Student Teaching Diversity Report

1. Student Teacher Name: ______Olivia Martin_______

2. Please indicate on which of the following you are reporting information:
Practicum Tier 1

Student Teaching Placement 1

Practicum Tier 2

Student Teaching Placement 2

3. Semester and year in which you are reporting this experience:

____Spring/2015____
4. Description of the type of classroom (i.e. inclusive, gifted):____General
education ____
5. Grade of the students you are reporting information: ____Third grade____
6. Number of students in the classroom:____17_____
7. Student Gender (number per category)
a. Male __10__
b. Female __7__
8. Student Economic Status (number per category) : School 68% of all
students
a. Free/Reduced Lunch: 11.5 students
b. Not Free/Reduced Lunch: 5.5 students
9. Student Race/Ethnicity (number per category)
a. American Indian or Alaskan Native __0__
b. Asian or Pacific Islander __0__
c. Black, non-Hispanic _ 9_
d. Hispanic _2___
e. Multiracial __5__
f. Non-resident Alien _____
g. Race/ethnicity unknown _____
h. White, non-Hispanic _3_
10.Please indicate whether you worked with students with these special needs
(check all that apply):
a. Bilingual __2___
If you are unable to obtain classroom level data
b. ESL 2__
for any categories, seek out school level
c. Gifted/Talented _____
percentages and then calculate the number of
d. 504 Plan _____
students in your class that would equal the
e. IEP __0___
school level percentages. (E.g., if you have 22
f. None _____
students in your class and 75% of school
students are on free/reduced lunch, then 75% x
22 = 16.5 students in your class on