Winston-Salem/Forsyth County – Career Technical Education
Master Log of CTE Modifications/Accommodations and Support Services
Student Name _____________________________
Student ID _________________
Course ___________________Period ___ Fall __ Spring Y Year
X
I. Instructional Programs: TESTING Modifications/Accommodations for Standardized Tests
(EC/504/LEP)
☐Alternative Assessment
☐Assistive Technology Device
☐Braille Writer
☐Dictionary /Native Lang.
☐Extended Time
☐Large Print
☐Magnification Device
☐Marks in Book
☐Multiple Sessions
☐Separate Room
Read Aloud (check all that apply)
☐Student Request
☐Entire Test
☐Student Reads Aloud
☐NO CTE Modifications
II. CLASSROOM Supplementary Aids, Services, Modifications/Accommodations, Support:
*EC, 504, LEP-as specified per plan (see attached)
*ED, AD, SP, DH-as needed
☐Administrative conference
☐Literacy strategies
☐Agenda book to maintain assignments
☐Modified blueprint
☐Alternate assessments (may include tests)
☐Oral testing
☐Alternate grading practices
☐Parent contact (email, phone, conference)
☐Answer list (word bank for fill-in bank test
☐Peer tutoring
☐Assigned seat (by teacher)
☐Portfolio
☐Assistance with instructional materials and aids
☐Preferential seating
☐Behavior contract
☐Progress reports
☐Attend IEP and/or 504 meeting (circle) date________
☐Oral and written instruction
☐Class assignments modified
☐Referral to social worker
☐Career counseling/inventories
☐Referral to student services
☐Computer assistance instruction
☐Remedial instruction
☐Copies of teacher/class notes
☐Separate setting for testing
☐Directions repeated quietly
☐Simplify/repeat directions
☐English/Native language dictionary
☐Small group instruction
☐Equipment modifications assistance
☐Student conference
☐Extended time
☐Study guide
☐Frequent contact with parent/guardian
☐Taped text/lecture
☐Graphic organizers/written outline
☐Test answers recorded for student
☐Guided outline for note-taking
☐Tutoring
☐Hands-on activities
☐Use of word processor/spell check
☐Interpreter
☐Vary activities
☐Limited choices for multiple choice
☐Visual presentation
Other Modifications______________________________________________
Note: If a student is making a D or an F in the course, check all that apply
☐Has difficulty staying on task
☐Frequent absences
☐Frequent talking
☐Sleeps/puts head down on desk
☐Incomplete /missing assignments
☐Suspensions/OSS or ISS
☐Frequent tardies
☐Other (see comments on back)
Teacher Name
Revised 06.2014
Date: ______________Signature:_____________________________________