Referral Fifth Grade Required fields are marked with an asterisk (*). Step 1 of 3 33% Date* MM slash DD slash YYYY Student Name* First Last Age* Grade Level* School* Parents/Guardians* Phone(s)* City of Residence Referring Teacher* Phone* Email* Is this student receiving extra support anywhere outside of the regular classroom (ex. Intervention, Special Education, After - school tutoring, In - school tutoring, etc)? If so, where?Currently our tutoring program is a two on one based tutoring where college volunteers provide supplemental education in order to bring a student up to grade level. Our volunteers are trained and receive weekly guidance and support, but they are college students not professionals. On a scale from 1 (not at all) to 5 (life - changing), in your professional opinion how much do you think this student could benefit from an after - school tutoring program? Please comment if necessary.Thank youWe thank you so much for taking the time to complete the attached pre-assessment form. We are in the process of transforming our tutoring program to better serve the students. The information you provide will be passed on to the tutors so that they can better choose materials during the tutoring s ession. During the school year, if you ever have any more information to share or desire any information from us, feel free to contact the tutoring team. Our goal this year is to create a better system of communication so that each student is receiving the most effective education possible. First-Grade Pre-Assessment (Adapted from the Common Core Standards.) Scores and Ranges (if applicable/available): MAP score (reading)* MAP score (math)* Lexile Range* Other Reading / WritingPlease select the skills that would be beneficial for the student to practice.Phonics Use combined knowledge of all letter-sound correspondences, syllabication patterns, and morphology (e.g., roots and affixes) to read accurately unfamiliar multisyllabic words in context and out of context. (RF.4.3.A) Part Two:Thinking about the student’s test scores, performance in class, and your observations, please select the top two categories of need for this particular student.Fluency Read grade-level text with purpose and understanding. (RF.5.4.A) Read grade-level prose and poetry orally with accuracy, appropriate rate, and expression. (RF.5.4.B) Use context to confirm or self-correct word recognition and understanding. (RF.5.4.C) Vocabulary Determine the meaning of words and phrases as they are used in a text, including figurative language such as metaphors and similes. (RL.5.4; RI.5.4) Use context (e.g., cause/effect relationships and comparisons in text) as a clue to the meaning of a word or phrase. (L.5.4.A) Use common, grade-appropriate Greek and Latin affixes and roots as clues to the meaning of a word (e.g., photograph, photosynthesis). (L.5.4.B) Consult reference materials (e.g., dictionaries, glossaries, thesauruses) to find the pronunciation and determine or clarify the precise meaning of key words and phrases. (L.5.4.C) Explain the meaning of common idioms, adages, and proverbs. (L.5.5.B) Compare words to their antonyms, synonyms, and homographs. (L.5.5.C) Comprehension Quote accurately from a text when explaining what the text says explicitly and when drawing inferences from the text. (RL.5.1; RI.5.1) Determine a theme or main idea of a text, using details to support his claim; summarize the text. (RL.5.2; RI.5.2) Compare and contrast two or more features of a text (e.g. characters, settings, events, ideas, concepts) (RL.5.3; RI.5.3) Analyze how a narrator's or speaker's point of view influences how events are described, noting important similarities and differences in the point of view they represent. (RL.5.6; RI.5.6) Compare and contrast stories in the same genre (e.g., mysteries and adventure stories) on their approaches to similar themes and topics. (RL.5.9) Explain how an author uses reasons and evidence to support particular points in a text. (RI.5.8) Interpret figurative language, including similes and metaphors, in context. (L.5.5.A) Writing/Verbal Skills Integrate information from several texts on the same topic in order answer a question or to write or speak about the subject knowledgeably. (RI.5.7; RI.5.9) Explain the function of conjunctions, prepositions, and interjections in general and their function in particular sentences. (L.5.1.A) Form and use the perfect (e.g., had, have, will have) verb tenses. (L.5.1.B) Use verb tense to convey various times, sequences, states, and conditions. (L.5.1.C) Recognize and correct inappropriate shifts in verb tense. (L.5.1.D) Use correlative conjunctions (e.g., either/or, neither/nor). (L.5.1.E) Use punctuation to separate items in a series. (L.5.2.A) Use a comma to separate an introductory element from the rest of the sentence. (L.5.2.B) Use a comma to set off the words yes and no, to set off a tag question from the rest of the sentence, and to indicate direct address. (L.5.2.C) Use underlining, quotation marks, or italics to indicate titles of works. (L.5.2.D) Expand, combine, and reduce sentences for meaning, reader/listener interest, and style. (L.5.3.A) Part Two: Thinking about the student’s test scores, performance in class, and your observations, please place a check where needed Phonemic Awareness Phonics Fluency Vocabulary Comprehension Writing Skills Writing/Verbal Skills Comments about this student’s reading/writing skill level: MathPlease select the skills that would be beneficial for the student to practice.Operations and Algebraic Thinking Evaluation numerical expressions with parentheses, brackets, or braces. (5.OA.A.1) Translate numerical expressions written as words into number form, without having to evaluate. (5.OA.A.2) Generate two numerical patterns using two given rules. Identify apparent relationships between corresponding terms. Form ordered pairs consisting of corresponding terms from the two patterns, and graph the ordered pairs on a coordinate plane. (5.OA.B.3) Base Ten Operations Explain that in a multi-digit number, a digit in one place represents 10 times as much as it represents in the place to its right and 1/10 of what it represents in the place to its left. (5.NBT.A.1; 5.NBT.A.2) Read and write decimals to thousandths using base-ten numerals, number names, and expanded form. (5.NBT.A.3.A) Compare two decimals to thousandths using >, =, and < symbols. (5.NBT.A.3.B Round decimals. (5.NBT.A.4) Fluently multiply multi-digit whole numbers. (5.NBT.B.5) Find whole-number quotients of whole numbers with up to four-digit dividends and two-digit divisors. (5.NBT.B.6) Add, subtract, multiply, and divide decimals to hundredths. (5.NBT.B.7) Fraction Operations Add and subtract fractions with unlike denominators. (5.NF.A.1) Solve word problems involving addition and subtraction of fractions referring to the same whole, including cases of unlike denominators. (5.NF.A.2) Interpret a fraction as division of the numerator by the denominator (a/b = a ÷ b). (5.NF.B.3) Multiply a fraction or whole number by a fraction. (5.NF.B.4) Multiply fractional side lengths to find areas of rectangles. (5.NF.B.4.B) Solve real world problems involving multiplication of fractions and mixed numbers. (5.NF.B.6) Measurement and Data Convert among different-sized standard measurement units. (5.MD.A.1) Measure volumes by counting unit cubes, using cubic cm, cubic in, and cubic ft. (5.MD.C.4) Relate volume to the operations of multiplication and addition and solve real world and mathematical problems involving volume. (5.MD.C.5) Geometry Graph an ordered pair on a coordinate plane. (5.GA.1) Represent real world and mathematical problems by graphing points in the first quadrant of the coordinate plane, and interpret coordinate values of points in the context of the situation. (5.G.A.2) Separate shapes into categories and sub-categories based on attributes. (5.G.B.3) Part Two: Thinking about the student’s test scores, performance in class, and your observations, please order the categories in order of need for this particular student {1 (most needed)—5 (least needed)} Operations and Algebra Base Ten Operations (Place Value and Decimals) Fraction Operations Measurement and Data Geometry Comments about this student’s math skill level: Δ