I. Basic Information
1. Student Name: _ _ _ _ _ _ _ _ Gender :□ Male □ Female
Guardian Name: _ _ _ _ _ _ Guardian Tel:
Date of birth: _ _ _ _ _ _
home address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
teaching place: _ _ _ _ _ _ _ _ _ _ _ _ _. Disability □ hearing disability
□ physical disability □ speech disability □ mental disability □ multiple disability
Disability level: _ _ _ _ _ _ _ _ _ _ _ _
4. Case-to-person relationship: □ normal □ abnormal
II. Parents' expectations of children:
Remarks: 1. This table.
2. after filling in this form, it should be incorporated into the student growth file of sending and teaching services.
summary of students' ability evaluation results
student name:
ability field
influence of existing ability
sensory perception
gross movements
fine movements
cognition
communication
self-care
student ability
summary <
Work Record of Teaching Delivery Service
Student's Name: Date of Delivery
Teaching
Subject
Teaching
Main content
Teaching
Process
Teaching
Fruiting
Teaching < In order to make your child grow up better, with the attention of the party and the government and the enthusiastic assistance of the school teachers, special personnel will be arranged to further evaluate your child's learning ability (or professional team evaluation), and an individualized education plan will be specially made for him or her. Promote his (her) ability development through regular teaching service, hoping to be more helpful to your child and make him (her) achieve more balanced development in academic, life, psychological and other aspects. Please reply to this consent form and return it to the staff. Thank you for your cooperation!
Letter of consent
Student name:
Are you willing to let your child receive the education service:
□ Yes
□ No, Because: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.
Parent's signature:
YY, MM, DD, YY, DD, YY, DD, DD, YY, DD, YY, DD, DD, DD, DD, DD, DD, DD, DD, DD, DD, DD, DD, DD, DD, DD, DD, DD, DD, DD, DD, DD, DD, DD, DD, DD, DD, DD, DD, DD P > teaching delivery effect and parents'
satisfaction
preparation
note
content 1
content 2
content 3
content 4
summary table of teaching delivery service in qimen county
reporting unit (seal): reporting time: year month day
No.
students.
(from _ _ _ _ _ to _ _ _ _ _ _ _ _)
Send teachers
Send times
Send teaching effect and parents'
Satisfaction
Remarks.