Resource Teacher of Literacy Referral Form – Hurunui Cluster
School:
Date
Group Referral (list students)
Year
Year
Year
Year
National Student Number
Reading Recovery
Student
Date of Birth
Has this student received
Reading Recovery? Yes / No
Outcome of RR
Current Information
How is the student described in relation to the National Standards for Reading and
Writing?
Student
NS Reading
NS Writing
Current Instructional Text Level / Reading Year Level
Have Running Record data and STAR data to present when we meet.
Seen Instructional Text Level
Read to Read
OR Reading Year Level
Colour
Journal
Yr
Pt
No
Are these students currently being instructed in a Guided Reading group?
If “Yes”
Group size
Frequency Daily
Is progress being made?
Have any of these students been / or / are to be referred to the RTLB or any
other agencies?
Please add any additional comment
(Including support from home, attendance if a concern)
Classroom Teacher
Email address
Cell phone
Thanks,
Pene Balk-Jarvis
RTLit Hurunui
Please return this referral form to me
(Electronically if possible)
Phone
Email
Address
027 390 5551
rtlit.hurunui@gmail.com
Box 11
Waipara School
Waipara
North Canterbury 7447