Student Teaching Diversity Report

1. Student Teacher Name: ________Rachel Chadwick_____________________

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, Title 1 classroom_____
5. Grade of the students you are reporting information: _____Kindergarten_______
6. Number of students in the classroom:_________17____________
7. Student Gender (number per category)
a. Male ___8_____
b. Female _ 9_____
8. Student Economic Status (number per category)
a. Free/Reduced Lunch 11
b. Not Free/Reduced Lunch 6
9. Student Race/Ethnicity (number per category)
a. American Indian or Alaskan Native __0___
b. Asian or Pacific Islander __0___
c. Black, non-Hispanic _8____
d. Hispanic __2___
e. Multiracial __2___
f. Non-resident Alien __0___
g. Race/ethnicity unknown __0___
h. White, non-Hispanic __5___
10.Please indicate whether you worked with students with these special needs
(check all that apply):
a. Bilingual _1____
If you are unable to obtain classroom level data
b. ESL __0___
for any categories, seek out school level
c. Gifted/Talented __0___
percentages and then calculate the number of
d. 504 Plan __0___
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