1. Technical College System of Georgia Office of Adult Education The FY18 Intake Assessment Form
Welcome to the tutorial for the FY18 Intake Assessment Form as required by the National Reporting System for Adult Education. This presentation is designed for personnel in local adult education programs in Georgia who assist students in the completion of the Intake Assessment Form, enter the information into the Georgia Adult Learners Information System (GALIS), or use the data for program management.
(This is a video recording of the presentation. If you would prefer a different format to receive this information, you can stop the video now and access the presentation with notes instead.)

2. Before Watching FY18 Intake Assessment Form Directions and Definitions
Before watching this tutorial, please take the time to locate and familiarize yourself with two documents, the FY18 Intake Assessment Form and the FY18 Intake Assessment Form Directions and Definitions. These are included in the reference documents for this tutorial under the Help page of GALIS.
Throughout this training tutorial, you will see references to pages in the Intake Assessment Form and the Directions and Definitions document in the lower left-hand corner of each slide.

3. Objectives Understand the importance of the Intake Assessment Form
Become familiar with each section
Learn key definitions and procedures
The objectives of this tutorial are to ensure that all participants have an understanding of the importance of the Intake Assessment Form, that they become familiar with each section, and that they learn key definitions and procedures.

4. Intake Assessment Form (IAF)
Completed by all students each fiscal year, even returning students
Adult Education personnel should assist students as they complete the form
Asterisks indicate required fields
Review forms for accuracy and completeness before GALIS data entry
Let’s begin with an overview of the importance of the Intake Assessment Form or IAF. The IAF is the foundation of data collection for Federal and State reporting. Although a few of the items on the form are for State or local purposes, the majority of the information is required by the National Reporting System (NRS).
The form is to be completed with all students in all programs upon entry each fiscal year. Students returning from a prior fiscal year must complete a new Intake Assessment Form, as well. Intake personnel should assist students with the completion of the form during the intake process. Students can be easily confused by the terms on the form. Therefore, everyone who is involved in registration and orientation should be well acquainted with the proper completion of the form, including the definitions of terms.
It is very important that the IAF is filled out accurately and completely. As you will see, the IAF contains items that are marked with an asterisk. The asterisks indicate a “required” field and should not be left blank, if applicable. For quality control purposes, all IAFs should be reviewed by local staff before the information is entered into GALIS. Students should be instructed to print their information onto the form as legibly as possible. They should also be provided a pen, so that they can sign and date the form in ink. Next, we will go over each section of the IAF.

5. Intake Assessment Form (IAF)
The Intake Assessment Form for FY18 is three pages in length. Most of the additions and changes to the form are to ensure that the Georgia Adult Education Program is collecting all of the information we need to meet the reporting requirements of the Workforce Innovation and Opportunity Act (WIOA) and the National Reporting System for Adult Education (NRS) that went into effect on July 1, We will go over each page and section in this tutorial. You may want to follow along on your own copy of the document.

6. Intake Assessment Form (IAF)
None of the fields on the IAF can be deleted. The only exception is the general “Adult Education Program” title at the top of the form which can be replaced with the name of the local program. This is not a requirement, but it is suggested for the purposes of local program identification and branding.
IAF, p. 1; DD, p. 2

7. IAF Section 1: EFL, Class Site, and Pre-test
The first section of the IAF contains the entry Educational Functioning Level, site/class, and pre-test information.
The Entry Educational Functioning Level (EFL), is determined by the student’s pre-test and is based upon the student’s lowest assessment score(s). This information is recorded by program staff. The listing of a site and class is optional. There is also a cell called “other information,” which can be used by the local program for any type of extra information, such as teacher name, or GALIS data entry tracking and date.
The student’s pre-test date, form/level, and score are entered in the cell on the right. There is no prescribed format for entering this data, but local programs are encouraged to adopt a consistent practice. Only the pre-test needs to be recorded on the intake form. All other assessment results should be recorded in GALIS and the hard copy records maintained in the student permanent file.
IAF, p. 1; DD, p. 2

8. IAF Section 2: Student Data
Section 2 of the IAF collects student data. First, students will enter today’s date, their social security number, date of birth, and age. A social security number is not required for program participation, but is strongly encouraged to support the state’s effort for data matching for several of the NRS core follow-up measures. Students should also print their full name.
This section also contains an optional space to record the orientation date, if different than the date that the IAF was completed.
IAF, p. 1; DD, p. 2

9. IAF Section 2: Student Data
The next demographic measure is Ethnicity. For this item, students mark Yes or No to indicate whether or not they are of Hispanic or Latino ethnicity. Hispanic or Latino refers to a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. Gender is the next demographic measure in this section. Students should identify whether they are male or female. Selection of race is next. Students can identify themselves in one or more categories. A listing of the race categories and their origins is provided on the next slide.
For each of these three required demographic measures, if the student is unable to or refuses to identify him/herself, a category can be selected for the student by local program personnel. Please see the Directions and Definitions supplement for complete information.
Note: A section for program use only is included on this page. The Institution 1 and 2 fields are for the organization to enter any extra information deemed necessary to identify the student. If entered into GALIS, the fields are searchable under the Students tab or can be exported and sorted using GALIS Report AL303 Institutional Use Data.
IAF, p. 1; DD, p. 2-3

10. Race Categories and Origins
Federal Category
Origins
American Indian or Alaskan Native
North and South America (including Central America) and who maintains tribal affiliation or community recognition
Asian
Far East, Southeast Asia, or the Indian subcontinent including Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam
Black or African American
Any of the Black racial groups of Africa
Native Hawaiian or Other Pacific Islander
Hawaii, Guam, Samoa, or other Pacific Islands
White
Europe, the Middle East, or North Africa
There are five Federal categories for race: American Indian or Alaskan Native, Asian, Native Hawaiian or Other Pacific Islander, Black or African American, and White. If students are confused about which category(ies) to select, please provide them with the definitions included in the Definitions and Directions supplement.
Hispanic/Latino students, in particular, are sometimes unsure of which category to select. If they consider themselves to be descendents of the native peoples of Central and South America, they should select American Indian or Alaskan Native. If they consider themselves descendents of the peoples of Africa, they should select Black or African American. If they consider themselves to be of European descent, they should select White, and so on.

11. IAF Section 2: Student Data
Next, students should identify the highest school grade completed. Then they should indicate the highest educational certificate/diploma/degree they have completed. If students have less than a high school diploma or GED, they should mark “None” in this section. Finally, they should identify whether their highest level of schooling was U.S. based or non-U.S. based.
IAF, p. 1; DD, p. 3

12. IAF Section 2: Student Data
Next, students should identify how they first heard about the program. If a student was referred to the adult education program by another Georgia department or agency, please have them indicate by checking the appropriate box. There is also a section here to indicate Special Enrollment conditions such as Ability to Benefit, Dual Enrollment, ACCUPLACER test review, and Other. Your local program will provide more information about when each of these boxes should be marked. There is also a place to record the student’s Banner ID number, if they have one. The next section is for students to indicate if they have previously or are currently part of a correctional program. It is only required, if applicable. An example of this would be students who attend a class held in a correctional facility.
IAF, p. 1; DD, p. 4

13. IAF Section 3: Student Contact Information
Section 3 of the IAF is Student Contact Information.
Students complete this section by providing general student contact information. Though not all of these data fields are required, it is still very important to try and gather as much information as you can in this section, particularly the student address. The information can be extremely useful in the retention efforts of the local program.
IAF, p. 2; DD, p. 4

14. IAF Section 4: Emergency Contact Information
The next section of the IAF is Section 4: Emergency Contact Information.
In this section, students enter their emergency contact information. This information is not required, but it could be helpful in case emergency situations arise.
IAF, p. 2; DD, p. 4

15. IAF Section 5: Student Status and Special Populations
The next section of the IAF is Section 5: Student Status and Special Populations. Labor Force Status identifies whether students are employed, unemployed, or not in the labor force at the time of entry into the adult education program. The categories on the intake form are worded in a way that should help students select their correct labor force status. The categories are “employed,” “employed, but I have received a notice of termination, facility closure, or I am a transitioning service member,” “unemployed and looking for work,” and “not working and not looking for work.” There is an additional question under unemployed, which is required by WIOA. It asks the student if they have been unemployed for 27 weeks or longer. The student should mark yes or no, as applicable.
The second student status measure in this section asks if the student receives Temporary Assistance for Needy Families assistance (TANF). If the student responds yes, he/she should also indicate if they are within two years of exhausting their lifetime eligibility.
The next student status measure asks if the student or someone in their household are receiving Supplemental Nutrition Assistance Program SNAP) benefits, formerly called Food Stamps. They should mark Yes or No.
IAF, p. 2; DD, p. 4-5

16. IAF Section 5: Student Status and Special Populations
The section for Special Status Populations is next. It asks each student to mark Yes or No for each of nine different student statuses. Each of the questions was written to simplify the more complicated definitions that can be found in the IAF Directions and Definitions document. Take some time to review those definitions so you are familiar with them. Each question must receive a Yes or No response.
IAF, p. 2; DD, p. 5-7

17. IAF Section 5: Student Status and Special Populations
The final section asks students to fill in the language spoken at home and their home country. Then students should read the Special Accommodations Notice and respond to the question that asks them if they are an individual with a disability. If the student indicates yes, he/she should identify if the disability is a learning disability, a physical disability, or if they have both. Then students should read the Special Accommodations Notice and read and respond, if needed, to the Confidentiality Notice. Then, they sign their name, and date their signature. Please ensure that students sign the form in ink.
IAF, p. 2; DD, p. 7

18. IAF Section 6: Student Goals
Before starting Section 6, students should write their name at the top of page 3. Section 6 of the IAF is Student Goals. Students should complete the section to indicate what they would like to achieve by attending the adult education program. It is very important that the student self-selects goals that are applicable to them personally. Most of these goals are not entered into GALIS. They are used by the local program to help guide instruction and provide services. The exception are the four goals listed under Integrated English Literacy/Civics Education (IELCE). All IELCE students are required to have at least one of these goals. They should be entered into GALIS and tracked for completion by the local program.
Please note: Most of the core measures of our program are tracked based upon demographic and assessment information collected on the first page of the intake form. They are not based upon the goals students mark in this box.
IAF, p. 3; DD, p. 7-8

19. IAF Section 6: Student Goals
After the student has completed the IAF and appropriate pre-testing, he/she must meet with a program staff member to discuss their goals and purposes for enrolling into the program. The interviewer will complete the four questions in the “program use only” area during an interview with the student.
These questions include, “What is the student’s primary reason for enrolling?, What services will the program provide the student?, What are the student’s college, career, or other goals? Did the student share any personal barriers that could affect program participation? If yes, please explain.” Both the interviewer and the student must sign the form upon completion of the conference.
IAF, p. 3; DD, p. 8

20. Conference Notes Academic Advisement Goal Progress Assessment Results
Service Referrals
Let’s take a moment to talk about conference notes, which are an important part of the student record. Local program personnel should conference with each currently enrolled student at least once per quarter. The topics of the conference can include academic advisement, goal progress and completion, assessment results and diagnostics, and service referrals.
Conference notes must be maintained either in hard copy format in the student permanent record or in GALIS. The hard copy conference notes page can be pulled from one of our previous IAFs or it can be created and customized by the local program.
Maintained in hard copy format in the student permanent record or in GALIS

21. Example of ABE/ASE Conference Note
I met with George to review his TABE math post-test.  He advanced to ASE 1 from ABE 4.  We discussed what is needed to prepare to pass the math portion of the GED® Test.  George committed to attend class as scheduled and complete assignments to be ready to take the math GED® Test within the next 6 weeks.
We sometimes get questions about what a good conference note looks like, so here is an example of an ABE/ASE note.
I met with George to review his TABE math post-test.  He advanced to ASE 1 from ABE 4.  We discussed what is needed to prepare to pass the math portion of the GED® Test.  George committed to attend class as scheduled and complete assignments to be ready to take the math GED® Test within the next 6 weeks.

22. Example of ABE Conference Note
Mr. Luster is working in Reading only (ABE 3). He attends class regularly and is making considerable progress. An informal assessment showed areas of weakness in the subskill 'Words in Context'. I am providing supplemental resources to target this area. He will be informally reassessed after 10 more hours of instruction.
Here is another example, but for a lower-level student.
Mr. Luster is working in Reading only (ABE 3). He attends class regularly and is making considerable progress. An informal assessment showed areas of weakness in the subskill 'Words in Context'. I am providing supplemental resources to target this area. He will be informally reassessed after 10 more hours of instruction.

23. Example of ESL Conference Note
Sunhee continues to progress in the Beginning ESL class. She has difficulty with friction sounds f, v, and th. I gave her a list of links to online videos that she can watch at home to practice those sounds. Sunhee registered for Intermediate ESL next semester.
Here is an example of a conference note for an ESL student.
Sunhee continues to progress in the Beginning ESL class. She has difficulty with friction sounds f, v, and th. I gave her a list of links to online videos that she can watch at home to practice those sounds. Sunhee registered for Intermediate ESL next semester.

24. WIOA and Periods of Participation
A new student intake process must be completed for every period of participation
A period of participation occurs when a student:
has a valid assessment,
attends at least 12 hours, and
exits the program for at least 90 days.
New intake process must include:
the opportunity for the student to change or update any information since his/her prior enrollment.
OAE will provide training on the intake process for 2nd and 3rd
periods of participation during the first quarter of FY18.
Student Intake for a 2nd or 3rd Periods of Participation
Starting in FY2018, the student intake process must be completed every time a student begins a new period of participation. A period of participation occurs when a student has a valid assessment, attends at least 12 hours, and then exits the program for at least 90 days. If the student returns to the organization, he/she must complete a new intake process for the new period of participation. This new intake process must give the student the opportunity to change or update any information since his/her prior enrollment.
OAE will provide more information about the intake process for second or third periods of participation through training sessions during the first quarter of FY18.

25. Office of Adult Education Instructional Services Director
Technical Assistance
Office of Adult Education
Instructional Services Director
Bobby Creech
Central/Southeast Georgia
Grant Program Support Coordinator
Felicia Phelps
Metro Atlanta/North Georgia
Charita Boles
Metro Atlanta/West Georgia
Leatricia Williams
South/Southwest Georgia
Steve Pearce
Instructional Services
Technical Coordinator
Kimberlee Bryant
GALIS Helpdesk
Data Management Assistant
Davida Shelton
This concludes the Intake Assessment Form training tutorial. Thank you for your participation. If you have questions or need further information about the Intake Assessment Form or about the student intake process, contact your lead teacher, supervisor, or program administrator. The OAE Grant Program Support Coordinators and other state staff members are available for technical assistance, as well. If you have questions related to GALIS, please contact the GALIS helpdesk.
Thank you and we hope you have a wonderful day.