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):_______Gifted
cluster________
5. Grade of the students you are reporting information: _____3 rd grade_________
6. Number of students in the classroom:_________AM: 22/ PM: 22___________
7. Student Gender (number per category)
a. Male ___AM: 11 / PM: 12_____
b. Female __AM: 11/ PM: 10_____
8. Student Economic Status (number per category)
a. Free/Reduced Lunch
*this information was not able to be obtained
b. Not Free/Reduced Lunch
9. Student Race/Ethnicity (number per category)
a. American Indian or Alaskan Native _ 0___
b. Asian or Pacific Islander __AM: 0 / PM: 2___
c. Black, non-Hispanic __0___
d. Hispanic _AM: 1 / PM: 0____
e. Multiracial __AM: 2 / PM: 4___
f. Non-resident Alien __0___
g. Race/ethnicity unknown __0___
h. White, non-Hispanic __AM: 19 / PM: 16___
10.Please indicate whether you worked with students with these special needs
(check all that apply):
a. Bilingual __0___
b. ESL __0___
If you are unable to obtain classroom level data
c. Gifted/Talented _AM: 7 /PM: 9 ___
for any categories, seek out school level
d. 504 Plan __0___
percentages and then calculate the number of
e. IEP __AM: 3 / PM: 1___
students in your class that would equal the
f. None _____
school level percentages. (E.g., if you have 22
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