: Wednesday, September 19, 2012-Thursday, January 31, 2013 Semester Two Classes Begin: Monday, February 11, 2013-Thursday, June 13, 2013 Schools are closed on the following HOLIDAYS and VACATION PERIODS

OPEN HOUSE FOR BHS Thursday, September 20, 2012

YOM KIPPUR Wednesday September 26, 2012

COLUMBUS DAY Monday October 8, 2012

PARENT CONFERENCES FOR BHS STUDENTS Thursday October, 18th, 2012

ELECTION DAY Tuesday November 6, 2012

VETERANS’ DAY Monday November 12, 2012

THANKSGIVING RECESS Thursday-November 22, 2012

CHRISTMAS RECESS Monday-Tuesday December 24, 2012-January 1, 2013

MARTIN LUTHER KING JR. DAY Monday January 21, 2013

WINTER RECESS Monday-Friday February 18, 22, 2013

PARENT CONFERNECES FOR BHS STUDENTS Thursday, March 21, 2013

SPRING RECESS Monday-Friday April 15-19, 2013

MEMORIAL DAY Monday May 27, 2013

GRADUATION EXERCISES FOR EDISON ACADEMY Wednesday, June 12, 2013

LAST DAY OF SCHOOL* Thursday June 13, 2013 Summer Component runs for 22 days; dates to TBA (Usually 22 days in July)

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Student: ________________________________________________ Intake Date: _________________

Edison Academy Assessment of Needs and Services

Personal Identification Information

Name: _________________________________________________________________ sex: _____________

DOB: ____________ City/Country of Birth: ____________________________________________________

If born outside the United States indicate date of entrance: __________________________________________

Primary language: ___________________ Ethnicity (insert DOE codes used by the district)

Race: Hispanic White Asian‐Islander African‐American

Primary Address: ___________________________________________________________________________

Secondary Address: _________________________________________________________________________

Primary Phone #: ___________________________ Secondary Phone #: _______________________________

Parent/Guardian Name:________________________________ Type of Guardianship: ___________________

Educational History

SASID#: ___________________________________ LASID #: ___________________________________

Last School/Program in attendance: __________________________________ Last Grade completed: ______

Previous Secondary Schools/Programs

From to Program/school Credits Services Reason for leaving

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MCAS

DATES

ELA

MATH

SCIENCE

Previously identified Service/Need: LEP SPED 504 EI ASD

Educational Background: Include comments on past school placements, impact of academic

retentions, and social/emotional/behavioral problems.

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Special Education History: Identify Needs /Disability and Services Provided

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

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__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

LEP : Identify Relevant Information/Placements

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

_________________________________________________________________________________________________

Educational Risk Factors

Attendance: Tardy Unexcused absences Truant

Discipline: Suspensions Chronic rule breaker Demerit Accumulation

Academic: Cut classes Failing Retained grade(s) Known learning disability

Identify interventions and attempts to address the problems (IEP/504 plan, Behavior plan, summer school, etc):

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

_________________________________________________________________________________________________

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Student Educational Goals

____________________________________________________________________________________________________________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Identified Barriers:

____________________________________________________________________________________________________________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

_________________________________________________________________________________________________

Student Strengths and Potential Support Systems:

___________________________________________________________________________________________________________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

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Family/Home Support

Name Relationship Age Education Occupation

1._________________________ ______________ _______ ______________ _________________

2.________________________ ______________ _______ ______________ _________________

3.________________________ ______________ _______ ______________ _________________

4.________________________ ______________ _______ ______________ _________________

5.________________________ ______________ _______ ______________ _________________

6.________________________ ______________ _______ ______________ __________________

Family Income: $ _______________ weekly bi‐weekly monthly other: _________________________

Other income: $ ______________ explain: __________________________________________________

Living situation: with parents with guardian with relatives w/a friend by him/herself

(circle) w/spouse w/roommate foster parents DCF placement

If not living with parents indicate date and reason for separation:

_________________________________________________________________________________________

If living with relative/guardian indicate date and relationship:

_________________________________________________________________________________________

Housing:

single family house multilevel apartment studio room other: _______________________________

Housing Cost: $ ____________________ (rent mortgage contribution)

Identified Serviced received by the students or his/her immediate family

Food Stamps WIC Disability Welfare

Identified Agencies serving the student or his/her immediate family

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Brockton Public Schools Department of Children & Families Department of Mental Health

Department of Youth Services

Department of Developmental Disabilities Brockton Area Multi Service, INC (BAMSI)

Department of Transitional Assistance Department of Elementary and Secondary

Education

Department of Public Health

Office of Medicaid (Medicare)

Health Related Information

SS#: _____________________ Medical Insurance: yes no Dental Insurance: yes no

Carrier Policy # Provider Comments

Student Medical Conditions

Reported Medical Condition(s):

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

Treatment(s) Needed/Provided:

___________________________________________________________________________________________________________

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

Comments/Impact on Functioning:

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Student Mental Health History: Summarize the psychiatric history including age of onset, developmental delays, symptoms,

trauma history, witness to violence, inpatient/residential history. Include current treatment if any.

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Comments/Needs related to Student Mental Health History:

History of:

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Inpatient psychiatric admission

Intensive Residential

Treatment Program (IRTP)

Acute Residential Treatment

(ART)

Residential/Group home

Placement

Medication

Prescription/Monitoring

Individual Therapy

Group Therapy

Family Therapy

Foster Placement

Respite Placement

Other _________________

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Substance Abuse History: Summarize substance abuse history including age of onset, treatment/detox

attempts. Drug(s) of choice. Family history of substance abuse. Effect of substance use in family functioning.

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

During the past 6 months, have you:

1. Used alcohol or drugs? Yes No

2. Felt you used too much alcohol or drugs? Yes No

3. Tried to stop/cut down alcohol or drug use? Yes No

4. Sought help for drug/alcohol problem? Yes No

Family Mental Health History

Parental Substance abuse Yes No UK Mental Illness Yes No

UK

Neglect Yes No UK Trauma Yes No

UK

Domestic Violence Yes No UK Witness to Violence Yes No UK

Imprisonment Yes No UK

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Comments/Impact on Family/Student Functioning:

Student Immediate Medical/Health Related Needs:

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Support Systems:

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

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Risk Factors

Suicidality: Yes History Current No Unknown

Comments:________________________________________________________________________

__________________________________________________________________________________

Self Injury: Yes History Current No Unknown

Comments:________________________________________________________________________

__________________________________________________________________________________

Violence Toward Others: Yes History Current No Unknown

Comments:________________________________________________________________________

__________________________________________________________________________________

Gang Involvement: Yes History Current No Unknown

Comments:________________________________________________________________________

__________________________________________________________________________________

Sexual Offending: Yes History Current No Unknown

Comments:________________________________________________________________________

_________________________________________________________________________________

Other Risk Factors Continued

Risky Sexual Behavior: Yes History Current No Unknown

Comments:________________________________________________________________________

__________________________________________________________________________________

Fire Play/Firesetting: Yes History Current No Unknown

Comments:________________________________________________________________________

__________________________________________________________________________________

Runaway: Yes History Current No Unknown

Comments:________________________________________________________________________

__________________________________________________________________________________

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Cruelty to Animals: Yes History Current No Unknown

Comments:________________________________________________________________________

__________________________________________________________________________________

Other:

__________________________________________________________________________________

__________________________________________________________________________________

Attempts to address these issues:

Other Agency Involvement

History of Involvement with Juvenile Justice? Yes No

Current Legal

Status______________________________________________________________________

History of:

1. Arrest? Yes No

2. Conviction of felony or admission of guilt? Yes No

3. CWOF (continuance without finding)? Yes No

4. Incarceration? Yes No

5. Probation? Yes PO Name______________________________ No

6. DYS custody or involvement? Yes Caseworker’s Name______________________ No

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Comments:

History of Involvement with Department of Children and Families (DCF) Yes No

Case Worker’s Name (if currently active): _______________________________________

Voluntary Services

CHINS stubborn truant

Care and Protection

DCF Services provided:

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

________________________________________

History of Involvement with Department of Mental Health? Yes No

Case Manager’s Name: ________________________________

Therapist’s Name: ____________________________________

Psychiatrist’s Name: __________________________________

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DMH Services Provided:

Other Agency?

Agency Name:

__________________________________________________________________________

Contact:

_______________________________________________________________________________

Services Provided:

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

Other Agency?

Agency Name:

__________________________________________________________________________

Contact:

_______________________________________________________________________________

Services Provided:

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

Other Agency?

Agency Name:

__________________________________________________________________________

Contact:

_______________________________________________________________________________

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Services Provided:

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

Work Experience:

Prior work experience (include internships ad job shadowing) Yes No

Employer : _________________________________________________________________

Job Title: ______________________________ Dates of Employment: _________________

Hours per Week: ________________________ Hourly Wage: _______________________

Reason for leaving: ___________________________________________________________

Employer : _________________________________________________________________

Job Title: ______________________________ Dates of Employment: _________________

Hours per Week: ________________________ Hourly Wage: _______________________

Reason for leaving: ___________________________________________________________

Career Interests and Skills:

Name of Career Interest Inventory____________________________

Date Completed _______________

Career Interest Inventory

Results___________________________________________________________

Top Three Career Choices:

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1. ______________________________________________________________________________ 2. ______________________________________________________________________________ 3. ______________________________________________________________________________

Career Pathway/Cluster:

Agriculture/Natural Resources Construction Manufacturing

Public Admin/Govt

IT Services Wholesale/retail Financial Services

Business Services Health Services Human Services

Legal & Protective Services Science & Engineering Education Services

Transportation Hospitality/Tourism Arts & Communication

Work Based Learning Competencies:

Needs

Development Competent Proficient Advanced

Communication & Literacy

Organization & Info Analysis

Problem Solving

Using Technology

Completing Activities

Acting Professional

Interacting with others

Understanding Aspects of Industry

Personal/Professional Development

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Other Challenges:

Employment Pregnant/Child Care Specify ____________

Disability Housing

Insurance Legal

Transportation Other __________________________

Comments:

Need Areas Identified:

1. _______________________________________________________________________________

2. _______________________________________________________________________________

3. _______________________________________________________________________________

4. __________________________________________________________________________________

5. __________________________________________________________________________________

6. __________________________________________________________________________________

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7. _________________________________________________________________________________

8. _________________________________________________________________________________

9. __________________________________________________________________________________

10. _________________________________________________________________________________

Completed by: ______________________________________ Date: ___________________

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City of Brockton

Interagency Permission to Share Information

Purpose of This Form

The objective of this permission is to allow the agencies, facilities and individuals that I have identified

below to share information for the purpose of making referrals, developing plans, or providing services

for the benefit of my child, my family, or me. I am permitting this exchange of information, so that

these organizations can do a better job of supporting my family. I understand that each organization

that serves members of my family will be more effective if its staff can coordinate services with those

being offered by other organizations.

Who Will Provide/Receive Information

I, _________________________________________, give my permission for the agencies, facilities, and

individuals that I have checked off below to receive and share information pertaining to members of my

family, my child _________________________________ or me:

Brockton Public Schools

43 Crescent Street

Brockton, MA 02301

School:________________________

Contact:_______________________

Phone:________________________

Department of Children & Families

110 Mulberry Street

Brockton, MA 02301

Contact:_______________________

Phone:________________________

Department of Mental Health

165 Quincy Street

Brockton, MA 02302

Contact: ______________________

Phone:________________________

Massachusetts Trial Court

Department of Juvenile Probation

Department of Youth Services

15A Bolton Place

Brockton Area Workforce

Investment Board (BAWIB)

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215 Main Street

Brockton, MA 02301

Contact:_______________________

Phone:________________________

Brockton, MA 02301

Contact:__________________________

Phone:___________________________

4 3 Crescent St

Brockton, MA 02301

508‐584‐3234

Contact:________________________

Phone:_________________________

Department of Mental Retardation

500 Belmont Street

Brockton, MA 02301

Contact: ____________________

Phone:_____________________

Department of Transitional Assistance

75 Commercial Street

Brockton, MA 02302

Contact:_________________________

Phone:__________________________

Department of Public Health

250 Washington Street

Boston, MA 02108

Contact:______________________

Phone:_______________________

Department of Education

Malden, MA

Contact:_______________________

Phone________________________

Office of Medicaid (Masshealth)

Boston, MA

Contact:______________________

Phone:_______________________

Private Insurance Company

Insurance:_______________________

Contact:_________________________

Phone:__________________________

Other:_______________________

___________________________

___________________________

Contact:________________________

Phone:_________________________

Other:_____________________

__________________________

__________________________

Contact:_______________________

Phone:________________________

Other:_____________________

__________________________

___________________________

Contact:_______________________

Phone:________________________

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City of Brockton


Information to Be Shared

General Health and Personal Information: [Check all that apply]

I give my permission for the agencies, individuals, and facilities that I have selected above to

communicate in person or via telephone conversation with each other about my child and other

members of my family for our benefit (this release does not authorize written materials and

documents and is solely designed to facilitation communication between agencies), and to share the

following information:

All information that is held about my child, my family or me, including but not limited to any service

plans, treatment plans, guardianship documents, court agreements, psychological testing, medical

history, hospital reports, medication history and claim records.

OR

All information that is held about my child, my family or me, but not limited to any service plans,

treatment plans, guardianship documents, court agreements, psychological testing, medical history,

hospital reports, medication history and claim records, except for the following information:

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Specific Health and Personal Information: [Check all that apply]

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I specifically give permission to release information about my child’s or my own history concerning

alcohol or drug treatment (protected by Federal Regulation 42CFR, part 2)

If my child has received alcohol or drug treatment, he or she specifically gives permission for the

above referenced agencies, individuals, and facilities to release his or her records that contain

information concerning alcohol or drug treatment (protected by Federal Regulation 42 CFR, part 2)

I specifically give permission to release my child’s or my own history concerning HIV antibody and

antigen testing (protected by MGL c. 111 § 70F), or and HIV/AIDS diagnosis or treatment.

If my child has given consent to receive medical or dental treatment in a situation where he or she

did not need parental consent, my child specifically gives permission to release his or her medical

information.

City of Brockton


I understand that I have a right to cancel this permission at any time. If I cancel this permission, I

must do so in writing to each of the applicable agencies, individuals and facilities. I understand that

cancellation will not apply to information that has already been released pursuant to this

authorization.

This authorization will NOT expire unless otherwise specified (identify date, time period or event)

_____________________________________________________________________________________

I understand that once the information listed above is disclosed, it may not be protected in the same

manner under federal laws or regulations.

The agency, facility, or individual that receives drug or alcohol information protected by Federal

Regulation 42 CFR Part 2 may not redisclose that information without my permission.

I understand that authorizing the use or disclosure of the information identified above is voluntary. I

understand that if I choose not to give or cancel this permission, I will still be able to receive any

87

treatment or benefits that my child, my family, or I am entitled to from the agencies with which I am

involved. However, I also understand that the agencies, individuals and facilities may not be able to

develop effective plans or proposals to meet and resolve the needs of my child, my family or myself.

I also understand that if I choose to not give this permission or if I cancel my permission, my child will

continue to receive all educational services that are required to be provided by law at no cost to me.

_________________________________Date_______

Your signature or Personal

Representative’s Signature

_________________________________Date_______

Your Child’s Signature, or if he / she has consented

To and received medical or dental treatment

____________________________________________

Print Your Name

____________________________________________

Print Your Child’s Name

_________________________________Date_______

Witness Signature

____________________________________________

Printed Name of Witness

____________________________________________

If signed by a Personal Representative, please indicate

the type of authority (ex. Court appointed, custodial

Parent)

Principal of Day/Evening School- Revised - Brockton Public

Documents

Transcript of Principal of Day/Evening School- Revised - Brockton Public