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2005-06 Ohio Alternate Assessment for Students with Disabilities Entry Sheet
(Complete one entry sheet for each academic content standard assessed) Entry Number:
Student Name:
Student ID#:
Subject Area:
Academic Content Standard: Select ONE standard for this entry (check appropriate box below).
Mathematics
Benchmark or Grade-Level Indicator from the Academic Content Standards:
Grade Level
Select GradeBenchmark Letter
Pick Letter OR Grade-Level Indicator Number (Grade 3-8 ONLY)
Pick Num.
Benchmark or Grade-Level Indicator Description (provide in the space below).
As appropriate, provide the standards-based application of knowledge/skill in the space below.
Types of Evidence and Task Descriptions: Include at least two pieces of evidence that differ in type.
Types of Evidence--Data Chart, Checklist, Work Sample, Captioned Photos, Videotape, Audiotape, Observation, Interview, or Other Evidence#1
Select Type or Describe "Other" ”
Evidence#2
Select Type or Describe "Other" ”
Evidence#3(optional)
Select Type or Describe "Other" ”
Remember: Note the following information on each piece of evidence: Instructional Context
Independence
Settings and Interactions
• Description of individuals with whom the 2005-06 Ohio Alternate Assessment for Students with Disabilities Entry Sheet
(Complete one entry sheet for each academic content standard assessed) Entry Number:
Student Name:
Student ID#:
Subject Area:
Academic Content Standard: Select ONE standard for this entry (check appropriate box below).
Mathematics
Benchmark or Grade-Level Indicator from the Academic Content Standards:
Grade Level
Select GradeBenchmark Letter
Pick Letter OR Grade-Level Indicator Number (Grades 3-8 ONLY)
Pick Num.
Benchmark or Grade-Level Indicator Description (provide in the space below).
As appropriate, provide the standards-based application of knowledge/skill in the space below.
Types of Evidence and Task Descriptions: Include at least two pieces of evidence that differ in type.
Types of Evidence--Data Chart, Checklist, Work Sample, Captioned Photos, Videotape, Audiotape, Observation, Interview, or Other Evidence#1
Select Type or Describe "Other" ”
Evidence#2
Select Type or Describe "Other" ”
Evidence#3(optional)
Select Type or Describe "Other" ”
Domain Considerations/Notations: (check when complete)
Remember: Note the following information on each piece of evidence:
Instructional Context
Independence
Settings and Interactions
• Description of individuals with whom the 2005-06 Ohio Alternate Assessment for Students with Disabilities Entry Sheet
(Complete one entry sheet for each academic content standard assessed) Entry Number:
Student Name:
Student ID#:
Subject Area:
Academic Content Standard: Select ONE standard for this entry (check appropriate box below).
Mathematics
(OGT only)
Benchmark or Grade-Level Indicator from the Academic Content Standards:
Grade Level
Select GradeBenchmark Letter
Pick Letter OR Grade-Level Indicator Number (Grades 3-8 ONLY)
Pick Num.
Benchmark or Grade-Level Indicator Description (provide in the space below).
As appropriate, provide the standards-based application of knowledge/skill in the space below.
Types of Evidence and Task Descriptions: Include at least two pieces of evidence that differ in type.
Types of Evidence--Data Chart, Checklist, Work Sample, Captioned Photos, Videotape, Audiotape, Observation, Interview, or Other Evidence#1
Select Type or Describe "Other" ”
Evidence#2
Select Type or Describe "Other" ”
Evidence#3(optional)
Select Type or Describe "Other" ”
Domain Considerations/Notations: (check when complete)
Remember: Note the following information on each piece of evidence:
Instructional Context
Independence
Settings and Interactions
• Description of individuals with whom the 2005-06 Ohio Alternate Assessment for Students with Disabilities Entry Sheet
(Complete one entry sheet for each academic content standard assessed) Entry Number:
Student Name:
Student ID#:
Subject Area:
Academic Content Standard: Select ONE standard for this entry (check appropriate box below)
Mathematics
(OGT only)
Benchmark or Grade-Level Indicator from the Academic Content Standards:
Grade Level
Select GradeBenchmark Letter
Pick Letter OR Grade-Level Indicator Number (Grades 3-8 ONLY)
Pick Num.
Benchmark or Grade-Level Indicator Description (provide in the space below).
As appropriate, provide the standards-based application of knowledge/skill in the space below.
Types of Evidence and Task Descriptions: Include at least two pieces of evidence that differ in type.
Types of Evidence--Data Chart, Checklist, Audiotape, Observation, Interview, or Other Evidence#1
Select Type or Describe "Other" ”
Evidence#2
Select Type or Describe "Other" ”
Evidence#3(optional)
Select Type or Describe "Other" ”
Domain Considerations/Notations: (check when complete)
Remember: Note the following information on each piece of evidence:
Instructional Context
Independence
Settings and Interactions
• Description of individuals with whom the

Source: http://loganhocking.k12.oh.us/files/documents/AlternateAssessment.pdf

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