Please do not submit the form, login from school account to fill the form. Thank you. Teacher Transition Questionnaire Please read the instructions regarding the completion of this form. Privacy Protocols Acknowledged - Kua tūtohu ngā tikanga noho matatapu(Required) The privacy protocols have been acknowledged NB: Parents/Caregivers may obtain access to this information. Teacher Name - Te ingoa o te kaiako(Required)Teacher Email(Required) Student Name - Te ingoa o te ākonga(Required)NSNStudent YearYear 1Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13Current School(Required)Current School Email(Required)School Transitioning to - Te kura hōu(Required)UnknownAlfredton SchoolBallance SchoolCarterton SchoolChanel CollegeDalefield SchoolDouglas Park SchoolEketahuna SchoolFeatherston SchoolFernridge SchoolGladstone SchoolGreytown SchoolHadlow Prepatory SchoolKahutara SchoolKuranui CollegeLakeview SchoolMakoura CollegeMakuri SchoolMangatainoka SchoolMartinborough SchoolMasterton Intermediate SchoolMasterton Primary SchoolMauriceville SchoolOpaki SchoolPahiatua SchoolPirinoa SchoolPonatahi Christian School (Yr 0-13)Pongaroa SchoolRathkeale CollegeSolway CollegeSolway Primary SchoolSouth End SchoolSouth Featherston SchoolSt Anthony's SchoolSt Mary's SchoolSt Matthew's CollegiateSt Patricks SchoolSt Teresa's SchoolTararua CollegeTe Kura Kaupapa Māori o WairarapaTinui SchoolWainuioru SchoolWairarapa CollegeWhareama SchoolTechnology SolutionsConfirmation(Required) I have checked and confirm my choice of "School Transitioning to" (above) Enrolment completed - Kua oti te whakauru(Required) Yes No Unknown Flags - Kia mataara(Required) Learning needs Health & Wellbeing needs Behaviour needs Agency involvement Assistive technology support ORS funded Recent LSC Intervention Nothing to report AttendanceThe last 2 years the students attendance has been (please indicate)(Required) Regular attendance / Over 90% attendance Irregular absence / More than 80% and up to 90% attendance Moderate absence / More than 70% and up to 80% attendance Chronic absence / 70% attendance or less Has there been truancy issues with this student?(Required) Yes No What interventions have been put in place?(Required)Student Strengths and InterestsHas this student been identified as a Gifted Learner?(Required) Yes No Please provide Gifted Learner details(Required)Does the student have special interest areas and/or strengths?(Required) N/A Cultural Sports Arts Leadership Digital / Technology Other Special Interest or Strength Details(Required)Curriculum Level / PhaseAcademic Information - Reading(Required) Needs support Progressing towards Proficient Exceeding Curriculum LevelAcademic Information - Writing(Required) Needs support Progressing towards Proficient Exceeding Curriculum LevelAcademic Information - Maths(Required) Needs support Progressing towards Proficient Exceeding Curriculum LevelStudents Needs - Learning Common language for Standardised LSRHas the student previously received support for, or has been diagnosed with any of the following?(Required) ADHD ASD Dyslexia Dysgraphia Dyscalculia Dyspraxia Speech and Language needs Sensory needs None of the above Does the student have an Individual Education Plan?(Required) Yes No Contact School (re. Needs - Learning) Please contact the contributing school for further detailed information. Students Needs - Health/WellbeingDoes this student have any known health or medical needs?(Required) Yes No Does the student have a health plan?(Required) Yes No Contact School (re. Needs - Health/Wellbeing) Please contact the contributing school for further detailed information. Students Needs - BehaviourDoes this student have any behavioural issues that may put themselves or others at risk?(Required) Yes No Does the student have a behaviour plan?(Required) Yes No Contact School (re. Needs - Behaviour) Please contact the contributing school for further detailed information. Agency InvolvementPlease indicate any current or previous outside agencies involved with this student(Required) N/A RTLB Severe Behaviour Educational Psychologist Occupational Therapist Speech/Language Therapist CAMHS Oranga Tamariki Open Home Foundation Other Other Agencies(Required)Assistive technology support Details of assistive technology support(Required)Key Competencies - Ngā pūkenga matua Please rate the student in how they achieve the key competencies Thinking - Whakaaro(Required) 1 2 3 4 5 1=Low, 5=highUsing language symbols and text - Whakaako(Required) 1 2 3 4 5 1=Low, 5=highManaging Self - Whakahaere(Required) 1 2 3 4 5 1=Low, 5=highRelating to others - Whakawhanaungatanga(Required) 1 2 3 4 5 1=Low, 5=highParticipating and contributing - Whakaurunga(Required) 1 2 3 4 5 1=Low, 5=highOther Information - Ētahi atu mōhiohioPlease provide any other information that may be of use to support this student:(Required)
