1. The Intake Assessment Form FY15 Technical College System of Georgia Office of Adult Education As required by the National Reporting System for Adult Education

2. FY15 Intake Assessment Form FY15 Intake Assessment Form Directions and Definitions 2 Before Watching

3.  Understand the importance of the Intake Assessment Form  Become familiar with each section  Learn key definitions and procedures 3 Objectives

4. Intake Assessment Form (IAF) 4

5. 5 IAF, p. 1; DD, p.2

6. IAF Section 1: EFL, Class Site, and Pre-test 6 IAF, p. 1; DD, p.2

7. IAF Section 2: Student Data 7 IAF, p. 1; DD, p. 2

8. IAF Section 2: Student Data 8 IAF, p. 1; DD, p. 2-3

9. Federal CategoryOrigins 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 AmericanAny of the Black racial groups of Africa Native Hawaiian or Other Pacific Islander Hawaii, Guam, Samoa, or other Pacific Islands WhiteEurope, the Middle East, or North Africa 9 Race Categories and Origins

10. IAF Section 2: Student Data 10 IAF, p. 1; DD, p. 3

11. IAF Section 2: Student Data 11 IAF, p. 1; DD, p. 3-4

12. 12 IAF Section 3: Student Contact Information IAF, p. 1; DD, p.4

13. 13 IAF Section 4: Emergency Contact Information IAF, p. 1; DD, p.4

14. 14 IAF Section 5: Student Status and Special Populations IAF, p.2; DD, p.4-6

15.  Low Income  Displaced Homemaker  Single Parent  Dislocated Worker  Learning Disabled Adult  Physically Disabled Adult  None of the Above 15 Special Populations IAF, p.1; DD, p.4-6

16. 16 IAF Section 6: Student Goals IAF, p. 2; DD, p.6-9

17. 17 IAF Section 6: Student Goals IAF, p. 2; DD, p. 9

18. 18 Conference Notes Academic Advisement Goal Progress Assessment Results Service Referrals Maintained in hard copy format in the student permanent record or in GALIS

19. 19 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.

20. 20 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 sub skill 'Words in Context'. I am providing supplemental resources to target this area. He will be informally reassessed after 10 more hours of instruction.

21. 21 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.

22.  Removed  Enrollment date, assessment page, conference notes page  Added  Pre-test score box, today’s date, Institution 1 & 2, I-BEST  Updated  Entry level to EFL  Goals page – students self-select  Separated EL/Civics goals from other secondary goals  Intake conference section with questions 22 Differences between FY14 and FY15

23. Technical Assistance 23 Office of Adult Education Instructional Services Director Bobby Creech rcreech@tcsg.edu 404-679-1641 Central/Southeast Georgia Grant Program Support Coordinator Felicia Phelps fphelps@tcsg.edu 478-329-4720 Metro Atlanta/North Georgia Grant Program Support Coordinator Charita Boles cboles@tcsg.edu 404-679-1628 Metro Atlanta/West Georgia Grant Program Support Coordinator Leatricia Williams lwilliams@tcsg.edu 404-679-5234 South/Southwest Georgia Grant Program Support Coordinator Steve Pearce spearce@tcsg.edu 404-679-0511 Instructional Services Technical Coordinator Kimberlee Bryant kbryant@tcsg.edu 404-248-1060 GALIS Helpdesk Data Management Assistant Davida Shelton datacenter@tcsg.edu 404-327-6907